There are 25 stand-alone Medicare Part D plans in Texas 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
CYTOXAN 500MG VIAL (12 SINGLE DOSE VIALS) (NDC: 00015050241) 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 |
||||||
Health Net Orange Option 1![]() ![]() |
$22.40 | $295 | No Gap Coverage | 4 | Injectable | 25% | n/a | None | |
Browse Plan Formulary | |||||||||
WellCare Classic![]() ![]() |
$23.20 | $295 | No Gap Coverage | 3 | Tier 3 | $90.00 | $270.00 | P | |
Browse Plan Formulary | |||||||||
SilverScript Value![]() ![]() |
$23.50 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | $98.00 | $269.50 | None | |
Browse Plan Formulary | |||||||||
BravoRx![]() ![]() |
$24.50 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials![]() ![]() |
$25.20 | $195 | No Gap Coverage | 4 | Tier 4 - Non-Preferred Brand | $68.00 | $136.00 | P | |
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 |
|
CIGNA Medicare Rx Plan One![]() ![]() |
$25.80 | $295 | No Gap Coverage | 3 | Tier 3 | $75.00 | $187.50 | P | |
Browse Plan Formulary | |||||||||
MedicareRx Rewards Value![]() ![]() |
$28.20 | $130 | No Gap Coverage | 4 | Tier 4 Non-Specialty Injectable | 29% | 29% | None | |
Browse Plan Formulary | |||||||||
WellCare Signature![]() ![]() |
$31.80 | $0 | No Gap Coverage | 3 | Tier 3 | $79.00 | $237.00 | P | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Rx Covg - Silver Plan![]() ![]() |
$36.80 | $170 | No Gap Coverage | 3 | Non-Preferred Brand | $80.00 | $200.00 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Enhanced S5884-020![]() ![]() |
$37.70 | $0 | No Gap Coverage | 3 | Non-Preferred Brand | $70.00 | $175.00 | P | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two![]() ![]() |
$38.30 | $0 | No Gap Coverage | 4 | Tier 4 | $80.00 | $200.00 | P | |
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 |
|
AARP MedicareRx Preferred![]() ![]() |
$38.40 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $73.30 | $204.90 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5884-080![]() ![]() |
$38.80 | $295 | No Gap Coverage | 3 | Other - Non-Preferred (Gen/Brand) | 41% | 41% | P | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Value![]() ![]() |
$38.90 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | 53% | 53% | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Choice![]() ![]() |
$45.10 | $0 | No Gap Coverage | 3 | Non-Preferred Brand | 75% | 75% | None | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Prescription Drug Cov![]() ![]() |
$47.00 | $0 | No Gap Coverage | 3 | Non-Preferred Brand | $66.00 | $132.00 | None | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 2![]() ![]() |
$48.00 | $0 | No Gap Coverage | 4 | Injectable | 33% | n/a | 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 Plus![]() ![]() |
$53.10 | $0 | Some Generics | 4 | Tier 4 - Non-Preferred Brand | $74.00 | $148.00 | P | |
Browse Plan Formulary | |||||||||
SilverScript Plus![]() ![]() |
$54.40 | $50 | Many Generics | 5 | Non-Preferred Brand | $95.00 | $261.00 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three![]() ![]() |
$66.50 | $0 | Some Generics | 3 | Tier 3 | $60.00 | $150.00 | P | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced![]() ![]() |
$71.60 | $0 | Many Generics | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $93.00 | $264.00 | None | |
Browse Plan Formulary | |||||||||
SilverScript Complete![]() ![]() |
$75.70 | $0 | Many Generics | 4 | Non-Preferred Brand | $98.00 | $270.00 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Access![]() ![]() |
$79.60 | $0 | All Generics | 3 | Non-Preferred Brand | 75% | 75% | 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![]() ![]() |
$80.50 | $0 | Many Generics | 4 | Tier 4 - Non-Preferred Brand | $65.00 | $130.00 | P | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5884-050![]() ![]() |
$90.10 | $0 | Many Generics | 3 | Non-Preferred Brand | $70.00 | $175.00 | P | |
Browse Plan Formulary |
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