There are 52 stand-alone Medicare Part D plans in Wisconsin 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
GLEEVEC 400MG TABLET (30 BOT) (NDC: 00078043815) 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![]() ![]() |
$13.70 | $175 | No Gap Coverage | 4 | Specialty-Generic and Brand | 28% | n/a | P Q:60 /30Days | |
Browse Plan Formulary | |||||||||
AdvantraRx Value![]() ![]() |
$23.10 | $0 | No Gap Coverage | 4 | Specialty-Generic and Brand | 33% | n/a | P Q:60 /30Days | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Saver![]() ![]() |
$28.70 | $295 | No Gap Coverage | 4 | Tier 4 - Specialty (Generic, Brand) | 25% | 25% | P | |
Browse Plan Formulary | |||||||||
Community CCRx Basic![]() ![]() |
$31.00 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | 45% | n/a | P Q:60 /30Days | |
Browse Plan Formulary | |||||||||
First Health Part D-Premier![]() ![]() |
$31.10 | $0 | No Gap Coverage | 4 | Specialty-Generic and Brand | 33% | n/a | P Q:60 /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 |
|
Prescriba Rx Bronze![]() ![]() |
$31.30 | $295 | No Gap Coverage | 3 | Tier 3 | 25% | 25% | P Q:60 /30Days | |
Browse Plan Formulary | |||||||||
Advantage Star Plan by RxAmerica![]() ![]() |
$33.60 | $295 | No Gap Coverage | 3 | Specialty | 25% | n/a | P | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Choice![]() ![]() |
$34.40 | $0 | No Gap Coverage | 4 | Specialty | 33% | 33% | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials![]() ![]() |
$34.60 | $200 | No Gap Coverage | 5 | Tier 5 - Specialty | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan One![]() ![]() |
$34.80 | $295 | No Gap Coverage | 4 | Tier 4 | 25% | 25% | P | |
Browse Plan Formulary | |||||||||
Prescriba Rx Gold![]() ![]() |
$34.90 | $0 | No Gap Coverage | 3 | Specialty | 33% | n/a | P Q:60 /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 |
|
BravoRx![]() ![]() |
$35.00 | $295 | No Gap Coverage | 3 | Tier 3 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 1![]() ![]() |
$35.00 | $295 | No Gap Coverage | 5 | Specialty | 25% | n/a | P | |
Browse Plan Formulary | |||||||||
SilverScript Value![]() ![]() |
$35.10 | $295 | No Gap Coverage | 4 | Specialty | 25% | n/a | None | |
Browse Plan Formulary | |||||||||
Humana PDP Enhanced S5884-014![]() ![]() |
$35.70 | $0 | No Gap Coverage | 4 | Specialty | 33% | n/a | P Q:60 /30Days | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Silver![]() ![]() |
$36.20 | $295 | No Gap Coverage | 5 | Tier 5 Specialty Drugs | 25% | n/a | None | |
Browse Plan Formulary | |||||||||
HealthSpring Prescription Drug Plan-Reg 16![]() ![]() |
$36.30 | $295 | No Gap Coverage | 2 | Tier 2 | 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 |
|
Blue MedicareRx Value![]() ![]() |
$36.60 | $130 | No Gap Coverage | 5 | Tier 5. | 29% | n/a | P | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Value![]() ![]() |
$36.60 | $295 | No Gap Coverage | 4 | Specialty | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
Community CCRx Choice![]() ![]() |
$37.10 | $0 | No Gap Coverage | 4 | Specialty | 33% | n/a | P Q:60 /30Days | |
Browse Plan Formulary | |||||||||
WellCare Classic![]() ![]() |
$37.80 | $295 | No Gap Coverage | 4 | Tier 4 | 25% | 25% | P | |
Browse Plan Formulary | |||||||||
Sterling Rx![]() ![]() |
$39.10 | $295 | No Gap Coverage | 4 | Specialty | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
WellCare Signature![]() ![]() |
$39.10 | $0 | No Gap Coverage | 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 |
|
AdvantraRx Premier![]() ![]() |
$39.30 | $0 | No Gap Coverage | 4 | Specialty-Generic and Brand | 33% | n/a | P Q:60 /30Days | |
Browse Plan Formulary | |||||||||
WPS MedicareRx Standard Plan![]() ![]() |
$39.30 | $295 | No Gap Coverage | 4 | Tier 4 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred![]() ![]() |
