ACTONEL 35MG TABLET (4 CRTN) (NDC: 00149047201)
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 |
Humana Gold Plus H2949-002 (HMO)
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:4 /28Days | $99.46 |
Browse Plan Formulary |
Humana Gold Plus H2949-007 (HMO)
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:4 /28Days | $100.46 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:4 /28Days | $106.90 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:4 /28Days | $106.90 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:4 /28Days | $106.90 |
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)
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:4 /28Days | $114.56 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:4 /28Days | $114.56 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:4 /28Days | $114.56 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:4 /28Days | $114.56 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:4 /28Days | $114.56 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:4 /28Days | $114.56 |
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)
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:4 /28Days | $114.56 |
Browse Plan Formulary |
Senior Dimensions Greater Nevada Plan (HM
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | n/a | Q:4 /28Days | $90.61 |
Browse Plan Formulary |
Senior Dimensions Northern Nevada Plan (HM
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | n/a | Q:4 /28Days | $90.61 |
Browse Plan Formulary |
Senior Dimensions Southern Nevada Plan (HM
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | n/a | Q:4 /28Days | $90.61 |
Browse Plan Formulary |
Senior Dimensions Southern Nevada Plan (HM
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | n/a | Q:4 /28Days | $90.61 |
Browse Plan Formulary |
Sierra Nevada Spectrum (Regional PPO)
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | n/a | Q:4 /28Days | $90.61 |
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 |
Sierra VillageHealth (HMO)
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | n/a | Q:4 /28Days | $90.61 |
Browse Plan Formulary |
Spectrum Care Plus (HMO)
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | n/a | Q:4 /28Days | $90.61 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$7.40 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:4 /28Days | $114.79 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$7.40 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:4 /28Days | $114.79 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$7.40 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:4 /28Days | $114.79 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$7.40 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:4 /28Days | $114.79 |
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 |
SmartValue Plus (PFFS)
|
$7.40 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:4 /28Days | $114.79 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$7.40 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:4 /28Days | $114.79 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$7.40 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:4 /28Days | $114.79 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$7.40 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:4 /28Days | $114.79 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$7.40 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:4 /28Days | $114.79 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$7.40 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:4 /28Days | $114.79 |
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 |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $108.20 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $108.20 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $108.20 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $108.20 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $108.20 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $108.16 |
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 |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $108.20 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $108.20 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $108.20 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $108.20 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $108.20 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $108.20 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $108.20 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $108.20 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $108.20 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $108.20 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $108.20 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $108.20 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $108.20 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $108.20 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $108.20 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $108.20 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $108.20 |
Browse Plan Formulary |
Anthem Medicare Preferred Premier (PPO)
|
$20.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:4 /28Days | $114.81 |
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 |
Anthem Medicare Preferred Premier (PPO)
|
$20.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:4 /28Days | $114.81 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $108.16 |
Browse Plan Formulary |
Anthem Medicare Preferred Select (PPO)
|
$24.20 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:4 /28Days | $114.81 |
Browse Plan Formulary |
Anthem Medicare Preferred Select (PPO)
|
$24.20 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:4 /28Days | $114.81 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:4 /28Days | $100.77 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:4 /28Days | $100.77 |
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 H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:4 /28Days | $100.77 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:4 /28Days | $100.77 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:4 /28Days | $100.77 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:4 /28Days | $100.77 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:4 /28Days | $100.77 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:4 /28Days | $100.77 |
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 H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:4 /28Days | $100.77 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:4 /28Days | $100.77 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:4 /28Days | $100.77 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:4 /28Days | $100.77 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:4 /28Days | $100.77 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:4 /28Days | $100.77 |
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 H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:4 /28Days | $100.77 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:4 /28Days | $100.77 |
Browse Plan Formulary |
HumanaChoice H9503-003 (PPO)
|
$33.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:4 /28Days | $100.14 |
Browse Plan Formulary |
Humana Gold Choice H2944-053 (PFFS)
|
$43.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:4 /28Days | $99.67 |
Browse Plan Formulary |
Humana Gold Choice H2944-053 (PFFS)
|
$43.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:4 /28Days | $99.67 |
Browse Plan Formulary |
Humana Gold Choice H2944-053 (PFFS)
|
$43.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:4 /28Days | $99.67 |
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 H2944-053 (PFFS)
|
$43.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:4 /28Days | $99.67 |
Browse Plan Formulary |
Humana Gold Choice H2944-053 (PFFS)
|
$43.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:4 /28Days | $99.67 |
Browse Plan Formulary |
Humana Gold Choice H2944-053 (PFFS)
|
$43.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:4 /28Days | $99.67 |
Browse Plan Formulary |