Choose a plan benefit
Each plan offers a distinct set of benefits designed to support different goals, making it easier to find the right fit for your situation.
| Monthly Premium, Deductible, and Limits on How Much You Pay for Covered Services | ||||
|---|---|---|---|---|
| Monthly Contribution |
This benefit is provided as part of your Pfizer retiree medical coverage. If you have any questions about your contribution, refer to your Personal Fact Sheet you receive during Annual Enrollment or contact the Pfizer Benefits Center at 1-877-208-0950, Monday through Friday, from 8:30 a.m. to midnight, Eastern time. |
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| Deductible |
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| Maximum Out of Pocket (MOOP) |
If you reach your Pfizer individual annual prescription drug maximum out-of-pocket of $3,500, you pay nothing for the rest of the calendar year when you use network pharmacies. |
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| Initial Coverage |
You pay the amounts in the tables below until your total yearly drug costs reach $2,100. Total yearly drug costs are the amounts paid by both you and the plan for Part D medications. You may get your medications at network retail pharmacies and mail order pharmacies. Some of our network pharmacies are preferred network retail pharmacies where your costs will be lower. |
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| Tier | Up to a 30-day supply at any retail network pharmacy | Up to a 90-day supply at a preferred retail network pharmacy* | Up to a 90-day supply at a standard retail network pharmacy |
|---|---|---|---|
| Most Pfizer-brand medications without a generic equivalent | $0 | $0 | $0 |
|
For Pfizer-brand medications with a generic equivalent and Non-Pfizer medications: |
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| Tier 1 - Generic | 25% of total cost | 25% of total cost | 25% of total cost |
| Tier 2 - Preferred Brand | 25% of total cost | 25% of total cost | 25% of total cost |
| Tier 3 - Non-Preferred Brand | 25% of total cost | 25% of total cost | 25% of total cost |
Most adult Part D vaccines are available at $0 copayment.
You won’t pay more than $35 for a one-month supply, $70 for a two-month supply or $105 for a three-month supply of each insulin product on our formulary, regardless of cost-sharing tier.
* If you have your prescription filled at a CVS Pharmacy®, Longs Drugs (operated by CVS Pharmacy), or Navarro Discount Pharmacy location, your costs will be lower.
| Tier | Up to a 90-day supply* |
|---|---|
| Most Pfizer-brand medications without a generic equivalent | $0 |
|
For Pfizer-brand medications with a generic equivalent and Non-Pfizer Medications: |
|
| Tier 1 - Generic | 25% of total cost |
| Tier 2 - Preferred Brand | 25% of total cost |
| Tier 3 - Non-Preferred Brand | 25% of total cost |
You won’t pay more than $105 for a three-month supply of each insulin product on our formulary, regardless of cost-sharing tier.
* If you have your prescription filled at a CVS Pharmacy®, Longs Drugs (operated by CVS Pharmacy), or Navarro Discount Pharmacy location, your costs will be lower.
| Tier | Up to a 31-day supply |
|---|---|
| Most Pfizer-brand medications without a generic equivalent | $0 |
|
For Pfizer-brand medication with a generic equivalent and Non-Pfizer Medications: |
|
| Tier 1 - Generic | 25% of total cost |
| Tier 2 - Preferred Brand | 25% of total cost |
| Tier 3 - Non-Preferred Brand | 25% of total cost |
| Most adult Part D vaccines are available at $0 copayment. You won’t pay more than $35 for a one-month supply of each insulin product on our formulary, regardless of cost-sharing tier. |
After you reach $2,100 in Medicare out-of-pocket costs for the year, you are in the Catastrophic Coverage stage and you will pay nothing for drugs included on the SilverScript formulary.
For drugs that are not on the SilverScript formulary but are covered through the additional coverage provided by Pfizer, you will have the same Pfizer benefit:
- $0 for most Pfizer-brand medications without a generic equivalent
- Your Pfizer coinsurance percentage for Pfizer-brand medications with a generic equivalent and non-Pfizer medications
If you reach your Pfizer individual annual prescription drug maximum out-of-pocket of $3,500, you pay nothing for the rest of the calendar year when you use network pharmacies.
| Monthly Premium, Deductible, and Limits on How Much You Pay for Covered Services | ||||
|---|---|---|---|---|
| Monthly Contribution |
This benefit is provided as part of your Pfizer retiree medical coverage. If you have any questions about your contribution, refer to your Personal Fact Sheet you receive during Annual Enrollment or contact the Pfizer Benefits Center at 1-877-208-0950, Monday through Friday, from 8:30 a.m. to midnight, Eastern time. |
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| Deductible |
|
|||
| Initial Coverage |
You pay the amounts in the tables below until your total yearly drug costs reach $2,100. Total yearly drug costs are the amounts paid by both you and the plan for Part D medications. You may get your medications at network retail pharmacies and mail order pharmacies. Some of our network pharmacies are preferred network retail pharmacies where your costs will be lower. |
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| Up to a 30-day supply at any retail network pharmacy | Up to a 90-day supply at a preferred retail network pharmacy* | Up to a 90-day supply at a standard retail network pharmacy | |
|---|---|---|---|
| Tier 1 - Generic | 25% of total cost | 25% of total cost | 25% of total cost |
| Tier 2 - Preferred Brand | 25% of total cost | 25% of total cost | 25% of total cost |
| Tier 3 - Non-Preferred Brand | 25% of total cost | 25% of total cost | 25% of total cost |
Most adult Part D vaccines are available at $0 copayment.
You won’t pay more than $35 for a one-month supply, $70 for a two-month supply or $105 for a three-month supply of each insulin product on our formulary, regardless of cost-sharing tier.
* If you have your prescription filled at a CVS Pharmacy®, Longs Drugs (operated by CVS Pharmacy), or Navarro Discount Pharmacy location, your costs will be lower.
| Up to a 90-day supply* | |
|---|---|
| Tier 1 - Generic | 25% of total cost |
| Tier 2 - Preferred Brand | 25% of total cost |
| Tier 3 - Non-Preferred Brand | 25% of total cost |
You won’t pay more than $105 for a three-month supply of each insulin product on our formulary, regardless of cost-sharing tier.
* If you have your prescription filled at a CVS Pharmacy®, Longs Drugs (operated by CVS Pharmacy), or Navarro Discount Pharmacy location, your costs will be lower.
| Up to a 31-day supply | |
|---|---|
| Tier 1 - Generic | 25% of total cost |
| Tier 2 - Preferred Brand | 25% of total cost |
| Tier 3 - Non-Preferred Brand | 25% of total cost |
| Most adult Part D vaccines are available at $0 copayment. You won’t pay more than $35 for a one-month supply of each insulin product on our formulary, regardless of cost-sharing tier. |
After you reach $2,100 in Medicare out-of-pocket costs for the year, you are in the Catastrophic Coverage stage and you will pay nothing for drugs included on the SilverScript formulary.
For drugs that are not on the SilverScript formulary but are covered through the additional coverage provided by Pfizer, you will pay the same Pfizer coinsurance percentage that you paid during the Initial Coverage stage.
