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Please note: The plan’s average retail drug price (30-day supply) shown below is from the dataset. Your actual retail drug price may differ significantly from the average shown. Please contact the Medicare plan or Medicare (1-800-Medicare) for more specific pricing based on your chosen pharmacy.
There are 52 stand-alone Medicare Part D plans in West Virginia 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
| DIVALPROEX SODIUM 125MG TBEC (NDC: 62756079613) 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 | 1 | Preferred Generic | $4.00 | n/a | None | |
| Browse Plan Formulary | |||||||||
|
AdvantraRx Value
|
$22.20 | $0 | No Gap Coverage | 1 | Preferred Generic | $8.00 | $16.00 | None | |
| Browse Plan Formulary | |||||||||
|
AARP MedicareRx Saver
|
$22.40 | $295 | No Gap Coverage | 1 | Tier 1 - Preferred Generic | $5.00 | $0.00 | None | |
| Browse Plan Formulary | |||||||||
|
Community CCRx Basic
|
$25.40 | $295 | No Gap Coverage | 1 | Generic | $0.00 | n/a | None | |
| Browse Plan Formulary | |||||||||
|
Advantage Star Plan by RxAmerica
|
$27.80 | $295 | No Gap Coverage | 1 | Preferred Generic | $5.50 | $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 |
|
|
MedicareRx Rewards Standard
|
$28.10 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | Q:60 /30Days | |
| Browse Plan Formulary | |||||||||
|
Medco Medicare Prescription Plan - Value
|
$28.50 | $295 | No Gap Coverage | 1 | Generic | 23% | 23% | None | |
| Browse Plan Formulary | |||||||||
|
AmeriHealth Advantage Rx Option I
|
$28.60 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | n/a | None | |
| Browse Plan Formulary | |||||||||
|
First Health Part D-Premier
|
$28.70 | $0 | No Gap Coverage | 1 | Preferred Generic | $7.00 | n/a | None | |
| Browse Plan Formulary | |||||||||
|
SilverScript Value
|
$28.70 | $295 | No Gap Coverage | 1 | Generic | $8.00 | $12.00 | None | |
| Browse Plan Formulary | |||||||||
|
Prescriba Rx Bronze
|
$28.80 | $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 |
|
|
HealthSpring Prescription Drug Plan -Reg 6
|
$29.90 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | None | |
| Browse Plan Formulary | |||||||||
|
CIGNA Medicare Rx Plan One
|
$30.00 | $295 | No Gap Coverage | 1 | Tier 1 | $2.50 | $6.25 | None | |
| Browse Plan Formulary | |||||||||
|
WellCare Classic
|
$31.40 | $295 | No Gap Coverage | 1 | Tier 1 | $0.00 | $0.00 | None | |
| Browse Plan Formulary | |||||||||
|
EnvisionRxPlus Silver
|
$32.00 | $295 | No Gap Coverage | 2 | Tier 2 Non Preferred Generics | $32.00 | $96.00 | None | |
| Browse Plan Formulary | |||||||||
|
Prescriba Rx Gold
|
$32.10 | $0 | No Gap Coverage | 1 | Generic | $6.00 | $12.00 | None | |
| Browse Plan Formulary | |||||||||
|
Medco Medicare Prescription Plan - Choice
|
$32.60 | $0 | No Gap Coverage | 1 | Generic | $6.00 | $6.00 | 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 |
|
|
MedicareRx Rewards Value
|
$32.90 | $130 | No Gap Coverage | 1 | Tier 1 Preferred Generic | $10.00 | $15.00 | Q:60 /30Days | |
| Browse Plan Formulary | |||||||||
|
Aetna Medicare Rx Essentials
|
$33.40 | $195 | No Gap Coverage | 2 | Tier 2 - Non-Preferred Generic | $11.00 | $22.00 | None | |
| Browse Plan Formulary | |||||||||
|
WellCare Signature
|
$33.90 | $0 | No Gap Coverage | 1 | Tier 1 | $0.00 | $0.00 | None | |
| Browse Plan Formulary | |||||||||
|
AARP MedicareRx Preferred
|
$34.80 | $0 | No Gap Coverage | 1 | Tier 1-Preferred Generic | $7.00 | $0.00 | None | |
| Browse Plan Formulary | |||||||||
|
Health Net Orange Option 1
|
$35.30 | $295 | No Gap Coverage | 1 | Preferred Generic | $2.00 | $4.00 | None | |
| Browse Plan Formulary | |||||||||
|
AdvantraRx Premier
|
$36.90 | $0 | No Gap Coverage | 1 | Preferred Generic | $5.00 | $10.00 | 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 |
|
|
Advantage Freedom Plan by RxAmerica
|
$38.30 | $0 | No Gap Coverage | 1 | Preferred Generic | $5.00 | $0.00 | None | |
| Browse Plan Formulary | |||||||||
|
UA Medicare Part D Rx Covg - Silver Plan
