There are 13 stand-alone Medicare Part D plans in Louisiana 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
PRILOSEC 20MG CAPSULE DR (NDC: 00186074282) 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 |
||||||
SilverScript Value |
$24.00 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | $98.00 | $269.50 | S Q:90 /365Days | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 1 |
$30.00 | $295 | No Gap Coverage | 2 | Preferred Brand | $41.00 | $82.00 | Q:2 /1Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials |
$30.70 | $200 | No Gap Coverage | 4 | Tier 4 - Non-Preferred Brand | $67.00 | $134.00 | S Q:1 /1Days | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred |
$37.50 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $66.25 | $183.75 | None | |
Browse Plan Formulary | |||||||||
Sterling Rx |
$39.80 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | $58.00 | $116.00 | S Q:34 /34Days | |
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 |
$40.30 | $0 | No Gap Coverage | 2 | Preferred Brand | $39.00 | $78.00 | Q:2 /1Days | |
Browse Plan Formulary | |||||||||
RxBLUE |
$45.30 | $0 | No Gap Coverage | 3 | Non-Preferred Brand | $73.00 | $219.00 | S Q:34 /34Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Plus |
$59.70 | $0 | Some Generics | 4 | Tier 4 - Non-Preferred Brand | $76.00 | $152.00 | S Q:1 /1Days | |
Browse Plan Formulary | |||||||||
SilverScript Plus |
$59.80 | $50 | Many Generics | 5 | Non-Preferred Brand | $95.00 | $261.00 | Q:90 /365Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three |
$69.90 | $0 | Some Generics | 3 | Tier 3 | $60.00 | $150.00 | S Q:60 /30Days | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced |
$73.60 | $0 | Many Generics | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $82.00 | $231.00 | 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 |
|
SilverScript Complete |
$79.90 | $0 | Many Generics | 4 | Non-Preferred Brand | $98.00 | $270.00 | Q:90 /365Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier |
$92.10 | $0 | Many Generics | 4 | Tier 4 - Non-Preferred Brand | $65.00 | $130.00 | S Q:1 /1Days | |
Browse Plan Formulary |
|