There are 52 stand-alone Medicare Part D plans in Colorado 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
PERPHENAZINE 16MG TABLET (100 CT) (100 BOT) (NDC: 54738055301) 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![]() ![]() |
$18.40 | $175 | No Gap Coverage | 1 | Preferred Generic | $4.00 | n/a | None | |
Browse Plan Formulary | |||||||||
Fox Value Plan![]() ![]() |
$24.90 | $295 | No Gap Coverage | 1 | Tier 1 | $0.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
HealthSpring Prescription Drug Plan-Reg 27![]() ![]() |
$25.80 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Value![]() ![]() |
$26.00 | $0 | No Gap Coverage | 1 | Preferred Generic | $9.00 | $18.00 | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Bronze![]() ![]() |
$26.10 | $295 | No Gap Coverage | 1 | Tier 1 | 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 |
|
First Health Part D-Premier![]() ![]() |
$26.80 | $0 | No Gap Coverage | 1 | Preferred Generic | $7.00 | n/a | None | |
Browse Plan Formulary | |||||||||
SilverScript Value![]() ![]() |
$28.20 | $295 | No Gap Coverage | 1 | Generic | $8.00 | $12.00 | None | |
Browse Plan Formulary | |||||||||
WellCare Classic![]() ![]() |
$28.90 | $295 | No Gap Coverage | 1 | Tier 1 | $0.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
SierraRx![]() ![]() |
$30.00 | $0 | No Gap Coverage | 1 | Generic | $10.00 | $30.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials![]() ![]() |
$30.80 | $200 | No Gap Coverage | 2 | Tier 2 - Non-Preferred Generic | $13.00 | $26.00 | None | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Value![]() ![]() |
$31.80 | $130 | No Gap Coverage | 1 | Tier 1 Preferred Generic | $10.00 | $15.00 | 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 |
|
EnvisionRxPlus Silver![]() ![]() |
$31.90 | $295 | No Gap Coverage | 1 | Tier 1 Preferred Generic | $4.00 | $12.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Saver![]() ![]() |
$33.00 | $295 | No Gap Coverage | 1 | Tier 1 - Preferred Generic | $5.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
Community CCRx Basic![]() ![]() |
$33.10 | $295 | No Gap Coverage | 1 | Generic | $0.00 | n/a | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Value![]() ![]() |
$33.50 | $295 | No Gap Coverage | 1 | Generic | 23% | 23% | P | |
Browse Plan Formulary | |||||||||
Advantage Star Plan by RxAmerica![]() ![]() |
$35.10 | $295 | No Gap Coverage | 1 | Preferred Generic | $5.25 | $0.00 | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Gold![]() ![]() |
$36.10 | $0 | No Gap Coverage | 1 | Generic | $6.00 | $12.00 | 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 |
|
WellCare Signature![]() ![]() |
$37.20 | $0 | No Gap Coverage | 1 | Tier 1 | $0.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred![]() ![]() |
$38.50 | $0 | No Gap Coverage | 1 | Tier 1-Preferred Generic | $7.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
BravoRx![]() ![]() |
$38.70 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | P | |
Browse Plan Formulary | |||||||||
Fox Grand Plan![]() ![]() |
$39.00 | $265 | Some Generics | 1 | Tier 1 | $0.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
SilverScript Plus![]() ![]() |
$39.40 | $50 | Many Generics | 2 | Generic | $9.00 | $23.00 | None | |
Browse Plan Formulary | |||||||||
Advantage Freedom Plan by RxAmerica![]() ![]() |
$39.50 | $0 | No Gap Coverage | 1 | Preferred Generic | $4.75 | $0.00 | 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 |
|
RMHP Essential Rx![]() ![]() |
$40.10 | $123 | No Gap Coverage | 1 | Generic drugs | $9.00 | $18.00 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5884-085![]() ![]() |
$40.90 | $295 | No Gap Coverage | 1 | Preferred Generic | 15% | 15% | None | |
Browse Plan Formulary | |||||||||
Sterling Rx![]() ![]() |
