There are 35 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
ZOVIRAX 5% CREAM (5 GM TUBE) (NDC: 64455099445) 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 | None | |
Browse Plan Formulary | |||||||||
HealthSpring Prescription Drug Plan-Reg 25 |
$27.70 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
Humana PDP Enhanced S5884-023 |
$29.80 | $0 | No Gap Coverage | 3 | Non-Preferred Brand | $70.00 | $175.00 | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Bronze |
$30.70 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | Q:5 /30Days | |
Browse Plan Formulary | |||||||||
Community CCRx Basic |
$31.00 | $295 | No Gap Coverage | 2 | Preferred Brand | 30% | n/a | Q:5 /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 Essentials |
$31.20 | $180 | No Gap Coverage | 4 | Tier 4 - Non-Preferred Brand | $62.00 | $124.00 | None | |
Browse Plan Formulary | |||||||||
SilverScript Value |
$31.80 | $295 | No Gap Coverage | 2 | Preferred Brand | $34.75 | $78.25 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Choice |
$33.50 | $0 | No Gap Coverage | 3 | Non-Preferred Brand | 75% | 75% | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Value |
$35.20 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | 53% | 53% | None | |
Browse Plan Formulary | |||||||||
MedicareRx Rewards Value |
$35.50 | $130 | No Gap Coverage | 2 | Tier 2 Preferred Brand | $41.50 | $103.75 | None | |
Browse Plan Formulary | |||||||||
WellCare Classic |
$36.90 | $295 | No Gap Coverage | 3 | Tier 3 | $82.00 | $246.00 | 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 |
|
BravoRx |
$37.60 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Gold |
$38.40 | $0 | No Gap Coverage | 2 | Brand | $44.00 | $88.00 | Q:5 /30Days | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5884-083 |
$40.60 | $295 | No Gap Coverage | 3 | Other - Non-Preferred (Gen/Brand) | 48% | 48% | None | |
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 | |||||||||
Health Net Orange Option 1 |
$41.60 | $295 | No Gap Coverage | 2 | Preferred Brand | $44.00 | $88.00 | None | |
Browse Plan Formulary | |||||||||
UnitedHealth Rx Basic |
$44.30 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $78.00 | $219.00 | 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 |
|
WellCare Signature |
$45.50 | $0 | No Gap Coverage | 3 | Tier 3 | $79.00 | $237.00 | None | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Rx Covg - Silver Plan |
$45.60 | $100 | No Gap Coverage | 3 | Non-Preferred Brand | $80.00 | $200.00 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two |
$45.90 | $0 | No Gap Coverage | 4 | Tier 4 | $85.00 | $212.50 | None | |
Browse Plan Formulary | |||||||||
Community CCRx Choice |
$46.60 | $0 | No Gap Coverage | 2 | Preferred Brand | $30.00 | n/a | Q:5 /30Days | |
Browse Plan Formulary | |||||||||
Sterling Rx |
$47.40 | $295 | No Gap Coverage | 2 | Preferred Brand | $25.00 | $50.00 | None | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Prescription Drug Cov |
$50.70 | $0 | No Gap Coverage | 3 | 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 |
|
Health Net Value Orange Option 2 |
$51.40 | $0 | No Gap Coverage | 2 | Preferred Brand | $39.00 | $78.00 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan One |
$51.70 | $295 | No Gap Coverage | 3 | Tier 3 | $87.00 | $217.50 | None | |
Browse Plan Formulary | |||||||||
SilverScript Plus |
$61.30 | $50 | Many Generics | 4 | Preferred Brand | $35.00 | $82.00 | None | |
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 | |||||||||
Community CCRx Gold |
$69.20 | $0 | All Generics | 2 | Preferred Brand | $30.00 | n/a | Q:5 /30Days | |
Browse Plan Formulary | |||||||||
Prescriba Rx Platinum |
$69.30 | $0 | All Generics | 2 | Brand | $44.00 | $88.00 | Q:5 /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 |
|
Medco Medicare Prescription Plan - Access |
$69.60 | $0 | All Generics | 3 | Non-Preferred Brand | 75% | 75% | 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 | 3 | Tier 3 | $60.00 | $150.00 | None | |
Browse Plan Formulary | |||||||||
SilverScript Complete |
$83.40 | $0 | Many Generics | 3 | Preferred Brand | $39.00 | $92.00 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5884-053 |
$99.40 | $0 | Many Generics | 3 | Non-Preferred Brand | $70.00 | $175.00 | None | |
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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