There are 33 stand-alone Medicare Part D plans in Vermont 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
SOMATULINE DEPOT FOR INJECTION 120MG/0.5ML (NDC: 15054012002) 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![]() ![]() |
$19.40 | $175 | No Gap Coverage | 4 | Specialty-Generic and Brand | 28% | n/a | P Q:1 /28Days | |
Browse Plan Formulary | |||||||||
AdvantraRx Value![]() ![]() |
$25.30 | $0 | No Gap Coverage | 4 | Specialty-Generic and Brand | 33% | n/a | P Q:1 /28Days | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Saver![]() ![]() |
$26.30 | $295 | No Gap Coverage | 4 | Tier 4 - Specialty (Generic, Brand) | 25% | 25% | P | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Value![]() ![]() |
$28.20 | $295 | No Gap Coverage | 4 | Specialty | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
SilverScript Value![]() ![]() |
$28.30 | $295 | No Gap Coverage | 4 | Specialty | 25% | n/a | 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 |
|
First Health Part D-Premier![]() ![]() |
$28.40 | $0 | No Gap Coverage | 4 | Specialty-Generic and Brand | 33% | n/a | P Q:1 /28Days | |
Browse Plan Formulary | |||||||||
BravoRx![]() ![]() |
$30.20 | $295 | No Gap Coverage | 3 | Tier 3 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan One![]() ![]() |
$30.60 | $295 | No Gap Coverage | 4 | Tier 4 | 25% | 25% | P | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 1![]() ![]() |
$31.70 | $295 | No Gap Coverage | 5 | Specialty | 25% | n/a | P Q:1 /28Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials![]() ![]() |
$31.80 | $195 | No Gap Coverage | 5 | Tier 5 - Specialty | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Rx Covg - Silver Plan![]() ![]() |
$36.90 | $180 | No Gap Coverage | 4 | Specialty | 25% | 25% | 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 |
|
Sterling Rx![]() ![]() |
$37.00 | $295 | No Gap Coverage | 4 | Specialty | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred![]() ![]() |
$38.50 | $0 | No Gap Coverage | 4 | Tier 4 - Specialty (Generic, Brand) | 33% | 30% | P | |
Browse Plan Formulary | |||||||||
Humana PDP Enhanced S5884-002![]() ![]() |
$39.30 | $0 | No Gap Coverage | 4 | Specialty | 33% | n/a | P Q:1 /28Days | |
Browse Plan Formulary | |||||||||
UnitedHealth Rx Basic![]() ![]() |
$39.90 | $0 | No Gap Coverage | 4 | Tier 4 - Specialty (Generic, Brand) | 33% | 30% | P | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Prescription Drug Cov![]() ![]() |
$41.00 | $0 | No Gap Coverage | 4 | Specialty | 33% | 33% | None | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5884-061![]() ![]() |
$41.40 | $295 | No Gap Coverage | 3 | Other - Non-Preferred (Gen/Brand) | 47% | 47% | 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 |
|
Blue MedicareRx Value![]() ![]() |
$41.70 | $295 | No Gap Coverage | 4 | Tier 4 Specialty | 25% | 25% | P | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two![]() ![]() |
$42.80 | $0 | No Gap Coverage | 5 | Tier 5 | 33% | 33% | P | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Value Plus![]() ![]() |
$43.30 | $0 | No Gap Coverage | 4 | Tier 4 Specialty | 33% | 33% | P | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier![]() ![]() |
$43.60 | $0 | No Gap Coverage | 4 | Specialty-Generic and Brand | 33% | n/a | P Q:1 /28Days | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 2![]() ![]() |
$46.20 | $0 | No Gap Coverage | 5 | Specialty | 33% | n/a | P Q:1 /28Days | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Choice![]() ![]() |
$46.40 | $0 | No Gap Coverage | 4 | Specialty | 33% | 33% | 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 Plus![]() ![]() |
$50.60 | $50 | Many Generics | 6 | Specialty | 31% | n/a | P | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier Plus![]() ![]() |
$59.20 | $0 | Many Generics | 4 | Specialty-Generic and Brand | 33% | n/a | P Q:1 /28Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Plus![]() ![]() |
$65.10 | $0 | Some Generics | 5 | Tier 5 - Specialty | 33% | 33% | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Access![]() ![]() |
$69.00 | $0 | All Generics | 4 | Specialty | 33% | 33% | None | |
Browse Plan Formulary | |||||||||
SilverScript Complete![]() ![]() |
$70.10 | $0 | Many Generics | 5 | Specialty | 33% | n/a | P | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three![]() ![]() |
$79.60 | $0 | Some Generics | 4 | Tier 4 | 33% | 33% | 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 |
|
Blue MedicareRx Premier![]() ![]() |
$80.90 | $0 | Many Generics | 4 | Tier 4 Specialty | 33% | 33% | P | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced![]() ![]() |
$81.90 | $0 | Many Generics | 4 | Tier 4 - Specialty (Generic, Brand) | 33% | 30% | P | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5884-031![]() ![]() |
$96.10 | $0 | Many Generics | 4 | Specialty | 33% | n/a | P Q:1 /28Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier![]() ![]() |
$111.30 | $0 | Many Generics | 5 | Tier 5 - Specialty | 33% | 33% | None | |
Browse Plan Formulary |
|