$41.60 | $295 | No Gap Coverage | 1 | Generic | $7.00 | $14.00 | None | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Rx Covg - Silver Plan![]() ![]() |
$42.00 | $140 | No Gap Coverage | 1 | Generic | $4.00 | $10.00 | P | |
Browse Plan Formulary | |||||||||
Humana PDP Enhanced S5884-025![]() ![]() |
$43.30 | $0 | No Gap Coverage | 1 | Preferred Generic | $7.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Prescription Drug Cov![]() ![]() |
$43.60 | $0 | No Gap Coverage | 1 | Generic | $6.00 | $15.00 | 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![]() ![]() |
$45.30 | $295 | No Gap Coverage | 1 | Preferred Generic | $2.00 | $4.00 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Choice![]() ![]() |
$45.60 | $0 | No Gap Coverage | 1 | Generic | $6.00 | $6.00 | P | |
Browse Plan Formulary | |||||||||
UnitedHealth Rx Basic![]() ![]() |
$45.80 | $0 | No Gap Coverage | 1 | Tier 1 - Preferred Generic | $7.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Plus![]() ![]() |
$47.20 | $0 | No Gap Coverage | 1 | Tier 1 Preferred Generic | $9.00 | $13.50 | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier![]() ![]() |
$48.30 | $0 | No Gap Coverage | 1 | Preferred Generic | $7.00 | $14.00 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two![]() ![]() |
$48.90 | $0 | No Gap Coverage | 2 | Tier 2 | $6.00 | $15.00 | 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 |
|
SilverScript Complete![]() ![]() |
$53.60 | $0 | Many Generics | 2 | Generic | $7.50 | $19.00 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan One![]() ![]() |
$53.70 | $295 | No Gap Coverage | 1 | Tier 1 | $2.50 | $6.25 | None | |
Browse Plan Formulary | |||||||||
Community CCRx Choice![]() ![]() |
$56.50 | $0 | No Gap Coverage | 1 | Generic | $5.00 | n/a | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx - Costco Plus Plan![]() ![]() |
$56.80 | $0 | Some Generics | 2 | Tier 2 - Non-Preferred Generic | $5.00 | $20.00 | None | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 2![]() ![]() |
$57.40 | $0 | No Gap Coverage | 1 | Preferred Generic | $5.00 | $10.00 | None | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Gold![]() ![]() |
$59.80 | $0 | No Gap Coverage | 1 | Tier 1 Preferred Generics | $0.00 | $0.00 | 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 |
|
SierraRx Basic![]() ![]() |
$62.20 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier Plus![]() ![]() |
$62.70 | $0 | Many Generics | 1 | Preferred Generic | $4.00 | $8.00 | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Platinum![]() ![]() |
$67.80 | $0 | All Generics | 1 | Generic | $6.00 | $12.00 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Access![]() ![]() |
$73.50 | $0 | All Generics | 1 | Generic | $6.00 | $6.00 | P | |
Browse Plan Formulary | |||||||||
Community CCRx Gold![]() ![]() |
$74.70 | $0 | All Generics | 1 | Generic | $5.00 | n/a | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced![]() ![]() |
$81.80 | $0 | Many Generics | 1 | Tier 1 - Preferred Generic | $7.00 | $0.00 | 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 |
|
Blue MedicareRx Premier![]() ![]() |
$86.50 | $0 | Many Generics | 1 | Tier 1 Preferred Generic | $9.00 | $13.50 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three![]() ![]() |
$88.90 | $0 | Some Generics | 1 | Tier 1 | $6.00 | $15.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier![]() ![]() |
$104.20 | $0 | Many Generics | 2 | Tier 2 - Non-Preferred Generic | $10.00 | $20.00 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5884-055![]() ![]() |
$107.60 | $0 | Many Generics | 1 | Preferred Generic | $7.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
RMHP Basic Rx![]() ![]() |
$112.70 | $0 | No Gap Coverage | 1 | Generic drugs | $8.75 | $17.50 | None | |
Browse Plan Formulary |
|