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CTPF 2027 MEDICARE HEALTH INSURANCE HANDBOOK
AARP® Medicare Supplement Insurance 
Plan F (UnitedHealthcare) with Express Scripts by 
Evernorth Health Services® (PDP) for CTPF 
Available to Medicare recipients who turned 65 
prior to 2020 or in some instances, with a Medicare Part A 
Effective Date prior to 1/1/2020.
BEHAVIORAL HEALTH SERVICES                      
(Medicare covered services only)
Outpatient: 100% after Medicare pays
Inpatient: 100% after Medicare pays
PRESCRIPTION DRUG BENEFITS
Preferred Value Network Pharmacy* 
(up to 31-Day supply)
	 $15	  Generic copay 
	 $45	  Preferred brand copay
	 $65	  Non-preferred brand copay
	 $65	  Specialty drugs 
Preferred Value Network Pharmacy* 
(up to 90-Day Supply)
$37.50	     Generic copay
$112.50    Preferred brand copay
	$162.50    Non-preferred brand copay
	$162.50    Specialty drugs
Express Scripts Mail Order (up to 90-Day Supply)
$30 	   Generic copay
$90	     Preferred brand copay
	$130	 Non-preferred brand copay
	$130	 Specialty drugs
Annual Brand Prescription Deductible  $200
Coverage 
Prescription coverage is provided through the Initial 
Coverage gap and generally stays the same as the copays 
listed above. For 2027, you will stay in this stage until the 
total cost of your Part D drugs reaches $2,400. Once you 
reach this limit, you move on to the Catastrophic 
Coverage stage. Most members will not reach the 
Catastrophic Coverage stage.
Non-Medicare Part D drugs are not covered (for example, 
lifestyle drugs for ED). 
Medicare Part B drugs, including diabetic supplies, are 
processed by your medical plan. 
Vaccinations   
Flu shots and shots to prevent pneumococcal infections 
are covered under Part B. Contact your Medicare drug 
plan for more information about vaccines.
Important Pharmacy Notes
Once your true out-of-pocket cost reaches $2,400,                  
your copay will be reduced. Once you meet this cost 
threshold, the plan pays the full cost for your covered Part 
D drugs. If your plan covers additional drugs not normally 
covered by Medicare, you may have a cost share for such 
drugs covered under an enhanced benefit.
Plan Comparisons: Medicare-Eligible Members
Cigna Surround Group Supplement Plan
with Express Scripts by Evernorth Health Services® (PDP) 
(mirrors Plan G)
Available to Medicare recipients who turned 65 
on or after 2020 (or Part A effective date on or after 1/1/2020).
BEHAVIORAL HEALTH SERVICES                     
(Medicare covered services only) 
(Part B deductible applies)   
Outpatient: 100% after Medicare pays
Inpatient: 100% after Medicare pays
PRESCRIPTION DRUG BENEFITS
Preferred Value Network Pharmacy* 
(up to 31-Day supply)
	 $15	  Generic copay 
	 $45	  Preferred brand copay
	 $65	  Non-preferred brand copay
	 $65	  Specialty drugs 
Preferred Value Network Pharmacy* 
(up to 90-Day Supply)
$37.50	     Generic copay
$112.50    Preferred brand copay
	$162.50    Non-preferred brand copay
	$162.50    Specialty drugs
Express Scripts Mail Order (up to 90-Day Supply)
$30 	   Generic copay
$90	     Preferred brand copay
	$130	 Non-preferred brand copay
	$130	 Specialty drugs
Annual Brand Prescription Deductible  $200
Coverage 
Prescription coverage is provided through the Initial Coverage 
stage and generally stays the same as the copays listed above. 
For 2027, you will stay in this stage until the total cost of your 
Part D drugs reaches $2,400. Once you reach this limit, you 
move on to the Catastrophic Coverage stage. Most members will 
not reach the Catastrophic Coverage stage.
Non-Medicare Part D drugs are not covered (for example, 
lifestyle drugs for ED). 
Medicare Part B drugs, including diabetic supplies, are processed 
by your medical plan. 
Vaccinations   
Flu shots and shots to prevent pneumococcal infections are 
covered under Part B. Contact your Medicare drug plan for more 
information about vaccines.
Important Pharmacy Notes
Once your true out-of-pocket cost reaches $2,400, your copay will 
be reduced. Once you meet this cost threshold, the plan pays the 
full cost for your covered Part D drugs. If your plan covers 
additional drugs not normally covered by Medicare, you may have 
a cost share for such drugs covered under an enhanced benefit.
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*Non-preferred network copays are $5 more than stated copays 

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