There are 21 stand-alone Medicare Part D plans in Missouri 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
VICODIN HP TABLET 10-660 (500 BOTPL) (NDC: 00074227454) 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 |
||||||
Community CCRx Basic |
$27.70 | $295 | No Gap Coverage | 1 | Generic | $0.00 | n/a | Q:181 /30Days | |
Browse Plan Formulary | |||||||||
HealthSpring Prescription Drug Plan-Reg 18 |
$30.50 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | Q:180 /30Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials |
$30.80 | $200 | No Gap Coverage | 1 | Tier 1 - Preferred Generic | $0.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Gold |
$33.20 | $0 | No Gap Coverage | 1 | Generic | $6.00 | $12.00 | Q:181 /30Days | |
Browse Plan Formulary | |||||||||
Advantage Star Plan by RxAmerica |
$34.70 | $295 | No Gap Coverage | 1 | Preferred Generic | $5.00 | $0.00 | 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 |
$36.30 | $295 | No Gap Coverage | 1 | Generic | $8.00 | $12.00 | None | |
Browse Plan Formulary | |||||||||
Advantage Freedom Plan by RxAmerica |
$37.10 | $0 | No Gap Coverage | 1 | Preferred Generic | $4.75 | $0.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred |
$37.80 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $83.00 | $234.00 | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Bronze |
$37.90 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | Q:181 /30Days | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 1 |
$39.00 | $295 | No Gap Coverage | 1 | Preferred Generic | $2.00 | $4.00 | None | |
Browse Plan Formulary | |||||||||
Sterling Rx |
$41.70 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | $58.00 | $116.00 | 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 |
|
Community CCRx Choice |
$43.30 | $0 | No Gap Coverage | 1 | Generic | $5.00 | n/a | Q:181 /30Days | |
Browse Plan Formulary | |||||||||
SilverScript Plus |
$56.00 | $50 | Many Generics | 2 | Generic | $9.00 | $23.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Plus |
$61.00 | $0 | Some Generics | 1 | Tier 1 - Preferred Generic | $0.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 2 |
$61.20 | $0 | No Gap Coverage | 1 | Preferred Generic | $5.00 | $10.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced |
$69.10 | $0 | Many Generics | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $95.00 | $270.00 | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Platinum |
$73.50 | $0 | All Generics | 1 | Generic | $6.00 | $12.00 | Q:181 /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 Complete |
$75.30 | $0 | Many Generics | 2 | Generic | $7.50 | $19.00 | None | |
Browse Plan Formulary | |||||||||
Community CCRx Gold |
$75.70 | $0 | All Generics | 1 | Generic | $5.00 | n/a | Q:181 /30Days | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Premier |
$77.10 | $0 | Many Generics | 3 | Tier 3 Non-Preferred Brand or Generic | $75.00 | $187.50 | Q:180 /30Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier |
$106.80 | $0 | Many Generics | 1 | Tier 1 - Preferred Generic | $0.00 | $0.00 | None | |
Browse Plan Formulary |
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