There are 35 stand-alone Medicare Part D plans in New York 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
PIPERACILLIN 4GM VIAL (10 X 4 GM VIALSD) (NDC: 63323039050) 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 |
||||||
GHI Medicare Prescription Drug Plan |
$19.60 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | P Q:40 /10Days | |
Browse Plan Formulary | |||||||||
HIP Part D New York |
$21.00 | $295 | No Gap Coverage | 1 | Tier 1 | $5.00 | $10.00 | P Q:40 /10Days | |
Browse Plan Formulary | |||||||||
SilverScript Value |
$26.10 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | $98.00 | $269.50 | None | |
Browse Plan Formulary | |||||||||
First Health Part D-Secure |
$26.40 | $175 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $47.00 | n/a | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan One |
$27.30 | $295 | No Gap Coverage | 2 | Tier 2 | $25.00 | $62.50 | 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 |
|
WellCare Classic |
$28.40 | $295 | No Gap Coverage | 1 | Tier 1 | $0.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 1 |
$28.50 | $295 | No Gap Coverage | 4 | Injectable | 25% | n/a | None | |
Browse Plan Formulary | |||||||||
First Health Part D-Premier |
$29.30 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $52.00 | n/a | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Value |
$30.60 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $55.00 | $165.00 | None | |
Browse Plan Formulary | |||||||||
HealthSpring Prescription Drug Plan -Reg 3 |
$31.00 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Silver |
$32.00 | $295 | No Gap Coverage | 4 | Tier 4 NonPreferred Brand | $75.00 | $225.00 | 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 |
|
Sterling Rx |
$32.10 | $295 | No Gap Coverage | 1 | Generic | $7.00 | $14.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials |
$32.70 | $205 | No Gap Coverage | 1 | Tier 1 - Preferred Generic | $0.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Saver |
$33.80 | $295 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $55.80 | $152.40 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred |
$34.80 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $80.75 | $227.25 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Enhanced S5552-001 |
$36.00 | $0 | No Gap Coverage | 1 | Preferred Generic | $7.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
MedicareRx Rewards Value |
$37.60 | $130 | No Gap Coverage | 4 | Tier 4 Non-Specialty Injectable | 29% | 29% | 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 |
|
WellCare Signature |
$37.60 | $0 | No Gap Coverage | 1 | Tier 1 | $0.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
HIP Enhanced Part D New York |
$39.00 | $0 | Many Generics | 1 | Tier 1 | $5.00 | $10.00 | P Q:40 /10Days | |
Browse Plan Formulary | |||||||||
Simply Prescriptions Rx 1 |
$42.80 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two |
$45.00 | $0 | No Gap Coverage | 3 | Tier 3 | $38.00 | $95.00 | None | |
Browse Plan Formulary | |||||||||
UnitedHealth Rx Basic |
$45.20 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $98.00 | $279.00 | None | |
Browse Plan Formulary | |||||||||
SilverScript Plus |
$45.40 | $50 | Many Generics | 5 | Non-Preferred Brand | $95.00 | $261.00 | 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 |
|
Simply Prescriptions Rx 3 |
$48.10 | $100 | No Gap Coverage | 1 | Generics | $5.00 | $12.50 | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier |
$48.20 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $72.00 | $216.00 | None | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 2 |
$48.40 | $0 | No Gap Coverage | 4 | Injectable | 33% | n/a | None | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5552-003 |
$55.20 | $295 | No Gap Coverage | 1 | Preferred Generic | 10% | 10% | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier Plus |
$65.90 | $0 | Many Generics | 3 | Non-Preferred Generic/Non-Preferred Brand | $75.00 | $225.00 | None | |
Browse Plan Formulary | |||||||||
SilverScript Complete |
$68.10 | $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 |
|
Aetna Medicare Rx - Costco Plus Plan |
$69.50 | $0 | Some Generics | 1 | Tier 1 - Preferred Generic | $0.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Gold |
$70.60 | $0 | No Gap Coverage | 4 | Tier 4 NonPreferred Brand | $75.00 | $225.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced |
$75.50 | $0 | Many Generics | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $95.00 | $270.00 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three |
$78.70 | $0 | Some Generics | 2 | Tier 2 | $35.00 | $87.50 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5552-002 |
$100.80 | $0 | Many Generics | 1 | Preferred Generic | $7.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier |
$136.80 | $0 | Many Generics | 1 | Tier 1 - Preferred Generic | $0.00 | $0.00 | None | |
Browse Plan Formulary |
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