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)
|
$16.70 |
$175 |
No Gap Coverage |
3 |
Non-Preferred Generic and Non-Preferred Brand |
52% | 52% | P Q:30 /30Days | $1,419.64 |
Browse Plan Formulary |
Community CCRx Basic (PDP)
|
$20.60 |
$310 |
No Gap Coverage |
3 |
Non-Preferred Brand |
65% | n/a | S Q:30 /30Days | $1,455.77 |
Browse Plan Formulary |
PrescribaRx Bronze (PDP)
|
$24.30 |
$310 |
No Gap Coverage |
2 |
Tier 2 |
25% | 25% | S Q:30 /30Days | $1,442.23 |
Browse Plan Formulary |
Humana Value S5884-104 (PDP)
|
$26.70 |
$150 |
No Gap Coverage |
3 |
Non-Preferred Brand |
36% | 36% | Q:30 /30Days | $1,334.98 |
Browse Plan Formulary |
AARP MedicareRx Saver (PDP)
|
$27.10 |
$310 |
No Gap Coverage |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$82.75 | $233.25 | S Q:31 /31Days | $1,420.17 |
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 One (PDP)
|
$28.10 |
$310 |
No Gap Coverage |
3 |
Tier 3 |
$90.00 | $225.00 | P Q:30 /30Days | $1,434.82 |
Browse Plan Formulary |
AdvantraRx Value (PDP)
|
$29.20 |
$100 |
No Gap Coverage |
3 |
Non-Preferred Generic and Non-Preferred Brand |
65% | 65% | P Q:30 /30Days | $1,419.64 |
Browse Plan Formulary |
Medco Medicare Prescription Plan - Value (
|
$29.90 |
$310 |
No Gap Coverage |
3 |
Tier 3 |
25% | 25% | Q:90 /90Days | $1,438.94 |
Browse Plan Formulary |
AmeriHealth Advantage (PDP)
|
$30.10 |
$310 |
No Gap Coverage |
3 |
Tier 3 |
25% | n/a | None | $1,524.61 |
Browse Plan Formulary |
BravoRx (PDP)
|
$30.70 |
$310 |
No Gap Coverage |
2 |
Tier 2 |
25% | 25% | P Q:90 /90Days | $1,438.89 |
Browse Plan Formulary |
Fox Value Plan (PDP)
|
$30.90 |
$310 |
No Gap Coverage |
4 |
Tier 4 |
60% | 50% | S Q:30 /30Days | 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 |
Health Net Orange Option 1 (PDP)
|
$30.90 |
$310 |
No Gap Coverage |
2 |
Tier 2 Preferred Brand |
$39.00 | $78.00 | Q:2 /1Days | $1,425.11 |
Browse Plan Formulary |
SilverScript Value (PDP)
|
$31.60 |
$310 |
No Gap Coverage |
3 |
Non-Preferred Brand Tier |
$95.00 | $261.25 | None | $1,425.12 |
Browse Plan Formulary |
Advantage Star Plan by RxAmerica (PDP)
|
$31.70 |
$310 |
No Gap Coverage |
4 |
Non-Preferred |
45% | 45% | S | $1,425.14 |
Browse Plan Formulary |
PrescribaRx Gold (PDP)
|
$32.10 |
$150 |
No Gap Coverage |
2 |
Brand |
$43.00 | $86.00 | S Q:30 /30Days | $1,442.23 |
Browse Plan Formulary |
HealthSpring Prescription Drug Plan -Reg 6
|
$32.50 |
$310 |
No Gap Coverage |
2 |
Tier 2 |
25% | 25% | Q:30 /30Days | $1,419.93 |
Browse Plan Formulary |
MedicareRx Rewards Standard (PDP)
|
$32.80 |
$310 |
No Gap Coverage |
2 |
Tier 2 Preferred Brand Certain Generic Drugs |
25% | 25% | Q:30 /30Days | $1,501.36 |
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 |
EnvisionRxPlus Silver (PDP)
|
$33.00 |
$310 |
No Gap Coverage |
4 |
Tier 4 |
25% | 25% | None | $1,467.92 |
