There are 11 stand-alone Medicare Part D plans in Nebraska 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
PERCOCET 10/650MG TABLET (100 BOT) (NDC: 63481062270) 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 |
||||||
Aetna Medicare Rx Essentials |
$31.20 | $180 | No Gap Coverage | 4 | Tier 4 - Non-Preferred Brand | $62.00 | $124.00 | S | |
Browse Plan Formulary | |||||||||
SilverScript Value |
$31.80 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | $98.00 | $269.50 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred |
$40.80 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $76.20 | $213.60 | None | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 1 |
$41.60 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | $90.00 | $225.00 | None | |
Browse Plan Formulary | |||||||||
Sterling Rx |
$47.40 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | $57.00 | $114.00 | 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 |
|
Health Net Value Orange Option 2 |
$51.40 | $0 | No Gap Coverage | 3 | Non-Preferred Brand | $75.00 | $188.00 | None | |
Browse Plan Formulary | |||||||||
SilverScript Plus |
$61.30 | $50 | Many Generics | 5 | Non-Preferred Brand | $95.00 | $261.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Plus |
$63.50 | $0 | Some Generics | 4 | Tier 4 - Non-Preferred Brand | $77.00 | $154.00 | S | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced |
$71.90 | $0 | Many Generics | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $95.00 | $270.00 | None | |
Browse Plan Formulary | |||||||||
SilverScript Complete |
$83.40 | $0 | Many Generics | 4 | Non-Preferred Brand | $98.00 | $270.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier |
$106.70 | $0 | Many Generics | 4 | Tier 4 - Non-Preferred Brand | $65.00 | $130.00 | S | |
Browse Plan Formulary |
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