Amerivantage Rx Basic (PDP)

Amerivantage Rx Basic (PDP) S8182-001 Plan Details
2 out of 5 stars

Amerivantage Rx Basic (PDP) is a plan offered by Anthem Inc..
Plan ID: S8182-001.

$79.30
Monthly Premium

Amerivantage Rx Basic (PDP) is a plan offered by Anthem Inc..
Plan ID: S8182-001.

Amerivantage Rx Basic (PDP) S8182-001 Plan Details
2 out of 5 stars

Amerivantage Rx Basic (PDP) is a plan offered by Anthem Inc..
Plan ID: S8182-001.

$79.30
Monthly Premium

Texas Counties Served

Anderson Angelina Aransas Bandera Cameron Camp Dona Ana El Paso Andrews Archer Armstrong Austin Bailey Bastrop Baylor Bee Bell Bexar Blanco Borden Bosque Bowie Brazoria Brazos Brewster Briscoe Brooks Brown Burleson Burnet Caldwell Calhoun Callahan Carson Cass Castro Chambers Cherokee Childress Clay Cochran Coke Coleman Collin Collingsworth Colorado Comal Comanche Concho Cooke Coryell Cottle Crane Crockett Crosby Culberson Dallam Dallas Dawson De Witt Deaf Smith Delta Denton Dickens Dimmit Donley Duval Eastland Ector Edwards Ellis Erath Falls Fannin Fayette Fisher Floyd Foard Fort Bend Franklin Freestone Frio Gaines Galveston Garza Gillespie Glasscock Goliad Gonzales Gray Grayson Gregg Grimes Guadalupe Hale Hall Hamilton Hansford Hardeman Hardin Harris Harrison Hartley Haskell Hays Hemphill Henderson Hidalgo Hill Hockley Hood Hopkins Houston Howard Hudspeth Hunt Hutchinson Irion Jack Jackson Jasper Jeff Davis Jefferson Jim Hogg Jim Wells Johnson Jones Karnes Kaufman Kendall Kenedy Kent Kerr Kimble King Kinney Kleberg Knox La Salle Lamar Lamb Lampasas Lavaca Lee Leon Liberty Limestone Lipscomb Live Oak Llano Loving Lubbock Lynn Madison Marion Martin Mason Matagorda Maverick Mcculloch Mclennan Mcmullen Medina Menard Midland Milam Mills Mitchell Montague Montgomery Moore Morris Motley Nacogdoches Navarro Newton Nolan Nueces Ochiltree Oldham Orange Palo Pinto Panola Parker Parmer Pecos Polk Potter Presidio Rains Randall Reagan Real Red River Reeves Refugio Roberts Robertson Rockwall Runnels Rusk Sabine San Augustine San Jacinto San Patricio San Saba Schleicher Scurry Shackelford Shelby Sherman Smith Somervell Starr Stephens Sterling Stonewall Sutton Swisher Tarrant Taylor Terrell Terry Throckmorton Titus Tom Green Travis Trinity Tyler Upshur Upton Uvalde Val Verde Van Zandt Victoria Walker Waller Ward Washington Webb Wharton Wheeler Wichita Wilbarger Willacy Williamson Wilson Winkler Wise Wood Yoakum Young Zapata Zavala

Basic Costs and Coverage

Coverage Cost
Monthly Deductible $505
Out of Pocket Max In-Network: $-1
Out-of-Network: N/A
Initial Coverage Limit $4660
Catastrophic Coverage Limit $7,400

Prescription Drug Costs and Coverage

The Amerivantage Rx Basic (PDP) plan offers the following prescription drug coverage, with an annual drug deductible of $505 (excludes Tiers 1 and 2) per year.

Coverage
Cost
Coverage & Cost
Annual Drug Deductible $505 (excludes Tiers 1 and 2)
Preferred Generic
  • Preferred cost-share retail $0.00
  • Standard retail $2.00
  • Standard mail order $0.00
Generic
  • Preferred cost-share retail $1.00
  • Standard retail $3.00
  • Standard mail order $1.00
Annual Drug Deductible $505 (excludes Tiers 1 and 2)
Preferred Generic
  • Preferred cost-share retail $0.00
  • Standard retail $4.00
  • Standard mail order $0.00
Generic
  • Preferred cost-share retail $2.00
  • Standard retail $6.00
  • Standard mail order $2.00
Annual Drug Deductible $505 (excludes Tiers 1 and 2)
Preferred Generic
  • Preferred cost-share retail $0.00
  • Standard retail $6.00
  • Standard mail order $0.00
Generic
  • Preferred cost-share retail $3.00
  • Standard retail $9.00
  • Standard mail order $3.00