There are 20 stand-alone Medicare Part D plans in Wisconsin meeting your criteria.
Caution: The 2009 Medicare Part D plan information below is for research purposes.
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IMITREX 6MG/0.5ML SYRNG KIT (2X0.5ML SYRINGE STATDOSE KIT) (NDC: 00173047900) 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 |
||||||
Advantage Star Plan by RxAmerica |
$33.60 | $295 | No Gap Coverage | 2 | Preferred Brand | 25% | 30% | P Q:4 /30Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan One |
$34.80 | $295 | No Gap Coverage | 2 | Tier 2 | $33.00 | $82.50 | Q:4 /30Days | |
Browse Plan Formulary | |||||||||
BravoRx |
$35.00 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | Q:24 /90Days | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 1 |
$35.00 | $295 | No Gap Coverage | 4 | Injectable | 25% | n/a | Q:4 /30Days | |
Browse Plan Formulary | |||||||||
SilverScript Value |
$35.10 | $295 | No Gap Coverage | 2 | Preferred Brand | $37.50 | $84.50 | Q:4 /25Days | |
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 |
|
Humana PDP Enhanced S5884-014 |
$35.70 | $0 | No Gap Coverage | 3 | Non-Preferred Brand | $70.00 | $175.00 | Q:6 /30Days | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Value |
$36.60 | $130 | No Gap Coverage | 4 | Tier 4 Non-Specialty Injectable | 29% | 29% | Q:4 /30Days | |
Browse Plan Formulary | |||||||||
Sterling Rx |
$39.10 | $295 | No Gap Coverage | 2 | Preferred Brand | $25.00 | $50.00 | Q:8 /28Days | |
Browse Plan Formulary | |||||||||
DeanCare Rx Value |
$39.90 | $0 | No Gap Coverage | 3 | Tier 3 | $78.00 | $156.00 | Q:4 /30Days | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Plus |
$40.40 | $0 | No Gap Coverage | 4 | Tier 4 Non-Specialty Injectable | 33% | 33% | Q:4 /30Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two |
$40.70 | $0 | No Gap Coverage | 3 | Tier 3 | $35.00 | $87.50 | Q:4 /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 |
|
Humana PDP Standard S5884-074 |
$43.80 | $295 | No Gap Coverage | 3 | Other - Non-Preferred (Gen/Brand) | 45% | 45% | Q:6 /30Days | |
Browse Plan Formulary | |||||||||
Health Net Value Orange Option 2 |
$46.70 | $0 | No Gap Coverage | 4 | Injectable | 33% | n/a | Q:4 /30Days | |
Browse Plan Formulary | |||||||||
Advantage Freedom Plan by RxAmerica |
$49.50 | $0 | No Gap Coverage | 2 | Preferred Brand | 35% | 40% | P Q:4 /30Days | |
Browse Plan Formulary | |||||||||
SilverScript Plus |
$52.80 | $50 | Many Generics | 4 | Preferred Brand | $35.00 | $82.00 | Q:4 /25Days | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Premier |
$70.70 | $0 | Many Generics | 4 | Tier 4 Non-Specialty Injectable | 33% | 33% | Q:4 /30Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three |
$71.70 | $0 | Some Generics | 2 | Tier 2 | $35.00 | $87.50 | Q:4 /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 |
$71.90 | $0 | Many Generics | 3 | Preferred Brand | $39.00 | $92.00 | Q:4 /25Days | |
Browse Plan Formulary | |||||||||
DeanCare Rx Enhanced |
$93.70 | $0 | Many Generics, Few Brands |
3 | Tier 3 | $70.00 | $140.00 | Q:4 /30Days | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5884-044 |
$95.00 | $0 | Many Generics | 3 | Non-Preferred Brand | $70.00 | $175.00 | Q:6 /30Days | |
Browse Plan Formulary |
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