There are 26 stand-alone Medicare Part D plans in New York 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 INJ (2X120MG ) (NDC: 55566840101) 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 |
||||||
GHI Medicare Prescription Drug Plan |
$19.60 | $295 | No Gap Coverage | 3 | Tier 3 | 25% | 25% | P | |
Browse Plan Formulary | |||||||||
HIP Part D New York |
$21.00 | $295 | No Gap Coverage | 3 | Tier 3 | 40% | 40% | P | |
Browse Plan Formulary | |||||||||
First Health Part D-Secure |
$26.40 | $175 | No Gap Coverage | 4 | Specialty-Generic and Brand | 28% | n/a | P Q:2 /30Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan One |
$27.30 | $295 | No Gap Coverage | 3 | Tier 3 | $72.50 | $181.25 | P | |
Browse Plan Formulary | |||||||||
BravoRx |
$27.50 | $295 | No Gap Coverage | 3 | Tier 3 | 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 |
|
WellCare Classic |
$28.40 | $295 | No Gap Coverage | 3 | Tier 3 | $91.00 | $273.00 | P Q:2 /180Days | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 1 |
$28.50 | $295 | No Gap Coverage | 5 | Specialty | 25% | n/a | P Q:2 /365Days | |
Browse Plan Formulary | |||||||||
First Health Part D-Premier |
$29.30 | $0 | No Gap Coverage | 4 | Specialty-Generic and Brand | 33% | n/a | P Q:2 /30Days | |
Browse Plan Formulary | |||||||||
AdvantraRx Value |
$30.60 | $0 | No Gap Coverage | 4 | Specialty-Generic and Brand | 33% | n/a | P Q:2 /30Days | |
Browse Plan Formulary | |||||||||
Sterling Rx |
$32.10 | $295 | No Gap Coverage | 2 | Preferred Brand | $25.00 | $50.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials |
$32.70 | $205 | No Gap Coverage | 5 | Tier 5 - Specialty | 25% | 25% | P Q:2 /365Days | |
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 S5552-001 |
$36.00 | $0 | No Gap Coverage | 4 | Specialty | 33% | n/a | P Q:2 /365Days | |
Browse Plan Formulary | |||||||||
MedicareRx Rewards Value |
$37.60 | $130 | No Gap Coverage | 5 | Tier 5. | 29% | n/a | None | |
Browse Plan Formulary | |||||||||
WellCare Signature |
$37.60 | $0 | No Gap Coverage | 3 | Tier 3 | $79.00 | $237.00 | P Q:2 /180Days | |
Browse Plan Formulary | |||||||||
HIP Enhanced Part D New York |
$39.00 | $0 | Many Generics | 3 | Tier 3 | 50% | 50% | P | |
Browse Plan Formulary | |||||||||
Simply Prescriptions Rx 1 |
$42.80 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two |
$45.00 | $0 | No Gap Coverage | 4 | Tier 4 | $85.00 | $212.50 | 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 |
|
Simply Prescriptions Rx 3 |
$48.10 | $100 | No Gap Coverage | 3 | Non-Preferred Brand | $75.00 | $187.50 | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier |
$48.20 | $0 | No Gap Coverage | 4 | Specialty-Generic and Brand | 33% | n/a | P Q:2 /30Days | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 2 |
$48.40 | $0 | No Gap Coverage | 5 | Specialty | 33% | n/a | P Q:2 /365Days | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5552-003 |
$55.20 | $295 | No Gap Coverage | 3 | Other - Non-Preferred (Gen/Brand) | 42% | 42% | P Q:2 /365Days | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier Plus |
$65.90 | $0 | Many Generics | 4 | Specialty-Generic and Brand | 33% | n/a | P Q:2 /30Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx - Costco Plus Plan |
$69.50 | $0 | Some Generics | 5 | Tier 5 - Specialty | 33% | 33% | P Q:2 /365Days | |
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 Three |
$78.70 | $0 | Some Generics | 3 | Tier 3 | $60.00 | $150.00 | P | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5552-002 |
$100.80 | $0 | Many Generics | 4 | Specialty | 33% | n/a | P Q:2 /365Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier |
$136.80 | $0 | Many Generics | 5 | Tier 5 - Specialty | 33% | 33% | P Q:2 /365Days | |
Browse Plan Formulary |
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