There are 56 stand-alone Medicare Part D plans in Pennsylvania 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
FLUPHENAZINE HCL 2.5MG/5ML ELIXIR (473 ML BOT) (NDC: 00121065416) 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![]() ![]() |
$13.70 | $175 | No Gap Coverage | 1 | Preferred Generic | $4.00 | n/a | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Value![]() ![]() |
$22.20 | $0 | No Gap Coverage | 1 | Preferred Generic | $8.00 | $16.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Saver![]() ![]() |
$22.40 | $295 | No Gap Coverage | 1 | Tier 1 - Preferred Generic | $5.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
Community CCRx Basic![]() ![]() |
$25.40 | $295 | No Gap Coverage | 1 | Generic | $0.00 | n/a | None | |
Browse Plan Formulary | |||||||||
Advantage Star Plan by RxAmerica![]() ![]() |
$27.80 | $295 | No Gap Coverage | 1 | Preferred Generic | $5.50 | $0.00 | 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 |
|
Medco Medicare Prescription Plan - Value![]() ![]() |
$28.50 | $295 | No Gap Coverage | 1 | Generic | 23% | 23% | None | |
Browse Plan Formulary | |||||||||
AmeriHealth Advantage Rx Option I![]() ![]() |
$28.60 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | n/a | None | |
Browse Plan Formulary | |||||||||
First Health Part D-Premier![]() ![]() |
$28.70 | $0 | No Gap Coverage | 1 | Preferred Generic | $7.00 | n/a | None | |
Browse Plan Formulary | |||||||||
SilverScript Value![]() ![]() |
$28.70 | $295 | No Gap Coverage | 1 | Generic | $8.00 | $12.00 | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Bronze![]() ![]() |
$28.80 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
HealthSpring Prescription Drug Plan -Reg 6![]() ![]() |
$29.90 | $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 |
|
CIGNA Medicare Rx Plan One![]() ![]() |
$30.00 | $295 | No Gap Coverage | 1 | Tier 1 | $2.50 | $6.25 | None | |
Browse Plan Formulary | |||||||||
WellCare Classic![]() ![]() |
$31.40 | $295 | No Gap Coverage | 1 | Tier 1 | $0.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
BravoRx![]() ![]() |
$31.60 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Silver![]() ![]() |
$32.00 | $295 | No Gap Coverage | 1 | Tier 1 Preferred Generic | $4.00 | $12.00 | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Gold![]() ![]() |
$32.10 | $0 | No Gap Coverage | 1 | Generic | $6.00 | $12.00 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Choice![]() ![]() |
$32.60 | $0 | No Gap Coverage | 1 | Generic | $6.00 | $6.00 | 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 |
|
MedicareRx Rewards Value![]() ![]() |
$32.90 | $130 | No Gap Coverage | 1 | Tier 1 Preferred Generic | $10.00 | $15.00 | None | |
Browse Plan Formulary | |||||||||
BlueRx Value![]() ![]() |
$33.10 | $295 | No Gap Coverage | 1 | Generic | $4.00 | $10.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials![]() ![]() |
$33.40 | $195 | No Gap Coverage | 2 | Tier 2 - Non-Preferred Generic | $11.00 | $22.00 | None | |
Browse Plan Formulary | |||||||||
WellCare Signature![]() ![]() |
$33.90 | $0 | No Gap Coverage | 1 | Tier 1 | $0.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred![]() ![]() |
$34.80 | $0 | No Gap Coverage | 1 | Tier 1-Preferred Generic | $7.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 1![]() ![]() |
$35.30 | $295 | No Gap Coverage | 1 | Preferred Generic | $2.00 | $4.00 | 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![]() ![]() |
$36.90 | $0 | No Gap Coverage | 1 | Preferred Generic | $5.00 | $10.00 | None | |
Browse Plan Formulary | |||||||||
Advantage Freedom Plan by RxAmerica![]() ![]() |
$38.30 | $0 | No Gap Coverage | 1 | Preferred Generic | $5.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Rx Covg - Silver Plan![]() ![]() |
$39.00 | $150 | No Gap Coverage | 1 | Generic | $4.00 | $10.00 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two![]() ![]() |
$39.50 | $0 | No Gap Coverage | 2 | Tier 2 | $6.00 | $15.00 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5884-064![]() ![]() |
