There are 41 stand-alone Medicare Part D plans in Indiana 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
DIOVAN HCT 80/12.5MG TABLET (90 BOT) (NDC: 00078031434) 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 |
$16.80 | $175 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $45.00 | n/a | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
AdvantraRx Value |
$24.40 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $55.00 | $165.00 | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
HealthSpring Prescription Drug Plan-Reg 15 |
$25.60 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
SilverScript Value |
$28.00 | $295 | No Gap Coverage | 2 | Preferred Brand | $33.50 | $75.50 | None | |
Browse Plan Formulary | |||||||||
First Health Part D-Premier |
$28.10 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $58.00 | n/a | Q:30 /30Days | |
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 Saver |
$28.20 | $295 | No Gap Coverage | 2 | Tier 2 - Generic and Preferred Brand | $22.00 | $51.00 | Q:62 /31Days | |
Browse Plan Formulary | |||||||||
Prescriba Rx Bronze |
$29.80 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Community CCRx Basic |
$31.80 | $295 | No Gap Coverage | 2 | Preferred Brand | 30% | n/a | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan One |
$33.50 | $295 | No Gap Coverage | 2 | Tier 2 | $30.00 | $75.00 | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials |
$33.90 | $200 | No Gap Coverage | 3 | Tier 3 - Preferred Brand | $28.00 | $56.00 | Q:1 /1Days | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 1 |
$34.80 | $295 | No Gap Coverage | 2 | Preferred Brand | $42.00 | $84.00 | Q:1 /1Days | |
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 |
|
WellCare Classic |
$34.90 | $295 | No Gap Coverage | 2 | Tier 2 | $31.00 | $93.00 | None | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Silver |
$35.00 | $295 | No Gap Coverage | 3 | Tier 3 Preferred Brand | $21.00 | $63.00 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Choice |
$35.10 | $0 | No Gap Coverage | 2 | Preferred Brand | $35.00 | $87.50 | Q:90 /90Days | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Value |
$37.70 | $130 | No Gap Coverage | 2 | Tier 2 Preferred Brand | $38.00 | $95.00 | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Gold |
$38.40 | $0 | No Gap Coverage | 2 | Brand | $44.00 | $88.00 | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
WellCare Signature |
$38.40 | $0 | No Gap Coverage | 2 | Tier 2 | $39.00 | $117.00 | 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 |
$40.50 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $73.00 | $219.00 | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two |
$41.20 | $0 | No Gap Coverage | 3 | Tier 3 | $38.00 | $95.00 | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred |
$41.90 | $0 | No Gap Coverage | 2 | Tier 2 - Generic and Preferred Brand | $38.00 | $99.00 | Q:62 /31Days | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5884-073 |
$42.10 | $295 | No Gap Coverage | 2 | Preferred Brand | 25% | 25% | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Sterling Rx |
$42.40 | $295 | No Gap Coverage | 2 | Preferred Brand | $25.00 | $50.00 | S | |
Browse Plan Formulary | |||||||||
Community CCRx Choice |
$43.40 | $0 | No Gap Coverage | 2 | Preferred Brand | $30.00 | n/a | Q:30 /30Days | |
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 |
|
UnitedHealth Rx Basic |
$44.00 | $0 | No Gap Coverage | 2 | Tier 2 - Generic and Preferred Brand | $35.00 | $90.00 | Q:62 /31Days | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Plus |
$44.30 | $0 | No Gap Coverage | 2 | Tier 2 Preferred Brand | $35.00 | $87.50 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Enhanced S5884-013 |
$47.90 | $0 | No Gap Coverage | 2 | Preferred Brand | $40.00 | $100.00 | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Prescription Drug Cov |
$48.70 | $0 | No Gap Coverage | 2 | Preferred Brand | $31.00 | $62.00 | Q:90 /90Days | |
Browse Plan Formulary | |||||||||
SilverScript Plus |
$51.30 | $50 | Many Generics | 3 | Value Brand | $30.00 | $71.00 | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier Plus |
$55.50 | $0 | Many Generics | 3 | Non-Preferred Generic/Non-Preferred Brand | $75.00 | $225.00 | Q:30 /30Days | |
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 |
$58.80 | $0 | Some Generics | 3 | Tier 3 - Preferred Brand | $38.00 | $76.00 | Q:1 /1Days | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 2 |
$62.00 | $0 | No Gap Coverage | 2 | Preferred Brand | $30.00 | $60.00 | Q:1 /1Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three |
$66.10 | $0 | Some Generics | 2 | Tier 2 | $35.00 | $87.50 | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Community CCRx Gold |
$66.70 | $0 | All Generics | 2 | Preferred Brand | $30.00 | n/a | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
SilverScript Complete |
$66.90 | $0 | Many Generics | 3 | Preferred Brand | $39.00 | $92.00 | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Platinum |
$69.50 | $0 | All Generics | 2 | Brand | $44.00 | $88.00 | Q:30 /30Days | |
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 - Access |
$71.30 | $0 | All Generics | 2 | Preferred Brand | $35.00 | $87.50 | Q:90 /90Days | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced |
$71.70 | $0 | Many Generics | 2 | Tier 2 - Generic and Preferred Brand | $39.00 | $102.00 | Q:62 /31Days | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Gold |
$72.30 | $0 | No Gap Coverage | 3 | Tier 3 Preferred Brand | $40.00 | $120.00 | None | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Premier |
$79.10 | $0 | Many Generics | 2 | Tier 2 Preferred Brand | $35.00 | $87.50 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5884-043 |
$98.40 | $0 | Many Generics | 2 | Preferred Brand | $40.00 | $100.00 | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier |
$100.90 | $0 | Many Generics | 3 | Tier 3 - Preferred Brand | $30.00 | $60.00 | Q:1 /1Days | |
Browse Plan Formulary |
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