There are 22 stand-alone Medicare Part D plans in New Hampshire 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
DEGARELIX SOLR (NDC: 55566830101) 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 |
||||||
First Health Part D-Secure |
$12.80 | $175 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $48.00 | n/a | P Q:1 /30Days | |
Browse Plan Formulary | |||||||||
AdvantraRx Value |
$13.50 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $50.00 | $150.00 | P Q:1 /30Days | |
Browse Plan Formulary | |||||||||
WellCare Classic |
$21.20 | $250 | No Gap Coverage | 3 | Tier 3 | $75.00 | $225.00 | P Q:1 /28Days | |
Browse Plan Formulary | |||||||||
First Health Part D-Premier |
$25.40 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $59.00 | n/a | P Q:1 /30Days | |
Browse Plan Formulary | |||||||||
WellCare Signature |
$28.80 | $0 | No Gap Coverage | 3 | Tier 3 | $79.00 | $237.00 | P Q:1 /28Days | |
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 |
|
CIGNA Medicare Rx Plan One |
$30.50 | $295 | No Gap Coverage | 3 | Tier 3 | $81.00 | $202.50 | P | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials |
$31.20 | $205 | No Gap Coverage | 4 | Tier 4 - Non-Preferred Brand | $67.00 | $134.00 | P Q:80 /28Days | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 1 |
$34.40 | $295 | No Gap Coverage | 4 | Injectable | 25% | n/a | P Q:1 /28Days | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Value |
$35.00 | $130 | No Gap Coverage | 5 | Tier 5. | 29% | n/a | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier |
$37.20 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $64.00 | $192.00 | P Q:1 /30Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two |
$37.20 | $0 | No Gap Coverage | 4 | Tier 4 | $80.00 | $200.00 | P | |
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 |
|
Sterling Rx |
$37.50 | $295 | No Gap Coverage | 2 | Preferred Brand | $25.00 | $50.00 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5884-092 |
$39.20 | $295 | No Gap Coverage | 3 | Other - Non-Preferred (Gen/Brand) | 45% | 45% | P Q:1 /30Days | |
Browse Plan Formulary | |||||||||
Humana PDP Enhanced S5884-095 |
$42.50 | $0 | No Gap Coverage | 4 | Specialty | 33% | n/a | P Q:1 /30Days | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Value Plus |
$45.50 | $0 | No Gap Coverage | 5 | Tier 5. | 33% | n/a | None | |
Browse Plan Formulary | |||||||||
Health Net Value Orange Option 2 |
$47.40 | $0 | No Gap Coverage | 4 | Injectable | 33% | n/a | P Q:1 /28Days | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier Plus |
$53.40 | $0 | Many Generics | 3 | Non-Preferred Generic/Non-Preferred Brand | $74.00 | $222.00 | P Q:1 /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 Plus |
$61.20 | $0 | Some Generics | 4 | Tier 4 - Non-Preferred Brand | $77.00 | $154.00 | P Q:80 /28Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three |
$67.60 | $0 | Some Generics | 3 | Tier 3 | $60.00 | $150.00 | P | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Premier |
$81.80 | $0 | Many Generics | 5 | Tier 5. | 33% | n/a | None | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5884-098 |
$100.20 | $0 | Many Generics | 4 | Specialty | 33% | n/a | P Q:1 /30Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier |
$101.70 | $0 | Many Generics | 4 | Tier 4 - Non-Preferred Brand | $65.00 | $130.00 | P Q:80 /28Days | |
Browse Plan Formulary |
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