There are 33 stand-alone Medicare Part D plans in Virginia 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
ISOLYTE M IN 5% DEXTROSE INJECTION (12 X 1000 ML BAG) (NDC: 00264772000) 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 |
||||||
SilverScript Value |
$26.90 | $295 | No Gap Coverage | 1 | Generic | $8.00 | $12.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Saver |
$27.10 | $295 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $62.00 | $171.00 | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Bronze |
$28.00 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 1 |
$28.40 | $295 | No Gap Coverage | 4 | Injectable | 25% | n/a | P | |
Browse Plan Formulary | |||||||||
HealthSpring Prescription Drug Plan -Reg 7 |
$29.00 | $295 | No Gap Coverage | 1 | Tier 1 | 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 |
|
Community CCRx Basic |
$30.30 | $295 | No Gap Coverage | 1 | Generic | $0.00 | n/a | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan One |
$30.80 | $295 | No Gap Coverage | 2 | Tier 2 | $30.00 | $75.00 | P | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Silver |
$31.40 | $295 | No Gap Coverage | 3 | Tier 3 Preferred Brand | $22.00 | $66.00 | None | |
Browse Plan Formulary | |||||||||
WellCare Classic |
$32.20 | $295 | No Gap Coverage | 2 | Tier 2 | $34.00 | $102.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials |
$32.30 | $200 | No Gap Coverage | 4 | Tier 4 - Non-Preferred Brand | $67.00 | $134.00 | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Gold |
$34.00 | $0 | No Gap Coverage | 1 | Generic | $6.00 | $12.00 | 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 |
|
Blue MedicareRx Value |
$35.30 | $130 | No Gap Coverage | 4 | Tier 4 Non-Specialty Injectable | 29% | 29% | None | |
Browse Plan Formulary | |||||||||
Humana PDP Enhanced S5884-006 |
$35.70 | $0 | No Gap Coverage | 3 | Non-Preferred Brand | $70.00 | $175.00 | None | |
Browse Plan Formulary | |||||||||
WellCare Signature |
$36.70 | $0 | No Gap Coverage | 2 | Tier 2 | $39.00 | $117.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred |
$38.20 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $80.30 | $225.90 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5884-065 |
$38.90 | $295 | No Gap Coverage | 3 | Other - Non-Preferred (Gen/Brand) | 45% | 45% | None | |
Browse Plan Formulary | |||||||||
UnitedHealth Rx Basic |
$39.30 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $97.00 | $276.00 | 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 |
|
CIGNA Medicare Rx Plan Two |
$39.80 | $0 | No Gap Coverage | 3 | Tier 3 | $38.00 | $95.00 | P | |
Browse Plan Formulary | |||||||||
Sterling Rx |
$40.10 | $295 | No Gap Coverage | 2 | Preferred Brand | $25.00 | $50.00 | None | |
Browse Plan Formulary | |||||||||
Health Net Value Orange Option 2 |
$40.90 | $0 | No Gap Coverage | 4 | Injectable | 33% | n/a | P | |
Browse Plan Formulary | |||||||||
Community CCRx Choice |
$44.10 | $0 | No Gap Coverage | 1 | Generic | $5.00 | n/a | None | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Plus |
$44.40 | $0 | No Gap Coverage | 4 | Tier 4 Non-Specialty Injectable | 33% | 33% | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx - Costco Plus Plan |
$53.20 | $0 | Some Generics | 4 | Tier 4 - Non-Preferred Brand | $90.00 | $180.00 | 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 Plus |
$59.00 | $50 | Many Generics | 2 | Generic | $9.00 | $23.00 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three |
$61.70 | $0 | Some Generics | 2 | Tier 2 | $35.00 | $87.50 | P | |
Browse Plan Formulary | |||||||||
Community CCRx Gold |
$64.20 | $0 | All Generics | 1 | Generic | $5.00 | n/a | None | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Gold |
$67.00 | $0 | No Gap Coverage | 3 | Tier 3 Preferred Brand | $40.00 | $120.00 | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Platinum |
$68.50 | $0 | All Generics | 1 | Generic | $6.00 | $12.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced |
$72.60 | $0 | Many Generics | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $95.00 | $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 |
|
SilverScript Complete |
$75.10 | $0 | Many Generics | 2 | Generic | $7.50 | $19.00 | None | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Premier |
$82.80 | $0 | Many Generics | 4 | Tier 4 Non-Specialty Injectable | 33% | 33% | None | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5884-035 |
$93.20 | $0 | Many Generics | 3 | Non-Preferred Brand | $70.00 | $175.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier |
$107.10 | $0 | Many Generics | 4 | Tier 4 - Non-Preferred Brand | $65.00 | $130.00 | None | |
Browse Plan Formulary |
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