There are 39 stand-alone Medicare Part D plans in Louisiana 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
GASTROCROM 100MG/5ML CONC (96 X 5 ML AMP) (NDC: 18860067870) 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 |
$17.90 | $175 | No Gap Coverage | 2 | Preferred Brand | $20.00 | n/a | None | |
Browse Plan Formulary | |||||||||
SilverScript Value |
$24.00 | $295 | No Gap Coverage | 2 | Preferred Brand | $28.25 | $63.50 | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Value |
$24.60 | $0 | No Gap Coverage | 2 | Preferred Brand | $24.00 | $48.00 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Value |
$24.70 | $295 | No Gap Coverage | 2 | Preferred Brand | 23% | 23% | None | |
Browse Plan Formulary | |||||||||
HealthSpring Prescription Drug Plan-Reg 21 |
$25.60 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | 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 Bronze |
$26.80 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
Community CCRx Basic |
$27.00 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | 50% | n/a | None | |
Browse Plan Formulary | |||||||||
Advantage Star Plan by RxAmerica |
$27.40 | $295 | No Gap Coverage | 2 | Preferred Brand | 25% | 30% | None | |
Browse Plan Formulary | |||||||||
BravoRx |
$27.60 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
First Health Part D-Premier |
$28.50 | $0 | No Gap Coverage | 2 | Preferred Brand | $27.00 | n/a | None | |
Browse Plan Formulary | |||||||||
WellCare Classic |
$28.50 | $295 | No Gap Coverage | 3 | Tier 3 | $83.00 | $249.00 | 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 |
$30.70 | $200 | No Gap Coverage | 3 | Tier 3 - Preferred Brand | $26.00 | $52.00 | None | |
Browse Plan Formulary | |||||||||
MedicareRx Rewards Value |
$31.70 | $130 | No Gap Coverage | 2 | Tier 2 Preferred Brand | $41.00 | $102.50 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Choice |
$32.10 | $0 | No Gap Coverage | 2 | Preferred Brand | $35.00 | $87.50 | None | |
Browse Plan Formulary | |||||||||
Advantage Freedom Plan by RxAmerica |
$34.80 | $0 | No Gap Coverage | 2 | Preferred Brand | 35% | 40% | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Saver |
$34.90 | $295 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $49.45 | $133.35 | None | |
Browse Plan Formulary | |||||||||
WellCare Signature |
$35.40 | $0 | No Gap Coverage | 3 | Tier 3 | $79.00 | $237.00 | 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 |
|
AARP MedicareRx Preferred |
$37.50 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $66.25 | $183.75 | None | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Rx Covg - Silver Plan |
$38.30 | $130 | No Gap Coverage | 2 | Preferred Brand | $40.00 | $100.00 | None | |
Browse Plan Formulary | |||||||||
Sterling Rx |
$39.80 | $295 | No Gap Coverage | 2 | Preferred Brand | $25.00 | $50.00 | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Gold |
$40.50 | $0 | No Gap Coverage | 2 | Brand | $44.00 | $88.00 | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier |
$41.50 | $0 | No Gap Coverage | 2 | Preferred Brand | $30.00 | $60.00 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5884-079 |
$43.70 | $295 | No Gap Coverage | 3 | Other - Non-Preferred (Gen/Brand) | 45% | 45% | 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 Prescription Drug Cov |
$44.50 | $0 | No Gap Coverage | 2 | Preferred Brand | $33.00 | $66.00 | None | |
Browse Plan Formulary | |||||||||
Community CCRx Choice |
$44.80 | $0 | No Gap Coverage | 3 | Non-Preferred Brand | $60.00 | n/a | None | |
Browse Plan Formulary | |||||||||
Humana PDP Enhanced S5884-019 |
$45.10 | $0 | No Gap Coverage | 3 | Non-Preferred Brand | $70.00 | $175.00 | None | |
Browse Plan Formulary | |||||||||
RxBLUE |
$45.30 | $0 | No Gap Coverage | 2 | Preferred Brand | $32.00 | $96.00 | None | |
Browse Plan Formulary | |||||||||
UnitedHealth Rx Basic |
$47.20 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $86.00 | $243.00 | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier Plus |
$55.90 | $0 | Many Generics | 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 Plus |
$59.70 | $0 | Some Generics | 3 | Tier 3 - Preferred Brand | $36.00 | $72.00 | None | |
Browse Plan Formulary | |||||||||
SilverScript Plus |
$59.80 | $50 | Many Generics | 4 | Preferred Brand | $35.00 | $82.00 | None | |
Browse Plan Formulary | |||||||||
Community CCRx Gold |
$63.80 | $0 | All Generics | 3 | Non-Preferred Brand | $60.00 | n/a | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Access |
$69.10 | $0 | All Generics | 2 | Preferred Brand | $35.00 | $87.50 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three |
$69.90 | $0 | Some Generics | 2 | Tier 2 | $35.00 | $87.50 | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Platinum |
$71.40 | $0 | All Generics | 2 | Brand | $44.00 | $88.00 | 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 |
|
AARP MedicareRx Enhanced |
$73.60 | $0 | Many Generics | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $82.00 | $231.00 | None | |
Browse Plan Formulary | |||||||||
SilverScript Complete |
$79.90 | $0 | Many Generics | 3 | Preferred Brand | $39.00 | $92.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier |
$92.10 | $0 | Many Generics | 3 | Tier 3 - Preferred Brand | $30.00 | $60.00 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5884-049 |
$93.60 | $0 | Many Generics | 3 | Non-Preferred Brand | $70.00 | $175.00 | None | |
Browse Plan Formulary |
|