There are 17 stand-alone Medicare Part D plans in Montana 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
RETIN-A MICRO 0.04% GEL (45 GM TUBE) (NDC: 00062020403) 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 |
||||||
AdvantraRx Value![]() ![]() |
$24.60 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $55.00 | $165.00 | Q:20 /30Days | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Saver![]() ![]() |
$26.50 | $295 | No Gap Coverage | 2 | Tier 2 - Generic and Preferred Brand | $22.00 | $51.00 | None | |
Browse Plan Formulary | |||||||||
HealthSpring Prescription Drug Plan-Reg 25![]() ![]() |
$27.70 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | P Q:45 /30Days | |
Browse Plan Formulary | |||||||||
First Health Part D-Premier![]() ![]() |
$30.60 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $54.00 | n/a | Q:20 /30Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials![]() ![]() |
$31.20 | $180 | No Gap Coverage | 4 | Tier 4 - Non-Preferred Brand | $62.00 | $124.00 | 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 Value![]() ![]() |
$31.80 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | $98.00 | $269.50 | P | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred![]() ![]() |
$40.80 | $0 | No Gap Coverage | 2 | Tier 2 - Generic and Preferred Brand | $38.00 | $99.00 | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier![]() ![]() |
$42.20 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $65.00 | $195.00 | Q:20 /30Days | |
Browse Plan Formulary | |||||||||
UnitedHealth Rx Basic![]() ![]() |
$44.30 | $0 | No Gap Coverage | 2 | Tier 2 - Generic and Preferred Brand | $35.00 | $90.00 | None | |
Browse Plan Formulary | |||||||||
Sterling Rx![]() ![]() |
$47.40 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | $57.00 | $114.00 | P | |
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AdvantraRx Premier Plus![]() ![]() |
$57.40 | $0 | Many Generics | 3 | Non-Preferred Generic/Non-Preferred Brand | $73.00 | $219.00 | Q:20 /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 |
|
SilverScript Plus![]() ![]() |
$61.30 | $50 | Many Generics | 5 | Non-Preferred Brand | $95.00 | $261.00 | P | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Plus![]() ![]() |
$63.50 | $0 | Some Generics | 4 | Tier 4 - Non-Preferred Brand | $77.00 | $154.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced![]() ![]() |
$71.90 | $0 | Many Generics | 2 | Tier 2 - Generic and Preferred Brand | $39.00 | $102.00 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three![]() ![]() |
$80.90 | $0 | Some Generics | 2 | Tier 2 | $35.00 | $87.50 | P | |
Browse Plan Formulary | |||||||||
SilverScript Complete![]() ![]() |
$83.40 | $0 | Many Generics | 4 | Non-Preferred Brand | $98.00 | $270.00 | P | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier![]() ![]() |
$106.70 | $0 | Many Generics | 4 | Tier 4 - Non-Preferred Brand | $65.00 | $130.00 | None | |
Browse Plan Formulary |
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