There are 30 stand-alone Medicare Part D plans in Indiana 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
LANREOTIDE INJECTION 30MG (NDC: 15054009001) 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 |
$16.80 | $175 | No Gap Coverage | 4 | Specialty-Generic and Brand | 28% | n/a | P Q:1 /28Days | |
Browse Plan Formulary | |||||||||
AdvantraRx Value |
$24.40 | $0 | No Gap Coverage | 4 | Specialty-Generic and Brand | 33% | n/a | P Q:1 /28Days | |
Browse Plan Formulary | |||||||||
SilverScript Value |
$28.00 | $295 | No Gap Coverage | 4 | Specialty | 25% | n/a | P | |
Browse Plan Formulary | |||||||||
First Health Part D-Premier |
$28.10 | $0 | No Gap Coverage | 4 | Specialty-Generic and Brand | 33% | n/a | P Q:1 /28Days | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Saver |
$28.20 | $295 | No Gap Coverage | 4 | Tier 4 - Specialty (Generic, Brand) | 25% | 25% | P | |
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 |
$28.90 | $295 | No Gap Coverage | 4 | Specialty | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
BravoRx |
$32.50 | $295 | No Gap Coverage | 3 | Tier 3 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan One |
$33.50 | $295 | No Gap Coverage | 4 | Tier 4 | 25% | 25% | P | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials |
$33.90 | $200 | No Gap Coverage | 5 | Tier 5 - Specialty | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 1 |
$34.80 | $295 | No Gap Coverage | 5 | Specialty | 25% | n/a | P Q:1 /28Days | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Choice |
$35.10 | $0 | No Gap Coverage | 4 | Specialty | 33% | 33% | 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 |
$40.50 | $0 | No Gap Coverage | 4 | Specialty-Generic and Brand | 33% | n/a | P Q:1 /28Days | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Rx Covg - Silver Plan |
$40.70 | $130 | No Gap Coverage | 4 | Specialty | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two |
$41.20 | $0 | No Gap Coverage | 5 | Tier 5 | 33% | 33% | P | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred |
$41.90 | $0 | No Gap Coverage | 4 | Tier 4 - Specialty (Generic, Brand) | 33% | 30% | P | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5884-073 |
$42.10 | $295 | No Gap Coverage | 3 | Other - Non-Preferred (Gen/Brand) | 47% | 47% | P Q:1 /28Days | |
Browse Plan Formulary | |||||||||
Sterling Rx |
$42.40 | $295 | No Gap Coverage | 4 | Specialty | 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 |
|
UnitedHealth Rx Basic |
$44.00 | $0 | No Gap Coverage | 4 | Tier 4 - Specialty (Generic, Brand) | 33% | 30% | P | |
Browse Plan Formulary | |||||||||
Humana PDP Enhanced S5884-013 |
$47.90 | $0 | No Gap Coverage | 4 | Specialty | 33% | n/a | P Q:1 /28Days | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Prescription Drug Cov |
$48.70 | $0 | No Gap Coverage | 4 | Specialty | 33% | 33% | None | |
Browse Plan Formulary | |||||||||
SilverScript Plus |
$51.30 | $50 | Many Generics | 6 | Specialty | 31% | n/a | P | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier Plus |
$55.50 | $0 | Many Generics | 4 | Specialty-Generic and Brand | 33% | n/a | P Q:1 /28Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Plus |
$58.80 | $0 | Some Generics | 5 | Tier 5 - Specialty | 33% | 33% | 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 |
|
Health Net Orange Option 2 |
$62.00 | $0 | No Gap Coverage | 5 | Specialty | 33% | n/a | P Q:1 /28Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three |
$66.10 | $0 | Some Generics | 4 | Tier 4 | 33% | 33% | P | |
Browse Plan Formulary | |||||||||
SilverScript Complete |
$66.90 | $0 | Many Generics | 5 | Specialty | 33% | n/a | P | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Access |
$71.30 | $0 | All Generics | 4 | Specialty | 33% | 33% | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced |
$71.70 | $0 | Many Generics | 4 | Tier 4 - Specialty (Generic, Brand) | 33% | 30% | P | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5884-043 |
$98.40 | $0 | Many Generics | 4 | Specialty | 33% | n/a | P Q:1 /28Days | |
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 Premier |
$100.90 | $0 | Many Generics | 5 | Tier 5 - Specialty | 33% | 33% | None | |
Browse Plan Formulary |
|