ALIMTA 500MG VIAL (1 VIAL) (NDC: 00002762301)
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 |
AARP MedicareComplete Balance Plus (HMO-PO
|
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,661.85 |
Browse Plan Formulary |
AARP MedicareComplete Balance Plus (HMO-PO
|
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,661.85 |
Browse Plan Formulary |
AARP MedicareComplete Balance Plus (HMO-PO
|
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,661.85 |
Browse Plan Formulary |
AARP MedicareComplete Balance Plus (HMO-PO
|
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,661.85 |
Browse Plan Formulary |
AARP MedicareComplete Balance Plus (HMO-PO
|
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,661.85 |
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 |
AARP MedicareComplete Balance Plus (HMO-PO
|
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,661.85 |
Browse Plan Formulary |
AARP MedicareComplete Balance Plus (HMO-PO
|
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,661.85 |
Browse Plan Formulary |
AARP MedicareComplete Balance Plus (HMO-PO
|
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,661.85 |
Browse Plan Formulary |
AARP MedicareComplete Balance Plus (HMO-PO
|
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,661.85 |
Browse Plan Formulary |
AARP MedicareComplete Plus (HMO-POS)
|
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,661.85 |
Browse Plan Formulary |
Aetna Medicare Value Plan (HMO)
|
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $2,634.26 |
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 |
AmeriChoice Personal Care Plus (HMO)
|
$0.00 |
$310 |
to be determined |
2 |
Tier 2 |
n/a | n/a | P | n/a |
Browse Plan Formulary |
AmeriChoice Personal Care Plus (HMO)
|
$0.00 |
$310 |
to be determined |
2 |
Tier 2 |
n/a | n/a | P | n/a |
Browse Plan Formulary |
AmeriChoice Personal Care Plus (HMO)
|
$0.00 |
$310 |
to be determined |
2 |
Tier 2 |
n/a | n/a | P | n/a |
Browse Plan Formulary |
AmeriChoice Personal Care Plus (HMO)
|
$0.00 |
$310 |
to be determined |
2 |
Tier 2 |
n/a | n/a | P | n/a |
Browse Plan Formulary |
AmeriChoice Personal Care Plus (HMO)
|
$0.00 |
$310 |
to be determined |
2 |
Tier 2 |
n/a | n/a | P | n/a |
Browse Plan Formulary |
AmeriChoice Personal Care Plus (HMO)
|
$0.00 |
$310 |
to be determined |
2 |
Tier 2 |
n/a | n/a | P | n/a |
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 |
AmeriChoice Personal Care Plus (HMO)
|
$0.00 |
$310 |
to be determined |
2 |
Tier 2 |
n/a | n/a | P | n/a |
Browse Plan Formulary |
AmeriChoice Personal Care Plus (HMO)
|
$0.00 |
$310 |
to be determined |
2 |
Tier 2 |
n/a | n/a | P | n/a |
Browse Plan Formulary |
AmeriChoice Personal Care Plus (HMO)
|
$0.00 |
$310 |
to be determined |
2 |
Tier 2 |
n/a | n/a | P | n/a |
Browse Plan Formulary |
AmeriChoice Personal Care Plus (HMO)
|
$0.00 |
$310 |
to be determined |
2 |
Tier 2 |
n/a | n/a | P | n/a |
Browse Plan Formulary |
AmeriChoice Personal Care Plus (HMO)
|
$0.00 |
$310 |
to be determined |
2 |
Tier 2 |
n/a | n/a | P | n/a |
Browse Plan Formulary |
AmeriChoice Personal Care Plus (HMO)
|
$0.00 |
$310 |
to be determined |
2 |
Tier 2 |
n/a | n/a | P | n/a |
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 |
Amerivantage Balance + Rx (HMO)
|
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $2,682.66 |
Browse Plan Formulary |
Amerivantage Classic + Rx (HMO)
|
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $2,682.66 |
Browse Plan Formulary |
Amerivantage Classic + Rx (HMO)
|
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $2,682.66 |
Browse Plan Formulary |
Amerivantage Classic + Rx (HMO)
|
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $2,682.66 |
Browse Plan Formulary |
Amerivantage Classic + Rx (HMO)
|
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $2,682.66 |
Browse Plan Formulary |
Amerivantage Classic + Rx (HMO)
|
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $2,682.66 |
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 |
Amerivantage Classic + Rx (HMO)
|
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $2,682.66 |
Browse Plan Formulary |