$39.40 | $0 | No Gap Coverage | 4 | Tier 4 - Specialty (Generic, Brand) | 33% | 30% | P | |
Browse Plan Formulary | |||||||||
DeanCare Rx Value![]() ![]() |
$39.90 | $0 | No Gap Coverage | 4 | Tier 4 | 33% | 33% | P | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Plus![]() ![]() |
$40.40 | $0 | No Gap Coverage | 5 | Tier 5. | 33% | n/a | P | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two![]() ![]() |
$40.70 | $0 | No Gap Coverage | 5 | Tier 5 | 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 |
|
UnitedHealth Rx Basic![]() ![]() |
$41.90 | $0 | No Gap Coverage | 4 | Tier 4 - Specialty (Generic, Brand) | 33% | 30% | P | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Rx Covg - Silver Plan![]() ![]() |
$43.30 | $130 | No Gap Coverage | 4 | Specialty | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5884-074![]() ![]() |
$43.80 | $295 | No Gap Coverage | 3 | Other - Non-Preferred (Gen/Brand) | 45% | 45% | P Q:60 /30Days | |
Browse Plan Formulary | |||||||||
WPS MedicareRx Enhanced Plan 1![]() ![]() |
$43.90 | $0 | No Gap Coverage | 4 | Specialty Brand | 33% | 33% | None | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Prescription Drug Cov![]() ![]() |
$45.10 | $0 | No Gap Coverage | 4 | Specialty | 33% | 33% | None | |
Browse Plan Formulary | |||||||||
Health Net Value Orange Option 2![]() ![]() |
$46.70 | $0 | No Gap Coverage | 5 | Specialty | 33% | 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 |
|
Advantage Freedom Plan by RxAmerica![]() ![]() |
$49.50 | $0 | No Gap Coverage | 3 | Specialty | 33% | n/a | P | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Gold![]() ![]() |
$51.00 | $0 | No Gap Coverage | 5 | Tier 5 Specialty | 33% | n/a | None | |
Browse Plan Formulary | |||||||||
SilverScript Plus![]() ![]() |
$52.80 | $50 | Many Generics | 6 | Specialty | 31% | n/a | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier Plus![]() ![]() |
$54.60 | $0 | Many Generics | 4 | Specialty-Generic and Brand | 33% | n/a | P Q:60 /30Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Plus![]() ![]() |
$61.60 | $0 | Some Generics | 5 | Tier 5 - Specialty | 33% | 33% | None | |
Browse Plan Formulary | |||||||||
Community CCRx Gold![]() ![]() |
$62.30 | $0 | All Generics | 4 | Specialty | 33% | n/a | P Q:60 /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 |
|
Medco Medicare Prescription Plan - Access![]() ![]() |
$62.80 | $0 | All Generics | 4 | Specialty | 33% | 33% | None | |
Browse Plan Formulary | |||||||||
DeanCare Rx Classic![]() ![]() |
$64.00 | $295 | No Gap Coverage | 3 | Tier 3 | 25% | 25% | P | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Premier![]() ![]() |
$70.70 | $0 | Many Generics | 5 | Tier 5. | 33% | n/a | P | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three![]() ![]() |
$71.70 | $0 | Some Generics | 4 | Tier 4 | 33% | 33% | P | |
Browse Plan Formulary | |||||||||
SilverScript Complete![]() ![]() |
$71.90 | $0 | Many Generics | 5 | Specialty | 33% | n/a | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Platinum![]() ![]() |
$73.60 | $0 | All Generics | 3 | Specialty | 33% | n/a | P Q:60 /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 |
|
WPS MedicareRx Enhanced Plan 2![]() ![]() |
$75.00 | $0 | All Generics | 4 | Specialty Brand | 33% | 33% | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced![]() ![]() |
$77.40 | $0 | Many Generics | 4 | Tier 4 - Specialty (Generic, Brand) | 33% | 30% | P | |
Browse Plan Formulary | |||||||||
DeanCare Rx Enhanced![]() ![]() |
$93.70 | $0 | Many Generics, Few Brands |
4 | Tier 4 | 33% | 33% | P | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5884-044![]() ![]() |
$95.00 | $0 | Many Generics | 4 | Specialty | 33% | n/a | P Q:60 /30Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier![]() ![]() |
$102.70 | $0 | Many Generics | 5 | Tier 5 - Specialty | 33% | 33% | None | |
Browse Plan Formulary |
|