ATRIPLA TABLET 600MG/200MG (NDC: 15584010101)
2010 Medicare Prescription Drug Plan (MAPD) 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 |
Plan’s Avg. Retail Drug Price 30-Day |
Tier Nbr. |
Tier Desc. |
30-Day Prfrd. Pharm |
90-Day Mail Order |
SmartValue Plus (PFFS)
|
$5.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,694.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:30 /30Days | $1,618.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,585.49 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:30 /30Days | $1,612.69 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$11.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:30 /30Days | $1,609.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$11.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:30 /30Days | $1,613.16 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$11.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:30 /30Days | $1,613.16 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:30 /30Days | $1,612.69 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:30 /30Days | $1,612.69 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:30 /30Days | $1,612.69 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:30 /30Days | $1,612.69 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$16.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:30 /30Days | $1,612.69 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:30 /30Days | $1,612.69 |
Browse Plan Formulary |
First Seniority Freedom - Drug (PFFS)
|
$17.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $1,661.04 |
Browse Plan Formulary |
First Seniority Freedom - Drug (PFFS)
|
$17.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $1,661.04 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$17.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:30 /30Days | $1,613.16 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$17.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:30 /30Days | $1,613.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,626.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,626.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,626.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,626.65 |
Browse Plan Formulary |
First Seniority Freedom - Drug (PFFS)
|
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $1,659.76 |
Browse Plan Formulary |
First Seniority Freedom - Drug (PFFS)
|
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $1,659.76 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
First Seniority Freedom - Drug (PFFS)
|
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $1,659.76 |
Browse Plan Formulary |
First Seniority Freedom - Drug (PFFS)
|
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $1,659.76 |
Browse Plan Formulary |
First Seniority Freedom - Drug (PFFS)
|
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $1,659.76 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,701.22 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,701.22 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,626.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,626.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,626.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,626.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,634.69 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,634.69 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,634.69 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,634.69 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$24.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:30 /30Days | $1,609.45 |
Browse Plan Formulary |
Humana Gold Choice H2944-073 (PFFS)
|
$24.70 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,583.93 |
Browse Plan Formulary |
Humana Gold Choice H2944-106 (PFFS)
|
$25.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,583.93 |
Browse Plan Formulary |
Northeast Community Care - Enhanced (HMO)
|
$27.00 |
$310 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $1,595.55 |
Browse Plan Formulary |
Northeast Community Care - Enhanced (HMO)
|
$27.00 |
$310 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $1,595.55 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Northeast Community Care - Enhanced (HMO)
|
$27.00 |
$310 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $1,595.55 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$37.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:30 /30Days | $1,618.01 |
Browse Plan Formulary |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.00 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | $1,661.04 |
Browse Plan Formulary |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.00 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | $1,661.04 |
Browse Plan Formulary |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.30 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | $1,659.76 |
Browse Plan Formulary |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.30 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | $1,659.76 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.30 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | $1,659.76 |
Browse Plan Formulary |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.30 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | $1,659.76 |
Browse Plan Formulary |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.30 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | $1,659.76 |
Browse Plan Formulary |