There are 35 stand-alone Medicare Part D plans in New Jersey 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
VIBRAMYCIN 50MG/5ML SYRUP (1 PT BOT) (NDC: 00069097193) 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 |
||||||
Fox Value Plan |
$24.60 | $295 | No Gap Coverage | 4 | Tier 4 | $75.00 | $225.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Saver |
$26.10 | $295 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $61.25 | $168.75 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Value |
$27.70 | $295 | No Gap Coverage | 2 | Preferred Brand | 23% | 23% | None | |
Browse Plan Formulary | |||||||||
First Health Part D-Premier |
$29.10 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $52.00 | n/a | None | |
Browse Plan Formulary | |||||||||
SilverScript Value |
$29.40 | $295 | No Gap Coverage | 2 | Preferred Brand | $39.00 | $87.75 | 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 |
|
AmeriHealth NJ Rx Option I |
$32.20 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | $88.00 | $264.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials |
$32.90 | $220 | No Gap Coverage | 4 | Tier 4 - Non-Preferred Brand | $63.00 | $126.00 | P | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 1 |
$32.90 | $295 | No Gap Coverage | 2 | Preferred Brand | $40.00 | $80.00 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Enhanced S5884-003 |
$33.70 | $0 | No Gap Coverage | 3 | Non-Preferred Brand | $70.00 | $175.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred |
$36.90 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $75.10 | $210.30 | None | |
Browse Plan Formulary | |||||||||
Sterling Rx |
$38.70 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | $58.00 | $116.00 | 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 |
|
Humana PDP Standard S5884-062 |
$38.90 | $295 | No Gap Coverage | 3 | Other - Non-Preferred (Gen/Brand) | 40% | 40% | None | |
Browse Plan Formulary | |||||||||
BravoRx |
$39.20 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
AmeriHealth NJ Rx Option II |
$40.20 | $0 | No Gap Coverage | 3 | Non-Preferred Brand | $70.00 | $140.00 | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier |
$40.80 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $69.00 | $207.00 | None | |
Browse Plan Formulary | |||||||||
UnitedHealth Rx Basic |
$41.40 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $98.00 | $279.00 | None | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Rx Covg - Silver Plan |
$41.50 | $160 | No Gap Coverage | 2 | Preferred Brand | $40.00 | $100.00 | 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 |
|
Fox Grand Plan |
$41.60 | $285 | Some Generics | 4 | Tier 4 | $75.00 | $150.00 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Choice |
$41.60 | $0 | No Gap Coverage | 2 | Preferred Brand | $38.00 | $95.00 | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Gold |
$42.70 | $0 | No Gap Coverage | 2 | Brand | $44.00 | $88.00 | None | |
Browse Plan Formulary | |||||||||
Community CCRx Basic |
$43.90 | $295 | No Gap Coverage | 2 | Preferred Brand | 25% | n/a | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Bronze |
$44.70 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Prescription Drug Cov |
$45.90 | $0 | No Gap Coverage | 2 | Preferred Brand | $33.00 | $66.00 | 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 |
$50.10 | $50 | Many Generics | 4 | Preferred Brand | $35.00 | $82.00 | None | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 2 |
$52.10 | $0 | No Gap Coverage | 2 | Preferred Brand | $30.00 | $60.00 | None | |
Browse Plan Formulary | |||||||||
Community CCRx Choice |
$56.40 | $0 | No Gap Coverage | 2 | Preferred Brand | $30.00 | n/a | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier Plus |
$56.80 | $0 | Many Generics | 3 | Non-Preferred Generic/Non-Preferred Brand | $71.00 | $213.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Plus |
$66.00 | $0 | Some Generics | 4 | Tier 4 - Non-Preferred Brand | $76.00 | $152.00 | P | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Access |
$71.40 | $0 | All Generics | 2 | Preferred Brand | $35.00 | $87.50 | 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 |
|
AARP MedicareRx Enhanced |
$73.30 | $0 | Many Generics | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $95.00 | $270.00 | None | |
Browse Plan Formulary | |||||||||
SilverScript Complete |
$74.30 | $0 | Many Generics | 3 | Preferred Brand | $39.00 | $92.00 | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Platinum |
$74.90 | $0 | All Generics | 2 | Brand | $44.00 | $88.00 | None | |
Browse Plan Formulary | |||||||||
Community CCRx Gold |
$76.50 | $0 | All Generics | 2 | Preferred Brand | $30.00 | n/a | None | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5884-032 |
$98.80 | $0 | Many Generics | 3 | Non-Preferred Brand | $70.00 | $175.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier |
$130.20 | $0 | Many Generics | 4 | Tier 4 - Non-Preferred Brand | $65.00 | $130.00 | P | |
Browse Plan Formulary |
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