Amerivantage Classic + Rx (HMO)
|
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $2,682.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,866.10 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,866.10 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,866.10 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,866.10 |
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 | P | $2,866.10 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (HMO)
|
$27.00 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $2,677.71 |
Browse Plan Formulary |
AmeriChoice Personal Care Plus (HMO)
|
$31.20 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P | $2,661.85 |
Browse Plan Formulary |
Evercare Plan IH (HMO)
|
$34.20 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,666.58 |
Browse Plan Formulary |
Aetna Medicare Dual Advantage Plan (HMO)
|
$35.00 |
$310 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $2,634.26 |
Browse Plan Formulary |
Aetna Medicare Dual Advantage Plan (HMO)
|
$35.00 |
$310 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $2,634.26 |
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 |
Aetna Medicare Dual Advantage Plan (HMO)
|
$35.00 |
$310 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $2,634.26 |
Browse Plan Formulary |
Aetna Medicare Dual Advantage Plan (HMO)
|
$35.00 |
$310 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $2,634.26 |
Browse Plan Formulary |
Aetna Medicare Dual Advantage Plan (HMO)
|
$35.00 |
$310 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $2,634.26 |
Browse Plan Formulary |
Aetna Medicare Dual Advantage Plan (HMO)
|
$35.00 |
$310 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $2,634.26 |
Browse Plan Formulary |
Aetna Medicare Dual Advantage Plan (HMO)
|
$35.00 |
$310 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $2,634.26 |
Browse Plan Formulary |
Aetna Medicare Dual Advantage Plan (HMO)
|
$35.00 |
$310 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $2,634.26 |
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 |
Aetna Medicare Dual Advantage Plan (HMO)
|
$35.00 |
$310 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $2,634.26 |
Browse Plan Formulary |
Aetna Medicare Dual Advantage Plan (HMO)
|
$35.00 |
$310 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $2,634.26 |
Browse Plan Formulary |
Amerivantage Specialty + Rx (HMO)
|
$35.00 |
$310 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $2,682.66 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
|
$39.90 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $2,634.26 |
Browse Plan Formulary |
Horizon Medicare Blue Value w/ Rx Std (HMO
|
$40.40 |
$310 |
to be determined |
2 |
Tier 2 |
$38.00 | $114.00 | P | $2,682.66 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
|
$48.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $2,677.71 |
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 |
Aetna Medicare Premier Plan (HMO)
|
$48.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $2,677.71 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
|
$48.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $2,677.71 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
|
$48.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $2,677.71 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
|
$48.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $2,677.71 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
|
$48.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $2,677.71 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
|
$48.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $2,677.71 |
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 |
Horizon Medicare Blue Value w/ Rx Enhanced
|
$66.30 |
$0 |
to be determined |
2 |
Tier 2 |
$37.00 | $111.00 | P | $2,682.66 |
Browse Plan Formulary |
Horizon Medicare Blue Access w/ Rx Std (HM
|
$67.10 |
$310 |
to be determined |
2 |
Tier 2 |
$43.00 | $129.00 | P | $2,682.66 |
Browse Plan Formulary |
Horizon Medicare Blue Access w/Rx Enhanced
|
$77.30 |
$0 |
to be determined |
2 |
Tier 2 |
$37.00 | $111.00 | P | $2,682.66 |
Browse Plan Formulary |