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2021
2022
Walmart Value Rx Plan – S5601-205
Premium: $17.20
Deductible: $445 (Tiers 3-5)
Basic Rx Plan – S5601-060
Premium: $34.00
Deductible: $445 (All Tiers)
Premier Rx Plan – S5601-061
Premium: $65.30
Deductible: $445 (Tiers 3-5)
Walmart Value Rx Plan – S5884-209
Premium: $22.70
Deductible: $480 (Tiers 3-5)
Basic Rx Plan – S5884-113
Premium: $38.20
Deductible: $480 (All Tiers)
Premier Rx Plan – S5884-176
Premium: $75.30
Deductible: $480 (Tiers 3-5)