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Region 5 - Delaware, District of Columbia, Maryland


Advantage Star Plan
TierNameCo-pay
Tier 1Generics $5 co-pay
Tier 2 Brands 25% co-pay
Tier 3 Specialty25% co-pay
Tier 4 Non-Preferred Brands 35% co-pay
Monthly Premium: $25.30
Advantage Freedom Plan
TierNameCo-pay
Tier 1 Generics$5 co-pay
Tier 2 Preferred Brands 35% co-pay
Tier 3 Specialty25% co-pay
Tier 4 Non-Preferred Brands 45% co-pay
Monthly Premium: $29.90
Advantage Star Plan
TierNameCo-pay
Tier 1Generics $5 co-pay
Tier 2 Brands 35% co-pay
Tier 3 Specialty25% co-pay
Tier 4 Non-Preferred Brands45% co-pay
Monthly Premium: $47.00
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