Educators Mutual Retiree Plan (PDP)
Standalone drug coverage
Medicare Prescription Drug Plan (PDP)
This plan covers prescription drugs. It is not Medicare Advantage and does not describe the member's hospital, medical, or supplemental coverage.
CMS-backed plan details
Drug plan at a glance
- Monthly premium
- Not published for this plan
- Part D deductible
- Not published for this plan
- Plan type
- Medicare Prescription Drug Plan
- Coverage area
- Idaho, Utah
- Employer-only
- Yes
- Part D star rating
- Not published for this plan
Plan-specific costs
Prescription drug coverage
Plan-specific drug deductible not published
Drug costs depend on the prescription, its formulary tier, and the pharmacy. Use current official plan materials before estimating what you will pay.
Contract Year 2027
How this drug plan works
- 1Deductible
The plan-specific deductible is not available here. What you pay and which tiers apply are controlled by the plan documents.
- 2Initial coverage
After any applicable deductible, you pay the plan's copay or coinsurance for covered drugs. Pharmacy type, supply length, and formulary tier can change the price.
- 3Catastrophic coverage
The 2027 out-of-pocket threshold is not reported for this record. Check that year's official plan documents.
- +Extra Help
People with limited income and resources may qualify for Extra Help with Part D premiums, deductibles, and prescription costs. Eligibility and assistance are separate from this plan's standard benefit.
Source trail
Official CMS, Contract Year 2027
Plan identity and benefits come from CMS PBP data. Benefits and drug cost sharing come from the approved annual PBP tabular extract and its CMS dictionary. Premiums and drug deductibles are cross-checked with the annual Landscape. Geography comes from annual PlanArea and PlanRegionArea records, including exact segments and partial-county or employer/group qualifiers. Quick-reference values should be confirmed in current official plan documents.
Plan context
Where S5877-804-000 fits
- Full CMS plan ID
S5877-804-000- Contract
S5877- Base plan code
S5877-804- Segment
000- Carrier
- EMI Health
- Plan type
- Medicare Prescription Drug Plan
- Service area
- State of Utah and State of Idaho (ID, UT)
County/service-area foundation
CMS service-area entries
Service areas come from the annual CMS PlanArea and PlanRegionArea tables for this exact contract, plan, and segment. Partial-county and employer/group qualifiers remain part of the coverage area. Regional PPO county entries use the matching annual Landscape expansion of the CMS region.
- ID — all counties (CMS marker)
- UT — all counties (CMS marker)
Is S5877-804-000 a Medicare Advantage plan?
No. S5877-804-000 is a standalone Medicare Part D prescription drug plan (PDP). It covers prescription drugs and does not replace Original Medicare or describe separate medical coverage.
What is the Part D deductible for S5877-804-000?
A plan-specific Part D deductible is not available in the CMS Landscape record matched to S5877-804-000. Check the plan's current official documents before estimating your costs.
Where can I find the S5877-804-000 formulary or drug list?
Use the plan carrier's current official formulary and search for each prescription by name, dose, and form. The CMS benefit data on this page describes tier costs but does not contain the plan's complete drug list.
Which pharmacies are in network for S5877-804-000?
Check the carrier's current pharmacy directory before filling a prescription. Preferred and standard network pharmacies can charge different amounts, and the CMS data on this page does not list individual pharmacies.
Who can enroll in S5877-804-000?
Educators Mutual Retiree Plan (PDP) is marked employer-only in CMS data and is generally available through an eligible employer or group, not for ordinary individual enrollment. Its listed coverage area is Idaho, Utah.
About this code
What S5877-804-000 identifies
S5877-804-000 is a Contract Year 2027 Medicare plan segment code. Searches written as S5877-804, S5877 804, or the compact full CMS ID S5877804000 refer to this plan or its base plan code.
Medicare Plan Lookup uses official CMS data as a quick reference. Benefit details, eligibility, service-area rules, and cost sharing should be confirmed in the current Summary of Benefits or Evidence of Coverage.