Cigna Extra Rx (PDP)

Cigna Extra Rx (PDP) S5617-274 Plan Details

3 out of 5 stars

Cigna Extra Rx (PDP) is a plan offered by Cigna.
Plan ID: S5617-274.

^$52.30

Monthly Premium

Cigna Extra Rx (PDP) is a plan offered by Cigna.
Plan ID: S5617-274.

Cigna Extra Rx (PDP) S5617-274 Plan Details

3 out of 5 stars

Cigna Extra Rx (PDP) is a plan offered by Cigna.
Plan ID: S5617-274.

^$52.30

Monthly Premium

Nevada Counties Served

Churchill Clark Washoe Carson City Douglas Elko Esmeralda Eureka Humboldt Lander Lincoln Lyon Mineral Nye Pershing Storey White Pine

Basic Costs and Coverage

Coverage	Cost
Monthly Deductible	$100
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 Cigna Extra Rx (PDP) plan offers the following prescription drug coverage, with an annual drug deductible of $100 (excludes Tiers 1, 2, 3 and 6) per year.

Coverage	Cost
Coverage & Cost
Annual Drug Deductible	$100 (excludes Tiers 1, 2, 3 and 6)
Preferred Generic	Preferred cost-share retail $4.00 Standard retail $15.00 Preferred cost-share mail order $4.00 Standard mail order $15.00
Generic	Preferred cost-share retail $10.00 Standard retail $20.00 Preferred cost-share mail order $10.00 Standard mail order $20.00
Preferred Brand	Preferred cost-share retail $45.00 Standard retail $47.00 Preferred cost-share mail order $45.00 Standard mail order $47.00
Select Care Drugs	Preferred cost-share retail $0.00 Standard retail $11.00 Preferred cost-share mail order $0.00 Standard mail order $11.00
Annual Drug Deductible	$100 (excludes Tiers 1, 2, 3 and 6)
Preferred Generic	Preferred cost-share retail $8.00 Standard retail $30.00 Preferred cost-share mail order $8.00 Standard mail order $30.00
Generic	Preferred cost-share retail $20.00 Standard retail $40.00 Preferred cost-share mail order $20.00 Standard mail order $40.00
Preferred Brand	Preferred cost-share retail $90.00 Standard retail $94.00 Preferred cost-share mail order $90.00 Standard mail order $94.00
Select Care Drugs	Preferred cost-share retail $0.00 Standard retail $22.00 Preferred cost-share mail order $0.00 Standard mail order $22.00
Annual Drug Deductible	$100 (excludes Tiers 1, 2, 3 and 6)
Preferred Generic	Preferred cost-share retail $12.00 Standard retail $45.00 Preferred cost-share mail order $0.00 Standard mail order $45.00
Generic	Preferred cost-share retail $30.00 Standard retail $60.00 Preferred cost-share mail order $2.00 Standard mail order $60.00
Preferred Brand	Preferred cost-share retail $135.00 Standard retail $141.00 Preferred cost-share mail order $135.00 Standard mail order $141.00
Select Care Drugs	Preferred cost-share retail $0.00 Standard retail $33.00 Preferred cost-share mail order $0.00 Standard mail order $33.00

Back to Plans in Nevada

Cigna Extra Rx (PDP)

Nevada Counties Served

Basic Costs and Coverage

Prescription Drug Costs and Coverage

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