There are 37 stand-alone Medicare Part D plans in Indiana 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
GRANISETRON HCL 1MG/ML VIAL (NDC: 00703787103) 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![]() ![]() |
$16.80 | $175 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $45.00 | n/a | P | |
Browse Plan Formulary | |||||||||
AdvantraRx Value![]() ![]() |
$24.40 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $55.00 | $165.00 | P | |
Browse Plan Formulary | |||||||||
HealthSpring Prescription Drug Plan-Reg 15![]() ![]() |
$25.60 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | P | |
Browse Plan Formulary | |||||||||
SilverScript Value![]() ![]() |
$28.00 | $295 | No Gap Coverage | 1 | Generic | $8.00 | $12.00 | None | |
Browse Plan Formulary | |||||||||
First Health Part D-Premier![]() ![]() |
$28.10 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $58.00 | 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 |
|
AARP MedicareRx Saver![]() ![]() |
$28.20 | $295 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $59.65 | $163.95 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Value![]() ![]() |
$28.90 | $295 | No Gap Coverage | 1 | Generic | 23% | 23% | Q:42 /90Days | |
Browse Plan Formulary | |||||||||
Advantage Freedom Plan by RxAmerica![]() ![]() |
$29.10 | $0 | No Gap Coverage | 1 | Preferred Generic | $4.50 | $0.00 | P | |
Browse Plan Formulary | |||||||||
Advantage Star Plan by RxAmerica![]() ![]() |
$31.00 | $295 | No Gap Coverage | 1 | Preferred Generic | $5.50 | $0.00 | P | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan One![]() ![]() |
$33.50 | $295 | No Gap Coverage | 2 | Tier 2 | $30.00 | $75.00 | P | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials![]() ![]() |
$33.90 | $200 | No Gap Coverage | 2 | Tier 2 - Non-Preferred Generic | $12.00 | $24.00 | 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 |
|
Health Net Orange Option 1![]() ![]() |
$34.80 | $295 | No Gap Coverage | 4 | Injectable | 25% | n/a | P | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Silver![]() ![]() |
$35.00 | $295 | No Gap Coverage | 2 | Tier 2 Non Preferred Generics | $31.00 | $93.00 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Choice![]() ![]() |
$35.10 | $0 | No Gap Coverage | 1 | Generic | $6.00 | $6.00 | Q:42 /90Days | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Value![]() ![]() |
$37.70 | $130 | No Gap Coverage | 4 | Tier 4 Non-Specialty Injectable | 29% | 29% | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier![]() ![]() |
$40.50 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $73.00 | $219.00 | P | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Rx Covg - Silver Plan![]() ![]() |
$40.70 | $130 | No Gap Coverage | 1 | Generic | $4.00 | $10.00 | Q:42 /90Days | |
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 Two![]() ![]() |
$41.20 | $0 | No Gap Coverage | 3 | Tier 3 | $38.00 | $95.00 | P | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred![]() ![]() |
$41.90 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $76.00 | $213.00 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5884-073![]() ![]() |
$42.10 | $295 | No Gap Coverage | 1 | Preferred Generic | 15% | 15% | Q:4 /28Days | |
Browse Plan Formulary | |||||||||
Sterling Rx![]() ![]() |
$42.40 | $295 | No Gap Coverage | 1 | Generic | $7.00 | $14.00 | None | |
Browse Plan Formulary | |||||||||
UnitedHealth Rx Basic![]() ![]() |
$44.00 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $89.00 | $252.00 | None | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Plus![]() ![]() |
$44.30 | $0 | No Gap Coverage | 4 | Tier 4 Non-Specialty Injectable | 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 |
|
Humana PDP Enhanced S5884-013![]() ![]() |
$47.90 | $0 | No Gap Coverage | 1 | Preferred Generic | $7.00 | $0.00 | Q:4 /28Days | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Prescription Drug Cov![]() ![]() |
$48.70 | $0 | No Gap Coverage | 1 | Generic | $5.00 | $13.00 | Q:42 /90Days | |
Browse Plan Formulary | |||||||||
SilverScript Plus![]() ![]() |
$51.30 | $50 | Many Generics | 2 | Generic | $9.00 | $23.00 | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier Plus![]() ![]() |
$55.50 | $0 | Many Generics | 3 | Non-Preferred Generic/Non-Preferred Brand | $75.00 | $225.00 | P | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Plus![]() ![]() |
$58.80 | $0 | Some Generics | 2 | Tier 2 - Non-Preferred Generic | $10.00 | $20.00 | P | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 2![]() ![]() |
$62.00 | $0 | No Gap Coverage | 4 | Injectable | 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 |
|
CIGNA Medicare Rx Plan Three![]() ![]() |
$66.10 | $0 | Some Generics | 2 | Tier 2 | $35.00 | $87.50 | P | |
Browse Plan Formulary | |||||||||
SilverScript Complete![]() ![]() |
$66.90 | $0 | Many Generics | 2 | Generic | $7.50 | $19.00 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Access![]() ![]() |
$71.30 | $0 | All Generics | 1 | Generic | $6.00 | $6.00 | Q:42 /90Days | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced![]() ![]() |
$71.70 | $0 | Many Generics | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $95.00 | $270.00 | None | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Gold![]() ![]() |
$72.30 | $0 | No Gap Coverage | 2 | Tier 2 NonPreferred Generic | $45.00 | $135.00 | None | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Premier![]() ![]() |
$79.10 | $0 | Many Generics | 4 | Tier 4 Non-Specialty Injectable | 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 |
|
Humana PDP Complete S5884-043![]() ![]() |
$98.40 | $0 | Many Generics | 1 | Preferred Generic | $7.00 | $0.00 | Q:4 /28Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier![]() ![]() |
$100.90 | $0 | Many Generics | 2 | Tier 2 - Non-Preferred Generic | $10.00 | $20.00 | P | |
Browse Plan Formulary |
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