There are 42 stand-alone Medicare Part D plans in Hawaii meeting your criteria.
Caution: The 2009 Medicare Part D plan information below is for research purposes.
Click here to see 2024 Medicare Part D plans
CONDYLOX 0.5% GEL (3.5 GM TUBE) (NDC: 55515010201) 2009 Medicare Prescription Drug Plan (PDP) Information Click here for the Chart Legend | |||||||||
Plan Name | Monthly Prem. |
De- duct- ible | Does Plan Offer Gap Coverage | Drug Tier Information | Cost-Sharing | Drug Usage Mgmt |
|||
---|---|---|---|---|---|---|---|---|---|
Tier Nbr. |
Tier Desc. |
30-Day Prfrd. Pharm |
90-Day Order |
||||||
First Health Part D-Secure |
$10.70 | $175 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $48.00 | n/a | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Value |
$19.00 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $55.00 | $165.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Saver |
$19.90 | $295 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $64.85 | $179.55 | None | |
Browse Plan Formulary | |||||||||
First Health Part D-Premier |
$23.70 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $62.00 | n/a | None | |
Browse Plan Formulary | |||||||||
Advantage Star Plan by RxAmerica |
$25.50 | $295 | No Gap Coverage | 2 | Preferred Brand | 25% | 30% | None | |
Browse Plan Formulary | |||||||||
Plan Name | Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Order |
Drug Usage Mgmt |
|
Medco Medicare Prescription Plan - Value |
$25.80 | $295 | No Gap Coverage | 2 | Preferred Brand | 23% | 23% | None | |
Browse Plan Formulary | |||||||||
BravoRx |
$26.00 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 1 |
$26.60 | $295 | No Gap Coverage | 2 | Preferred Brand | $43.00 | $86.00 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan One |
$27.60 | $295 | No Gap Coverage | 3 | Tier 3 | $83.00 | $207.50 | None | |
Browse Plan Formulary | |||||||||
WellCare Signature |
$27.60 | $0 | No Gap Coverage | 3 | Tier 3 | $79.00 | $237.00 | None | |
Browse Plan Formulary | |||||||||
WellCare Classic |
$27.90 | $295 | No Gap Coverage | 3 | Tier 3 | $81.00 | $243.00 | None | |
Browse Plan Formulary | |||||||||
Plan Name | Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Order |
Drug Usage Mgmt |
|
SilverScript Value |
$28.10 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | $98.00 | $269.50 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5884-093 |
$30.70 | $295 | No Gap Coverage | 3 | Other - Non-Preferred (Gen/Brand) | 47% | 47% | None | |
Browse Plan Formulary | |||||||||
Community CCRx Basic |
$30.90 | $295 | No Gap Coverage | 2 | Preferred Brand | 25% | n/a | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Bronze |
$31.20 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Silver |
$31.70 | $295 | No Gap Coverage | 4 | Tier 4 NonPreferred Brand | $75.00 | $225.00 | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier |
$33.10 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $74.00 | $222.00 | None | |
Browse Plan Formulary | |||||||||
Plan Name | Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Order |
Drug Usage Mgmt |
|
UA Medicare Part D Rx Covg - Silver Plan |
$33.20 | $190 | No Gap Coverage | 2 | Preferred Brand | $40.00 | $100.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred |
$34.60 | $0 | No Gap Coverage | 2 | Tier 2 - Generic and Preferred Brand | $38.00 | $99.00 | None | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Prescription Drug Cov |
$35.30 | $0 | No Gap Coverage | 2 | Preferred Brand | $31.00 | $62.00 | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Gold |
$36.00 | $0 | No Gap Coverage | 2 | Brand | $44.00 | $88.00 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Enhanced S5884-096 |
$36.30 | $0 | No Gap Coverage | 3 | Non-Preferred Brand | $70.00 | $175.00 | None | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 2 |
$36.90 | $0 | No Gap Coverage | 2 | Preferred Brand | $30.00 | $60.00 | None | |
Browse Plan Formulary | |||||||||
Plan Name | Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Order |
Drug Usage Mgmt |
|
Aetna Medicare Rx Essentials |
$38.10 | $200 | No Gap Coverage | 4 | Tier 4 - Non-Preferred Brand | $67.00 | $134.00 | None | |
Browse Plan Formulary | |||||||||
Sterling Rx |
$41.40 | $295 | No Gap Coverage | 2 | Preferred Brand | $25.00 | $50.00 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Choice |
$42.90 | $0 | No Gap Coverage | 2 | Preferred Brand | $35.00 | $87.50 | None | |
Browse Plan Formulary | |||||||||
Advantage Freedom Plan by RxAmerica |
$43.00 | $0 | No Gap Coverage | 2 | Preferred Brand | 35% | 40% | None | |
Browse Plan Formulary | |||||||||
UnitedHealth Rx Basic |
$44.60 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $98.00 | $279.00 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two |
$45.30 | $0 | No Gap Coverage | 4 | Tier 4 | $88.00 | $220.00 | None | |
Browse Plan Formulary | |||||||||
Plan Name | Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Order |
Drug Usage Mgmt |
|
AdvantraRx Premier Plus |
$49.10 | $0 | Many Generics | 3 | Non-Preferred Generic/Non-Preferred Brand | $70.00 | $210.00 | None | |
Browse Plan Formulary | |||||||||
SilverScript Plus |
$49.10 | $50 | Many Generics | 5 | Non-Preferred Brand | $95.00 | $261.00 | None | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Gold |
$54.00 | $0 | No Gap Coverage | 4 | Tier 4 NonPreferred Brand | $75.00 | $225.00 | None | |
Browse Plan Formulary | |||||||||
Community CCRx Choice |
$56.60 | $0 | No Gap Coverage | 2 | Preferred Brand | $30.00 | n/a | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx - Costco Plus Plan |
$62.70 | $0 | Some Generics | 4 | Tier 4 - Non-Preferred Brand | $90.00 | $180.00 | None | |
Browse Plan Formulary | |||||||||
SilverScript Complete |
$63.40 | $0 | Many Generics | 4 | Non-Preferred Brand | $98.00 | $270.00 | None | |
Browse Plan Formulary | |||||||||
Plan Name | Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Order |
Drug Usage Mgmt |
|
Prescriba Rx Platinum |
$68.70 | $0 | All Generics | 2 | Brand | $44.00 | $88.00 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Access |
$70.70 | $0 | All Generics | 2 | Preferred Brand | $35.00 | $87.50 | None | |
Browse Plan Formulary | |||||||||
Community CCRx Gold |
$72.90 | $0 | All Generics | 2 | Preferred Brand | $30.00 | n/a | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced |
$73.00 | $0 | Many Generics | 2 | Tier 2 - Generic and Preferred Brand | $39.00 | $102.00 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three |
$88.70 | $0 | Some Generics | 3 | Tier 3 | $60.00 | $150.00 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5884-099 |
$94.70 | $0 | Many Generics | 3 | Non-Preferred Brand | $70.00 | $175.00 | None | |
Browse Plan Formulary | |||||||||
Plan Name | Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Order |
Drug Usage Mgmt |
|
Aetna Medicare Rx Premier |
$111.10 | $0 | Many Generics | 4 | Tier 4 - Non-Preferred Brand | $65.00 | $130.00 | None | |
Browse Plan Formulary |
|