$39.50 | $295 | No Gap Coverage | 1 | Preferred Generic | 15% | 15% | None | |
Browse Plan Formulary | |||||||||
Sterling Rx![]() ![]() |
$42.10 | $295 | No Gap Coverage | 1 | Generic | $7.00 | $14.00 | 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 |
|
UA Medicare Part D Prescription Drug Cov![]() ![]() |
$42.40 | $0 | No Gap Coverage | 1 | Generic | $5.00 | $13.00 | None | |
Browse Plan Formulary | |||||||||
Community CCRx Choice![]() ![]() |
$42.60 | $0 | No Gap Coverage | 1 | Generic | $5.00 | n/a | None | |
Browse Plan Formulary | |||||||||
SecureRx - Option 4![]() ![]() |
$43.00 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
UnitedHealth Rx Basic![]() ![]() |
$43.10 | $0 | No Gap Coverage | 1 | Tier 1 - Preferred Generic | $7.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
UPMC for Life Prescription Drug Plan![]() ![]() |
$44.10 | $0 | No Gap Coverage | 1 | Generic | $5.00 | $12.50 | None | |
Browse Plan Formulary | |||||||||
Geisinger Gold Rx 1![]() ![]() |
$44.50 | $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 |
|
SecureRx - Option 3![]() ![]() |
$44.60 | $0 | No Gap Coverage | 1 | Generic Drugs | $9.00 | $25.00 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Enhanced S5884-005![]() ![]() |
$44.90 | $0 | No Gap Coverage | 1 | Preferred Generic | $7.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
Health Net Value Orange Option 2![]() ![]() |
$46.60 | $0 | No Gap Coverage | 1 | Preferred Generic | $0.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
BlueRx Plus![]() ![]() |
$49.10 | $0 | No Gap Coverage | 1 | Generic | $5.00 | $12.50 | None | |
Browse Plan Formulary | |||||||||
SilverScript Plus![]() ![]() |
$51.50 | $50 | Many Generics | 2 | Generic | $9.00 | $23.00 | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier Plus![]() ![]() |
$52.80 | $0 | Many Generics | 1 | Preferred Generic | $4.00 | $8.00 | 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 |
|
AmeriHealth Rx Option I![]() ![]() |
$54.30 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
AmeriHealth Rx Option II![]() ![]() |
$58.90 | $0 | No Gap Coverage | 1 | Generic | $7.00 | $14.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Plus![]() ![]() |
$63.90 | $0 | Some Generics | 2 | Tier 2 - Non-Preferred Generic | $10.00 | $20.00 | None | |
Browse Plan Formulary | |||||||||
SierraRx Basic![]() ![]() |
$64.90 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Platinum![]() ![]() |
$65.00 | $0 | All Generics | 1 | Generic | $6.00 | $12.00 | None | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Gold![]() ![]() |
$66.60 | $0 | No Gap Coverage | 1 | Tier 1 Preferred Generics | $0.00 | $0.00 | 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 |
|
Medco Medicare Prescription Plan - Access![]() ![]() |
$68.30 | $0 | All Generics | 1 | Generic | $6.00 | $6.00 | None | |
Browse Plan Formulary | |||||||||
SilverScript Complete![]() ![]() |
$69.10 | $0 | Many Generics | 2 | Generic | $7.50 | $19.00 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three![]() ![]() |
$72.60 | $0 | Some Generics | 1 | Tier 1 | $6.00 | $15.00 | None | |
Browse Plan Formulary | |||||||||
Community CCRx Gold![]() ![]() |
$75.10 | $0 | All Generics | 1 | Generic | $5.00 | n/a | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced![]() ![]() |
$76.40 | $0 | Many Generics | 1 | Tier 1 - Preferred Generic | $7.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
SecureRx - Option 1![]() ![]() |
$86.90 | $0 | Many Generics | 1 | Generic Drugs | $7.00 | $17.00 | 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 Complete S5884-034![]() ![]() |
$95.40 | $0 | Many Generics | 1 | Preferred Generic | $7.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier![]() ![]() |
$99.90 | $0 | Many Generics | 2 | Tier 2 - Non-Preferred Generic | $10.00 | $20.00 | None | |
Browse Plan Formulary | |||||||||
BlueRx Complete![]() ![]() |
$108.00 | $0 | Many Generics | 1 | Generic | $5.00 | $12.50 | None | |
Browse Plan Formulary |
|