ARIXTRA 7.5MG SYRINGE (10 X .6 ML SYR) (NDC: 00007323411)
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 |
Northeast Community Care - Dual Plus (HMO)
|
$0.00 |
$310 |
to be determined |
2 |
Tier 2 |
n/a | n/a | None | n/a |
Browse Plan Formulary |
Northeast Community Care - Dual Plus (HMO)
|
$0.00 |
$310 |
to be determined |
2 |
Tier 2 |
n/a | n/a | None | n/a |
Browse Plan Formulary |
Northeast Community Care - Dual Plus (HMO)
|
$0.00 |
$310 |
to be determined |
2 |
Tier 2 |
n/a | n/a | None | n/a |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,324.12 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:18 /30Days | $1,267.93 |
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 |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,239.61 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:18 /30Days | $1,258.94 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$11.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:18 /30Days | $1,256.71 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$11.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:18 /30Days | $1,258.20 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$11.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:18 /30Days | $1,258.20 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:18 /30Days | $1,258.94 |
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:18 /30Days | $1,258.94 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:18 /30Days | $1,258.94 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:18 /30Days | $1,258.94 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:18 /30Days | $1,258.94 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:18 /30Days | $1,258.94 |
Browse Plan Formulary |
First Seniority Freedom - Drug (PFFS)
|
$17.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,299.03 |
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)
|
$17.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,299.03 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$17.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:18 /30Days | $1,258.20 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$17.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:18 /30Days | $1,258.20 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | Q:18 /365Days | $1,273.70 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | Q:18 /365Days | $1,273.70 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | Q:18 /365Days | $1,273.70 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | Q:18 /365Days | $1,273.70 |
Browse Plan Formulary |
First Seniority Freedom - Drug (PFFS)
|
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,294.09 |
Browse Plan Formulary |
First Seniority Freedom - Drug (PFFS)
|
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,294.09 |
Browse Plan Formulary |
First Seniority Freedom - Drug (PFFS)
|
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,294.09 |
Browse Plan Formulary |
First Seniority Freedom - Drug (PFFS)
|
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,294.09 |
Browse Plan Formulary |
First Seniority Freedom - Drug (PFFS)
|
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,294.09 |
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 |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,324.77 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,324.77 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | Q:18 /365Days | $1,273.70 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | Q:18 /365Days | $1,273.70 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | Q:18 /365Days | $1,273.70 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | Q:18 /365Days | $1,273.70 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | Q:18 /365Days | $1,271.69 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | Q:18 /365Days | $1,271.69 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | Q:18 /365Days | $1,271.69 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | Q:18 /365Days | $1,271.69 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$24.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:18 /30Days | $1,256.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-073 (PFFS)
|
$24.70 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:14 /30Days | $1,229.00 |
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 |
Humana Gold Choice H2944-106 (PFFS)
|
$25.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:14 /30Days | $1,229.00 |
Browse Plan Formulary |
Northeast Community Care - Enhanced (HMO)
|
$27.00 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $1,244.42 |
Browse Plan Formulary |
Northeast Community Care - Enhanced (HMO)
|
$27.00 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $1,244.42 |
Browse Plan Formulary |
Northeast Community Care - Enhanced (HMO)
|
$27.00 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $1,244.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$37.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:18 /30Days | $1,267.93 |
Browse Plan Formulary |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.00 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | P | $1,299.03 |
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)
|
$60.00 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | P | $1,299.03 |
Browse Plan Formulary |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.30 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | P | $1,294.09 |
Browse Plan Formulary |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.30 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | P | $1,294.09 |
Browse Plan Formulary |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.30 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | P | $1,294.09 |
Browse Plan Formulary |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.30 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | P | $1,294.09 |
Browse Plan Formulary |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.30 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | P | $1,294.09 |
Browse Plan Formulary |