ABILIFY 2MG TABLET (30 BOX) (NDC: 59148000613)
2010 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 |
Plan’s Avg. Retail Drug Price 30-Day |
Tier Nbr. |
Tier Desc. |
30-Day Prfrd. Pharm |
90-Day Mail Order |
First Health Part D-Secure (PDP)
|
$19.50 |
$175 |
No Gap Coverage |
3 |
Non-Preferred Generic and Non-Preferred Brand |
49% | 49% | P Q:30 /30Days | $1,420.34 |
Browse Plan Formulary |
GHI Medicare Prescription Drug Plan (PDP)
|
$27.60 |
$310 |
No Gap Coverage |
2 |
Tier #2 |
25% | 25% | None | $1,455.60 |
Browse Plan Formulary |
CIGNA Medicare Rx Plan One (PDP)
|
$27.70 |
$310 |
No Gap Coverage |
3 |
Tier 3 |
$74.00 | $185.00 | P Q:30 /30Days | $1,434.76 |
Browse Plan Formulary |
Medco Medicare Prescription Plan - Value (
|
$28.00 |
$310 |
No Gap Coverage |
3 |
Tier 3 |
25% | 25% | Q:90 /90Days | $1,437.14 |
Browse Plan Formulary |
PrescribaRx Bronze (PDP)
|
$28.30 |
$310 |
No Gap Coverage |
2 |
Tier 2 |
25% | 25% | S Q:30 /30Days | $1,438.22 |
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 |
Advantage Star Plan by RxAmerica (PDP)
|
$28.80 |
$310 |
No Gap Coverage |
4 |
Non-Preferred |
45% | 45% | S | $1,425.07 |
Browse Plan Formulary |
Fox Value Plan (PDP)
|
$29.30 |
$310 |
No Gap Coverage |
4 |
Tier 4 |
60% | 50% | S | n/a |
Browse Plan Formulary |
BravoRx (PDP)
|
$30.60 |
$310 |
No Gap Coverage |
2 |
Tier 2 |
25% | 25% | P Q:90 /90Days | $1,437.12 |
Browse Plan Formulary |
HIP Part D New York (PDP)
|
$30.60 |
$310 |
No Gap Coverage |
2 |
Tier #2 |
25% | 25% | None | $1,455.60 |
Browse Plan Formulary |
EnvisionRxPlus Silver (PDP)
|
$31.20 |
$310 |
No Gap Coverage |
4 |
Tier 4 |
25% | 25% | None | $1,460.04 |
Browse Plan Formulary |
SilverScript Value (PDP)
|
$31.60 |
$310 |
No Gap Coverage |
3 |
Non-Preferred Brand Tier |
$95.00 | $261.25 | None | $1,424.54 |
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 |
Community CCRx Basic (PDP)
|
$33.40 |
$310 |
No Gap Coverage |
3 |
Non-Preferred Brand |
60% | n/a | S Q:30 /30Days | $1,451.21 |
Browse Plan Formulary |
SmartHealth RX PDP (PDP)
|
$35.50 |
$100 |
No Gap Coverage |
3 |
Non Preferred Generic/Brand |
40% | 33% | Q:90 /90Days | $1,636.25 |
Browse Plan Formulary |
Advantage Freedom Plan by RxAmerica (PDP)
|
$35.70 |
$0 |
No Gap Coverage |
5 |
Non-Preferred |
45% | 45% | S | $1,421.78 |
Browse Plan Formulary |
Community CCRx Choice (PDP)
|
$36.20 |
$150 |
No Gap Coverage |
3 |
Non-Preferred Brand |
$65.00 | n/a | S Q:30 /30Days | $1,451.21 |
Browse Plan Formulary |
AARP MedicareRx Saver (PDP)
|
$36.40 |
$310 |
No Gap Coverage |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$93.00 | $264.00 | S Q:31 /31Days | $1,417.51 |
Browse Plan Formulary |
Health Net Orange Option 1 (PDP)
|
$37.10 |
$310 |
No Gap Coverage |
2 |
Tier 2 Preferred Brand |
$35.00 | $70.00 | Q:2 /1Days | $1,424.50 |
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 MedicareRx Preferred (PDP)
|
$37.40 |
$0 |
No Gap Coverage |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$71.25 | $198.75 | S Q:31 /31Days | $1,417.51 |
Browse Plan Formulary |
PrescribaRx Gold (PDP)
|
$37.60 |
$150 |
No Gap Coverage |
2 |
Brand |
$43.00 | $86.00 | S Q:30 /30Days | $1,438.22 |
Browse Plan Formulary |
First Health Part D-Premier (PDP)
|
$38.20 |
$150 |
No Gap Coverage |
3 |
Non-Preferred Generic/Non-Preferred Brand |
44% | 44% | P Q:30 /30Days | $1,420.28 |
Browse Plan Formulary |
First UA Medicare Part D Rx Covg - Silver
|
$38.20 |
$160 |
No Gap Coverage |
3 |
Non-Preferred Brand |
$90.00 | $225.00 | Q:90 /90Days | $1,437.02 |
Browse Plan Formulary |
MedicareRx Rewards Standard (PDP)
|
$38.70 |
$310 |
No Gap Coverage |
2 |
Tier 2 Preferred Brand Certain Generic Drugs |
25% | 25% | Q:30 /30Days | $1,506.01 |
Browse Plan Formulary |
CIGNA Medicare Rx Plan Two (PDP)
|
$40.80 |
$100 |
No Gap Coverage |
4 |
Tier 4 |
$90.00 | $225.00 | P Q:30 /30Days | $1,434.76 |
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 |
HealthSpring Prescription Drug Plan -Reg 3
|
$41.10 |
$310 |
No Gap Coverage |
2 |
Tier 2 |
