There are 27 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
OXYCODONE HCL ER TABLETS 80MG 100 BOT (100 BOT) (NDC: 00406059601) 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-Premier |
$27.60 | $0 | No Gap Coverage | 4 | Specialty-Generic and Brand | 33% | n/a | P | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Value |
$28.60 | $295 | No Gap Coverage | 1 | Generic | 23% | 23% | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials |
$30.80 | $200 | No Gap Coverage | 2 | Tier 2 - Non-Preferred Generic | $13.00 | $26.00 | Q:4 /1Days | |
Browse Plan Formulary | |||||||||
BravoRx |
$36.10 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Silver |
$36.10 | $295 | No Gap Coverage | 2 | Tier 2 Non Preferred Generics | $31.00 | $93.00 | 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 |
|
AARP MedicareRx Saver |
$36.30 | $295 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $56.95 | $155.85 | Q:186 /31Days | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred |
$37.80 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $83.00 | $234.00 | Q:186 /31Days | |
Browse Plan Formulary | |||||||||
Humana PDP Enhanced S5884-016 |
$38.30 | $0 | No Gap Coverage | 1 | Preferred Generic | $7.00 | $0.00 | Q:120 /30Days | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier |
$38.90 | $0 | No Gap Coverage | 4 | Specialty-Generic and Brand | 33% | n/a | P | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 1 |
$39.00 | $295 | No Gap Coverage | 1 | Preferred Generic | $2.00 | $4.00 | Q:4 /1Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan One |
$41.70 | $295 | No Gap Coverage | 2 | Tier 2 | $30.00 | $75.00 | Q:120 /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 |
|
Sterling Rx |
$41.70 | $295 | No Gap Coverage | 1 | Generic | $7.00 | $14.00 | Q:90 /30Days | |
Browse Plan Formulary | |||||||||
UnitedHealth Rx Basic |
$42.40 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $91.00 | $258.00 | Q:186 /31Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two |
$42.50 | $0 | No Gap Coverage | 3 | Tier 3 | $38.00 | $95.00 | Q:120 /30Days | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Rx Covg - Silver Plan |
$43.10 | $140 | No Gap Coverage | 1 | Generic | $4.00 | $10.00 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Choice |
$44.20 | $0 | No Gap Coverage | 1 | Generic | $6.00 | $6.00 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5884-076 |
$44.60 | $295 | No Gap Coverage | 1 | Preferred Generic | 15% | 15% | Q:120 /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 |
|
UA Medicare Part D Prescription Drug Cov |
$48.60 | $0 | No Gap Coverage | 1 | Generic | $5.00 | $13.00 | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier Plus |
$54.50 | $0 | Many Generics | 4 | Specialty-Generic and Brand | 33% | n/a | P | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Plus |
$61.00 | $0 | Some Generics | 2 | Tier 2 - Non-Preferred Generic | $10.00 | $20.00 | Q:4 /1Days | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 2 |
$61.20 | $0 | No Gap Coverage | 1 | Preferred Generic | $5.00 | $10.00 | Q:4 /1Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three |
$68.90 | $0 | Some Generics | 2 | Tier 2 | $35.00 | $87.50 | Q:120 /30Days | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced |
$69.10 | $0 | Many Generics | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $95.00 | $270.00 | Q:186 /31Days | |
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 |
|
EnvisionRxPlus Gold |
$70.20 | $0 | No Gap Coverage | 2 | Tier 2 NonPreferred Generic | $45.00 | $135.00 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Access |
$75.00 | $0 | All Generics | 1 | Generic | $6.00 | $6.00 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5884-046 |
$99.30 | $0 | Many Generics | 1 | Preferred Generic | $7.00 | $0.00 | Q:120 /30Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier |
$106.80 | $0 | Many Generics | 2 | Tier 2 - Non-Preferred Generic | $10.00 | $20.00 | Q:4 /1Days | |
Browse Plan Formulary |
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