|
$39.00 | $150 | No Gap Coverage | 1 | Generic | $4.00 | $10.00 | None | |
| Browse Plan Formulary | |||||||||
|
CIGNA Medicare Rx Plan Two
|
$39.50 | $0 | No Gap Coverage | 2 | Tier 2 | $6.00 | $15.00 | None | |
| Browse Plan Formulary | |||||||||
|
Humana PDP Standard S5884-064
|
$39.50 | $295 | No Gap Coverage | 1 | Preferred Generic | 15% | 15% | None | |
| Browse Plan Formulary | |||||||||
|
Sterling Rx
|
$42.10 | $295 | No Gap Coverage | 1 | Generic | $7.00 | $14.00 | None | |
| Browse Plan Formulary | |||||||||
|
UA Medicare Part D Prescription Drug Cov
|
$42.40 | $0 | No Gap Coverage | 1 | Generic | $5.00 | $13.00 | 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 |
|
|
Community CCRx Choice
|
$42.60 | $0 | No Gap Coverage | 1 | Generic | $5.00 | n/a | None | |
| Browse Plan Formulary | |||||||||
|
SecureRx - Option 4
|
$43.00 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | None | |
| Browse Plan Formulary | |||||||||
|
UnitedHealth Rx Basic
|
$43.10 | $0 | No Gap Coverage | 1 | Tier 1 - Preferred Generic | $7.00 | $0.00 | None | |
| Browse Plan Formulary | |||||||||
|
UPMC for Life Prescription Drug Plan
|
$44.10 | $0 | No Gap Coverage | 1 | Generic | $5.00 | $12.50 | None | |
| Browse Plan Formulary | |||||||||
|
SecureRx - Option 3
|
$44.60 | $0 | No Gap Coverage | 1 | Generic Drugs | $9.00 | $25.00 | None | |
| Browse Plan Formulary | |||||||||
|
Humana PDP Enhanced S5884-005
|
$44.90 | $0 | No Gap Coverage | 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 |
|
|
Health Net Value Orange Option 2
|
$46.60 | $0 | No Gap Coverage | 1 | Preferred Generic | $0.00 | $0.00 | None | |
| Browse Plan Formulary | |||||||||
|
SilverScript Plus
|
$51.50 | $50 | Many Generics | 2 | Generic | $9.00 | $23.00 | None | |
| Browse Plan Formulary | |||||||||
|
AdvantraRx Premier Plus
|
$52.80 | $0 | Many Generics | 1 | Preferred Generic | $4.00 | $8.00 | None | |
| Browse Plan Formulary | |||||||||
|
AmeriHealth Rx Option I
|
$54.30 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | None | |
| Browse Plan Formulary | |||||||||
|
AmeriHealth Rx Option II
|
$58.90 | $0 | No Gap Coverage | 1 | Generic | $7.00 | $14.00 | None | |
| Browse Plan Formulary | |||||||||
|
Aetna Medicare Rx Plus
|
$63.90 | $0 | Some Generics | 2 | Tier 2 - Non-Preferred Generic | $10.00 | $20.00 | 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
|
$64.90 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | None | |
| Browse Plan Formulary | |||||||||
|
Prescriba Rx Platinum
|
$65.00 | $0 | All Generics | 1 | Generic | $6.00 | $12.00 | None | |
| Browse Plan Formulary | |||||||||
|
EnvisionRxPlus Gold
|
$66.60 | $0 | No Gap Coverage | 2 | Tier 2 NonPreferred Generic | $45.00 | $135.00 | None | |
| Browse Plan Formulary | |||||||||
|
Medco Medicare Prescription Plan - Access
|
$68.30 | $0 | All Generics | 1 | Generic | $6.00 | $6.00 | None | |
| Browse Plan Formulary | |||||||||
|
SilverScript Complete
|
$69.10 | $0 | Many Generics | 2 | Generic | $7.50 | $19.00 | None | |
| Browse Plan Formulary | |||||||||
|
CIGNA Medicare Rx Plan Three
|
$72.60 | $0 | Some Generics | 1 | Tier 1 | $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 |
|
|
Community CCRx Gold
|
$75.10 | $0 | All Generics | 1 | Generic | $5.00 | n/a | None | |
| Browse Plan Formulary | |||||||||
|
AARP MedicareRx Enhanced
|
$76.40 | $0 | Many Generics | 1 | Tier 1 - Preferred Generic | $7.00 | $0.00 | None | |
| Browse Plan Formulary | |||||||||
|
SecureRx - Option 1
|
$86.90 | $0 | Many Generics | 1 | Generic Drugs | $7.00 | $17.00 | None | |
| Browse Plan Formulary | |||||||||
|
Humana PDP Complete S5884-034
|
$95.40 | $0 | Many Generics | 1 | Preferred Generic | $7.00 | $0.00 | None | |
| Browse Plan Formulary | |||||||||
|
Aetna Medicare Rx Premier
|
$99.90 | $0 | Many Generics | 2 | Tier 2 - Non-Preferred Generic | $10.00 | $20.00 | None | |
| Browse Plan Formulary | |||||||||
Chart Legend:
What does all this mean? Below are a few notes to help you understand the above 2009 Medicare Part D Plan Formulary.
|