SecureRx – Option 3 (PDP)
S8067 - 001 - 0
(3 / 5)
SecureRx – Option 3 (PDP) is a Medicare Part D Prescription Drug Plan by Avalon Insurance Company.
This page features plan details for 2023 SecureRx – Option 3 (PDP) S8067 – 001 – 0.
IMPORTANT: This page has been updated with plan and premium data for 2023.
Locations
SecureRx – Option 3 (PDP) is offered in the following locations.
Plan Overview
SecureRx – Option 3 (PDP) offers the following coverage and cost-sharing.
| Insurer: | Avalon Insurance Company |
| Drugs Covered: | Yes |
Ready to sign up for SecureRx – Option 3 (PDP) ?
Get help from a licensed insurance agent.
Click to Call 1-877-354-4611 TTY 711.
Mon-Fri 8am-9pm EST | Sat 8am-8pm EST.
Drug Info
SecureRx – Option 3 (PDP) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.
| Drug Deductible: | $315.00 |
| Initial Coverage Limit: | $4,660.00 |
| Catastrophic Coverage Limit: | $7,400.00 |
| Drug Benefit Type: | Basic Alternative |
| Gap Coverage: | Yes |
| Formulary Link: | Formulary Link |
Part D Premium Reduction
The Low-Income Subsidy (also known as LIS or “Extra Help”) helps people with Medicare lower the cost of prescription drugs. The table below shows how the LIS impacts the Part D premium of this plan.| Part D | LIS 25% | LIS 50% | LIS 75% | LIS Full |
|---|---|---|---|---|
| $78.10 | $67.80 | $57.60 | $47.30 | $37.00 |
Initial Coverage Phase
After you pay your $315.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $4,660.00. Once you reach that amount, you will enter the next coverage phase.
30 Day
60 Day
90 Day
30 Day
| Tier | Pref. Pharm | Std. Pharm | Pref. Mail | Std. Mail |
|---|---|---|---|---|
| 1 (Preferred Generic) | $5.00 copay | $15.00 copay | $5.00 copay | |
| 2 (Generic) | $12.00 copay | $20.00 copay | $12.00 copay | |
| 3 (Preferred Brand) | $40.00 copay | $47.00 copay | $40.00 copay | |
| 4 (Non-Preferred Drug) | 47% | 47% | 47% | |
| 5 (Specialty Tier) | 28% | 28% | 28% |
60 Day
| Tier | Pref. Pharm | Std. Pharm | Pref. Mail | Std. Mail |
|---|---|---|---|---|
| 1 (Preferred Generic) | ||||
| 2 (Generic) | ||||
| 3 (Preferred Brand) | ||||
| 4 (Non-Preferred Drug) | ||||
| 5 (Specialty Tier) |
90 Day
| Tier | Pref. Pharm | Std. Pharm | Pref. Mail | Std. Mail |
|---|---|---|---|---|
| 1 (Preferred Generic) | $15.00 copay | $45.00 copay | $15.00 copay | |
| 2 (Generic) | $36.00 copay | $60.00 copay | $36.00 copay | |
| 3 (Preferred Brand) | $120.00 copay | $141.00 copay | $120.00 copay | |
| 4 (Non-Preferred Drug) | 47% | 47% | 47% | |
| 5 (Specialty Tier) |
Gap Coverage Phase
After your total drug costs (including what this plan has paid and what you have paid) reach $4,660.00, you will pay no more than the amounts below for any drug tier until you reach $7,400.00.
30 Day
90 Day
30 Day
90 Day
| Tier | Cost |
|---|---|
| All other tiers (Generic) | 25% |
| All other tiers (Brand-name) | 25% |
Catastrophic Coverage Phase
After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $7,400.00, you will pay no more than the greater of the two amounts listed below for generic and brand-name drugs.
| Drug Type | Cost Share |
|---|---|
| Generic drugs | $4.15 copay or 5% (whichever costs more) |
| Brand-name drugs | $10.35 copay or 5% (whichever costs more) |
Ready to sign up for SecureRx – Option 3 (PDP) ?
Get help from a licensed insurance agent.
Click to Call 1-877-354-4611 TTY 711.
Mon-Fri 8am-9pm EST | Sat 8am-8pm EST.