There are 30 stand-alone Medicare Part D plans in South Dakota 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
OXYCODONE HCL ER TABLETS 80MG 100 BOT (100 BOT) (NDC: 00406059601) 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 |
$26.50 | $295 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $71.55 | $199.65 | Q:186 /31Days | |
Browse Plan Formulary | |||||||||
MedicareBlue Rx Option 1 |
$29.70 | $295 | No Gap Coverage | 1 | Level 1: Covered Generic | 10% | 10% | Q:90 /30Days | |
Browse Plan Formulary | |||||||||
Humana PDP Enhanced S5884-023 |
$29.80 | $0 | No Gap Coverage | 1 | Preferred Generic | $7.00 | $0.00 | Q:120 /30Days | |
Browse Plan Formulary | |||||||||
First Health Part D-Premier |
$30.60 | $0 | No Gap Coverage | 4 | Specialty-Generic and Brand | 33% | n/a | P | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials |
$31.20 | $180 | No Gap Coverage | 2 | Tier 2 - Non-Preferred Generic | $10.00 | $20.00 | Q:4 /1Days | |
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 - Choice |
$33.50 | $0 | No Gap Coverage | 1 | Generic | $6.00 | $6.00 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Value |
$35.20 | $295 | No Gap Coverage | 1 | Generic | 23% | 23% | None | |
Browse Plan Formulary | |||||||||
BravoRx |
$37.60 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Silver |
$38.20 | $295 | No Gap Coverage | 2 | Tier 2 Non Preferred Generics | $30.00 | $90.00 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5884-083 |
$40.60 | $295 | No Gap Coverage | 1 | Preferred Generic | 15% | 15% | Q:120 /30Days | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred |
$40.80 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $76.20 | $213.60 | Q:186 /31Days | |
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 1 |
$41.60 | $295 | No Gap Coverage | 1 | Preferred Generic | $2.00 | $4.00 | Q:4 /1Days | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier |
$42.20 | $0 | No Gap Coverage | 4 | Specialty-Generic and Brand | 33% | n/a | P | |
Browse Plan Formulary | |||||||||
UnitedHealth Rx Basic |
$44.30 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $78.00 | $219.00 | Q:186 /31Days | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Rx Covg - Silver Plan |
$45.60 | $100 | No Gap Coverage | 1 | Generic | $4.00 | $10.00 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two |
$45.90 | $0 | No Gap Coverage | 3 | Tier 3 | $38.00 | $95.00 | Q:120 /30Days | |
Browse Plan Formulary | |||||||||
Sterling Rx |
$47.40 | $295 | No Gap Coverage | 1 | Generic | $7.00 | $14.00 | Q:90 /30Days | |
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 |
$50.70 | $0 | No Gap Coverage | 1 | Generic | $5.00 | $13.00 | None | |
Browse Plan Formulary | |||||||||
Health Net Value Orange Option 2 |
$51.40 | $0 | No Gap Coverage | 1 | Preferred Generic | $0.00 | $0.00 | Q:4 /1Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan One |
$51.70 | $295 | No Gap Coverage | 2 | Tier 2 | $30.00 | $75.00 | Q:120 /30Days | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier Plus |
$57.40 | $0 | Many Generics | 4 | Specialty-Generic and Brand | 33% | n/a | P | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Plus |
$63.50 | $0 | Some Generics | 2 | Tier 2 - Non-Preferred Generic | $10.00 | $20.00 | Q:4 /1Days | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Gold |
$63.60 | $0 | No Gap Coverage | 2 | Tier 2 NonPreferred Generic | $45.00 | $135.00 | 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 |
|
MedicareBlue Rx Option 2 |
$65.60 | $0 | No Gap Coverage | 1 | Level 1: Covered Generic | $4.00 | $8.00 | Q:90 /30Days | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Access |
$69.60 | $0 | All Generics | 1 | Generic | $6.00 | $6.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced |
$71.90 | $0 | Many Generics | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $95.00 | $270.00 | Q:186 /31Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three |
$80.90 | $0 | Some Generics | 2 | Tier 2 | $35.00 | $87.50 | Q:120 /30Days | |
Browse Plan Formulary | |||||||||
MedicareBlue Rx Option 3 |
$93.50 | $0 | Many Generics | 1 | Level 1: Covered Generic | $3.00 | $6.00 | Q:90 /30Days | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5884-053 |
$99.40 | $0 | Many Generics | 1 | Preferred Generic | $7.00 | $0.00 | Q:120 /30Days | |
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 |
$106.70 | $0 | Many Generics | 2 | Tier 2 - Non-Preferred Generic | $10.00 | $20.00 | Q:4 /1Days | |
Browse Plan Formulary |
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