There are 20 stand-alone Medicare Part D plans in Hawaii 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
OXACILLIN 1GM/50ML INJ (50 ML BAG) (NDC: 00338101341) 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 |
||||||
AARP MedicareRx Saver |
$19.90 | $295 | No Gap Coverage | 4 | Tier 4 - Specialty (Generic, Brand) | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 1 |
$26.60 | $295 | No Gap Coverage | 4 | Injectable | 25% | n/a | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan One |
$27.60 | $295 | No Gap Coverage | 2 | Tier 2 | $33.00 | $82.50 | None | |
Browse Plan Formulary | |||||||||
SilverScript Value |
$28.10 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | $98.00 | $269.50 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5884-093 |
$30.70 | $295 | No Gap Coverage | 1 | Preferred Generic | 15% | 15% | 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 Preferred |
$34.60 | $0 | No Gap Coverage | 4 | Tier 4 - Specialty (Generic, Brand) | 33% | 30% | None | |
Browse Plan Formulary | |||||||||
MedicareRx Rewards Value |
$34.60 | $130 | No Gap Coverage | 4 | Tier 4 Non-Specialty Injectable | 29% | 29% | None | |
Browse Plan Formulary | |||||||||
Humana PDP Enhanced S5884-096 |
$36.30 | $0 | No Gap Coverage | 1 | Preferred Generic | $7.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 2 |
$36.90 | $0 | No Gap Coverage | 4 | Injectable | 33% | n/a | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials |
$38.10 | $200 | No Gap Coverage | 4 | Tier 4 - Non-Preferred Brand | $67.00 | $134.00 | None | |
Browse Plan Formulary | |||||||||
Sterling Rx |
$41.40 | $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 |
$44.60 | $0 | No Gap Coverage | 4 | Tier 4 - Specialty (Generic, Brand) | 33% | 30% | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two |
$45.30 | $0 | No Gap Coverage | 3 | Tier 3 | $47.00 | $117.50 | None | |
Browse Plan Formulary | |||||||||
SilverScript Plus |
$49.10 | $50 | Many Generics | 5 | Non-Preferred Brand | $95.00 | $261.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx - Costco Plus Plan |
$62.70 | $0 | Some Generics | 4 | Tier 4 - Non-Preferred Brand | $90.00 | $180.00 | None | |
Browse Plan Formulary | |||||||||
SilverScript Complete |
$63.40 | $0 | Many Generics | 4 | Non-Preferred Brand | $98.00 | $270.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced |
$73.00 | $0 | Many Generics | 4 | Tier 4 - Specialty (Generic, Brand) | 33% | 30% | 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 Three |
$88.70 | $0 | Some Generics | 2 | Tier 2 | $35.00 | $87.50 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5884-099 |
$94.70 | $0 | Many Generics | 1 | Preferred Generic | $7.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier |
$111.10 | $0 | Many Generics | 4 | Tier 4 - Non-Preferred Brand | $65.00 | $130.00 | None | |
Browse Plan Formulary |
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