Browse Plan Formulary |
CIGNA Medicare Rx Plan Two (PDP)
|
$33.60 |
$100 |
No Gap Coverage |
4 |
Tier 4 |
$82.00 | $205.00 | P Q:30 /30Days | $1,434.82 |
Browse Plan Formulary |
MedicareRx Rewards Plus (PDP)
|
$33.90 |
$0 |
No Gap Coverage |
2 |
Tier 2 Preferred Brand Certain Generic Drugs |
$43.00 | $107.50 | Q:30 /30Days | $1,501.36 |
Browse Plan Formulary |
Community CCRx Choice (PDP)
|
$35.40 |
$150 |
No Gap Coverage |
3 |
Non-Preferred Brand |
$65.00 | n/a | S Q:30 /30Days | $1,455.77 |
Browse Plan Formulary |
Aetna Medicare Rx Plus (PDP)
|
$36.70 |
$0 |
No Gap Coverage |
4 |
Tier 4 - Non-Preferred Brand |
$80.00 | $225.00 | S Q:1 /1Days | $1,453.14 |
Browse Plan Formulary |
AARP MedicareRx Preferred (PDP)
|
$37.40 |
$0 |
No Gap Coverage |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$90.00 | $255.00 | S Q:31 /31Days | $1,420.17 |
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
|
$38.90 |
$100 |
No Gap Coverage |
3 |
Non-Preferred Brand |
75% | 75% | Q:90 /90Days | $1,438.94 |
Browse Plan Formulary |
First Health Part D-Premier (PDP)
|
$40.00 |
$150 |
No Gap Coverage |
3 |
Non-Preferred Generic/Non-Preferred Brand |
43% | 43% | P Q:30 /30Days | $1,419.64 |
Browse Plan Formulary |
AdvantraRx Premier (PDP)
|
$41.00 |
$0 |
No Gap Coverage |
3 |
Non-Preferred Generic and Non-Preferred Brand |
52% | 52% | P Q:30 /30Days | $1,419.64 |
Browse Plan Formulary |
Humana Enhanced S5884-005 (PDP)
|
$41.20 |
$0 |
No Gap Coverage |
3 |
Non-Preferred Brand |
$75.00 | $187.50 | Q:30 /30Days | $1,334.98 |
Browse Plan Formulary |
UA Medicare Part D Rx Covg - Silver Plan (
|
$41.90 |
$170 |
No Gap Coverage |
3 |
Non-Preferred Brand |
$90.00 | $225.00 | Q:90 /90Days | $1,438.85 |
Browse Plan Formulary |
Sterling Rx (PDP)
|
$45.20 |
$310 |
No Gap Coverage |
2 |
Brand |
$29.00 | $58.00 | Q:34 /34Days | $1,487.24 |
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 |
CVS Caremark Plus (PDP)
|
$45.40 |
$50 |
No Gap Coverage |
5 |
Non-Preferred Brand Tier |
$90.00 | $248.00 | None | $1,421.70 |
Browse Plan Formulary |
UA Medicare Part D Prescription Drug Cov (
|
$46.10 |
$0 |
No Gap Coverage |
3 |
Non-Preferred Brand |
$76.00 | $152.00 | Q:90 /90Days | $1,438.85 |
Browse Plan Formulary |
SecureRx - Option 4 (PDP)
|
$47.30 |
$310 |
No Gap Coverage |
2 |
Tier 2 |
25% | 25% | Q:30 /30Days | $1,480.14 |
Browse Plan Formulary |
Advantage Freedom Plan by RxAmerica (PDP)
|
$49.00 |
$0 |
No Gap Coverage |
5 |
Non-Preferred |
45% | 45% | S | $1,421.74 |
Browse Plan Formulary |
Aetna Medicare Rx Essentials (PDP)
|
$49.00 |
$310 |
No Gap Coverage |
4 |
Tier 4 - Non-Preferred Brand |
$68.00 | $189.00 | S Q:1 /1Days | $1,453.14 |
Browse Plan Formulary |
SecureRx - Option 3 (PDP)
|
$49.00 |
$0 |
No Gap Coverage |
2 |
Formulary Brand Drugs |
$45.00 | $112.00 | Q:30 /30Days | $1,480.14 |
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 |