25% | 25% | Q:30 /30Days | $1,435.69 |
Browse Plan Formulary |
Aetna Medicare Rx Costco Plus Plan (PDP)
|
$42.00 |
$0 |
No Gap Coverage |
4 |
Tier 4 - Non-Preferred Brand |
$80.00 | $225.00 | S Q:1 /1Days | $1,441.64 |
Browse Plan Formulary |
Humana Enhanced S5552-001 (PDP)
|
$42.70 |
$0 |
No Gap Coverage |
3 |
Non-Preferred Brand |
41% | 41% | Q:30 /30Days | $1,332.53 |
Browse Plan Formulary |
Simply Prescriptions Rx 1 (PDP)
|
$43.70 |
$310 |
No Gap Coverage |
2 |
Tier 2 |
25% | 25% | None | $1,447.79 |
Browse Plan Formulary |
First UA Medicare Part D Prescription Drug
|
$46.00 |
$0 |
No Gap Coverage |
3 |
Non-Preferred Brand |
$78.00 | $156.00 | Q:90 /90Days | $1,437.02 |
Browse Plan Formulary |
AdvantraRx Value (PDP)
|
$47.10 |
$100 |
No Gap Coverage |
3 |
Non-Preferred Generic and Non-Preferred Brand |
65% | 65% | P Q:30 /30Days | $1,420.28 |
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 |
Medco Medicare Prescription Plan - Choice
|
$47.20 |
$100 |
No Gap Coverage |
3 |
Non-Preferred Brand |
75% | 75% | Q:90 /90Days | $1,437.14 |
Browse Plan Formulary |
Aetna Medicare Rx Essentials (PDP)
|
$50.00 |
$310 |
No Gap Coverage |
4 |
Tier 4 - Non-Preferred Brand |
$67.00 | $186.00 | S Q:1 /1Days | $1,441.64 |
Browse Plan Formulary |
EnvisionRxPlus Gold (PDP)
|
$51.10 |
$150 |
No Gap Coverage |
4 |
Tier 4 NonPreferred Brand |
25% | 25% | None | $1,460.04 |
Browse Plan Formulary |
CVS Caremark Plus (PDP)
|
$51.40 |
$50 |
No Gap Coverage |
5 |
Non-Preferred Brand Tier |
$90.00 | $248.00 | None | $1,421.27 |
Browse Plan Formulary |
MedicareRx Rewards Plus (PDP)
|
$51.40 |
$0 |
No Gap Coverage |
2 |
Tier 2 Preferred Brand Certain Generic Drugs |
$43.00 | $107.50 | Q:30 /30Days | $1,506.01 |
Browse Plan Formulary |
Simply Prescriptions Rx 3 (PDP)
|
$57.00 |
$100 |
No Gap Coverage |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,447.79 |
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 |
AdvantraRx Premier (PDP)
|
$57.40 |
$0 |
No Gap Coverage |
3 |
Non-Preferred Generic and Brand |
50% | 50% | P Q:30 /30Days | $1,420.28 |
Browse Plan Formulary |
Humana Standard S5552-003 (PDP)
|
$59.90 |
$310 |
No Gap Coverage |
3 |
Non-Preferred Brand |
38% | 38% | Q:30 /30Days | $1,332.53 |
Browse Plan Formulary |
Sterling Rx (PDP)
|
$64.90 |
$310 |
No Gap Coverage |
2 |
Brand |
$30.00 | $60.00 | Q:34 /34Days | $1,489.67 |
Browse Plan Formulary |
Health Net Orange Option 2 (PDP)
|
$65.80 |
$0 |
No Gap Coverage |
2 |
Tier 2 Preferred Brand |
$35.00 | $70.00 | Q:2 /1Days | $1,424.50 |
Browse Plan Formulary |
AdvantraRx Premier Plus (PDP)
|
$67.20 |
$0 |
Many Generics |
4 |
Non-Preferred Brand |
75% | 75% | P Q:30 /30Days | $1,420.28 |
Browse Plan Formulary |
HIP Enhanced Part D New York (PDP)
|
$68.60 |
$0 |
Many Generics |
2 |
Tier #2 |
$25.00 | $50.00 | None | $1,455.60 |
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 Rx Plan Three (PDP)
|
$71.00 |
$0 |
Many Generics, Few Brands |
3 |
Tier 3 |
$60.00 | $150.00 | P Q:30 /30Days | $1,434.76 |
Browse Plan Formulary |
CVS Caremark Complete (PDP)
|
$76.70 |
$0 |
Many Generics |
4 |
Non-Preferred Brand Tier |
$98.00 | $270.00 | None | $1,421.23 |
Browse Plan Formulary |
Medco Medicare Prescription Plan - Access
|
$77.80 |
$0 |
Many Generics |
3 |
Non-Preferred Brand |
75% | 75% | Q:90 /90Days | $1,437.14 |
Browse Plan Formulary |
AARP MedicareRx Enhanced (PDP)
|
$80.10 |
$0 |
Many Generics |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$90.00 | $255.00 | S Q:31 /31Days | $1,417.51 |
Browse Plan Formulary |
Community CCRx Gold (PDP)
|
$81.00 |
$0 |
All Generics |
3 |
Non-Preferred Brand |
$65.00 | n/a | S Q:30 /30Days | $1,451.21 |
Browse Plan Formulary |
Humana Complete S5552-002 (PDP)
|
$105.50 |
$0 |
Many Generics |
3 |
Non-Preferred Brand |
$75.00 | $187.50 | Q:30 /30Days | $1,332.53 |
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 Rx Premier (PDP)
|
$117.50 |
$0 |
Many Generics |
4 |
Tier 4 - Non-Preferred Brand |
$88.00 | $249.00 | S Q:1 /1Days | $1,441.64 |
Browse Plan Formulary |