Geisinger Gold Rx 1 (PDP)
|
$50.40 |
$310 |
No Gap Coverage |
2 |
Tier 2 |
25% | 25% | None | $1,404.35 |
Browse Plan Formulary |
BlueRx Plus (PDP)
|
$51.30 |
$0 |
No Gap Coverage |
3 |
Non-Preferred Brand |
$90.00 | $225.00 | None | $1,442.45 |
Browse Plan Formulary |
Health Net Value Orange Option 2 (PDP)
|
$51.70 |
$0 |
No Gap Coverage |
2 |
Tier 2 Preferred Brand |
$42.00 | $84.00 | Q:2 /1Days | $1,425.11 |
Browse Plan Formulary |
UPMC for Life (PDP)
|
$52.30 |
$0 |
No Gap Coverage |
2 |
Tier 2 - Preferred Brand |
$32.00 | $80.00 | P Q:31 /31Days | $1,480.38 |
Browse Plan Formulary |
EnvisionRxPlus Gold (PDP)
|
$54.80 |
$150 |
No Gap Coverage |
4 |
Tier 4 NonPreferred Brand |
25% | 25% | None | $1,467.92 |
Browse Plan Formulary |
BlueRx Value (PDP)
|
$56.20 |
$310 |
No Gap Coverage |
3 |
Non Preferred Brand |
$63.00 | $157.50 | None | $1,442.45 |
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 |
CIGNA Medicare Rx Plan Three (PDP)
|
$57.40 |
$0 |
Many Generics, Few Brands |
3 |
Tier 3 |
$60.00 | $150.00 | P Q:30 /30Days | $1,434.82 |
Browse Plan Formulary |
AdvantraRx Premier Plus (PDP)
|
$61.20 |
$0 |
Many Generics |
4 |
Non-Preferred Brand |
75% | 75% | P Q:30 /30Days | $1,419.64 |
Browse Plan Formulary |
AmeriHealth Rx Option I (PDP)
|
$65.50 |
$310 |
No Gap Coverage |
3 |
Tier 3 |
25% | 25% | None | $1,517.63 |
Browse Plan Formulary |
AmeriHealth Rx Option II (PDP)
|
$66.70 |
$100 |
Many Generics |
3 |
Preferred Brand |
$35.00 | $70.00 | None | $1,517.63 |
Browse Plan Formulary |
CVS Caremark Complete (PDP)
|
$66.90 |
$0 |
Many Generics |
4 |
Non-Preferred Brand Tier |
$98.00 | $270.00 | None | $1,421.70 |
Browse Plan Formulary |
Medco Medicare Prescription Plan - Access
|
$73.80 |
$0 |
Many Generics |
3 |
Non-Preferred Brand |
75% | 75% | Q:90 /90Days | $1,438.94 |
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 |
Community CCRx Gold (PDP)
|
$77.30 |
$0 |
All Generics |
3 |
Non-Preferred Brand |
$65.00 | n/a | S Q:30 /30Days | $1,455.77 |
Browse Plan Formulary |
AARP MedicareRx Enhanced (PDP)
|
$81.10 |
$0 |
Many Generics |
3 |
Tier 3 Non-Preferred Generic Non-Preferred Brand |
$90.00 | $255.00 | S Q:31 /31Days | $1,420.17 |
Browse Plan Formulary |
Aetna Medicare Rx Premier (PDP)
|
$83.70 |
$0 |
Many Generics |
4 |
Tier 4 - Non-Preferred Brand |
$86.00 | $243.00 | S Q:1 /1Days | $1,453.14 |
Browse Plan Formulary |
BlueRx Complete (PDP)
|
$93.90 |
$0 |
Many Generics |
3 |
Non-Preferred Brand |
$70.00 | $175.00 | None | $1,442.45 |
Browse Plan Formulary |
Humana Complete S5884-034 (PDP)
|
$100.10 |
$0 |
Many Generics |
3 |
Non-Preferred Brand |
$75.00 | $187.50 | Q:30 /30Days | $1,334.98 |
Browse Plan Formulary |
SecureRx - Option 1 (PDP)
|
$110.70 |
$0 |
Many Generics |
2 |
Preferred Brand Drugs |
$35.00 | $85.00 | Q:30 /30Days | $1,480.14 |
Browse Plan Formulary |