METHADONE HCL ORAL CONCENTRATE 10MG 946ML BOT (946 ML BOT) (NDC: 66689069439)
2011 Medicare Prescription Drug Plan (MAPD) Information
Click here for the Chart Legend |
Plan Name |
Monthly Prem. |
De- duct- ible |
Does Plan Offer Additional 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 Choice (PPO)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $12.00 | None | $61.42 |
Browse Plan Formulary |
AARP MedicareComplete Choice Plan 2 (Regional PPO)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $12.00 | None | $62.74 |
Browse Plan Formulary |
AARP MedicareComplete Plus Plan 1 (HMO-POS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $12.00 | None | $61.42 |
Browse Plan Formulary |
Advantage (HMO)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $10.00 | Q:24 /1Days | $62.27 |
Browse Plan Formulary |
Advantage Health Florida (HMO SNP)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | Q:24 /1Days | $62.27 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Advantage Silver (HMO)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | Q:24 /1Days | $62.65 |
Browse Plan Formulary |
Amerivantage Classic + Rx (HMO)
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$4.00 | $8.00 | None | $62.34 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$15.00 | $30.00 | None | n/a |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$3.00 | $6.00 | None | n/a |
Browse Plan Formulary |
CareOne (HMO)
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $0.00 | None | $1,030.50 |
Browse Plan Formulary |
CareOne Plus (HMO)
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$0.00 | $0.00 | None | n/a |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Citrus Total (HMO)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $60.45 |
Browse Plan Formulary |
Coventry Advantra Ideal (HMO)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $58.88 |
Browse Plan Formulary |
Coventry Advantra Maximum (HMO SNP)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $60.49 |
Browse Plan Formulary |
Coventry Advantra Plus (HMO)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $60.49 |
Browse Plan Formulary |
Coventry Advantra Select (HMO-POS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $60.49 |
Browse Plan Formulary |
e-Any, Any, Any Gold Direct (PFFS)
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$15.00 | $30.00 | None | n/a |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
e-Medicare Masterpiece Direct (HMO)
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$6.00 | $12.00 | None | n/a |
Browse Plan Formulary |
e-Medicare Masterpiece Premier Direct (HMO)
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$2.00 | $4.00 | None | n/a |
Browse Plan Formulary |
Freedom Medicare Plan Rx (HMO)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | Q:360 /30Days | $65.14 |
Browse Plan Formulary |
Freedom Savings Plan Rx (HMO)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | Q:360 /30Days | $65.14 |
Browse Plan Formulary |
Freedom VIP Care (HMO SNP)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | Q:360 /30Days | $65.51 |
Browse Plan Formulary |
Freedom VIP Care COPD (HMO SNP)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | Q:360 /30Days | $65.51 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Freedom VIP Savings (HMO SNP)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | Q:360 /30Days | $65.51 |
Browse Plan Formulary |
Freedom VIP Savings COPD (HMO SNP)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | Q:360 /30Days | $65.51 |
Browse Plan Formulary |
Humana Gold Plus H1036-025 (HMO)
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$0.00 | $0.00 | None | $853.22 |
Browse Plan Formulary |
Humana Gold Plus H1036-141 (HMO)
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$8.00 | $0.00 | None | n/a |
Browse Plan Formulary |
Medicare Masterpiece (HMO)
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$4.00 | $8.00 | None | $58.33 |
Browse Plan Formulary |
Medicare Masterpiece (PPO)
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$15.00 | $30.00 | None | $60.98 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Masterpiece Premier (HMO)
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$0.00 | $0.00 | None | $60.98 |
Browse Plan Formulary |
Medicare Masterpiece Premier SNP - COPD (HMO SNP)
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$0.00 | $0.00 | None | $60.98 |
Browse Plan Formulary |
Medicare Masterpiece Premier SNP - Dementia (HMO SNP)
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$0.00 | $0.00 | None | $60.98 |
Browse Plan Formulary |
Medicare Masterpiece Premier SNP - Diabetes (HMO SNP)
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$0.00 | $0.00 | None | $60.98 |
Browse Plan Formulary |
Medicare Masterpiece Premier SNP - Institutional (HMO SNP)
|
$0.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $60.98 |
Browse Plan Formulary |
Molina Medicare Options Palm Beach, Hillsb & Pinel (HMO)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $15.00 | None | $67.29 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Optimum Gold Plan (HMO-POS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | Q:360 /30Days | $65.14 |
Browse Plan Formulary |
Optimum Platinum Plan (HMO)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | Q:360 /30Days | $65.14 |
Browse Plan Formulary |
Optimum Platinum Plus (HMO-POS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | Q:360 /30Days | n/a |
Browse Plan Formulary |
Preferred Care Partners Preferred Gold Option (HMO)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | n/a |
Browse Plan Formulary |
Preferred Care Partners Preferred PremiumAdvantage (HMO-POS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $64.41 |
Browse Plan Formulary |
PUP Easy (HMO)
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$0.00 | $0.00 | Q:24 /1Days | $61.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
PUP Rewards (HMO)
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$5.00 | $15.00 | Q:24 /1Days | $61.42 |
Browse Plan Formulary |
Value One Florida (HMO SNP)
|
$0.00 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:24 /1Days | $62.27 |
Browse Plan Formulary |
Freedom Medi-Medi (HMO SNP)
|
$8.70 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | Q:360 /30Days | $65.42 |
Browse Plan Formulary |
Optimum Emerald Partial (HMO SNP)
|
$11.40 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | Q:360 /30Days | $65.14 |
Browse Plan Formulary |
Optimum Emerald Full (HMO SNP)
|
$11.50 |
$310 |
to be determined |
1 |
Tier 1 |
n/a | n/a | Q:360 /30Days | $65.14 |
Browse Plan Formulary |
PUP Extra (HMO SNP)
|
$13.50 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | Q:24 /1Days | $61.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Masterpiece Plus (HMO-POS)
|
$13.90 |
$0 |
to be determined |
2 |
Tier 2 |
$15.00 | $30.00 | None | $60.98 |
Browse Plan Formulary |
Aetna Medicare Value Plan (HMO)
|
$18.40 |
$0 |
to be determined |
1 |
Tier 1: Preferred Generic Drugs |
$8.00 | $16.00 | Q:20 /1Days | $54.24 |
Browse Plan Formulary |
HumanaChoice R5826-074 (Regional PPO)
|
$20.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | None | $949.34 |
Browse Plan Formulary |
Humana Gold Plus SNP-DE H1036-102 (HMO SNP)
|
$23.30 |
$310 |
to be determined |
2 |
Tier 2 |
$0.00 | $0.00 | None | $1,030.50 |
Browse Plan Formulary |
Evercare Plan DH (HMO SNP)
|
$23.50 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $61.42 |
Browse Plan Formulary |
Evercare Plan DH (HMO SNP)
|
$24.00 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $61.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Amerivantage Specialty + Rx (HMO SNP)
|
$25.40 |
$310 |
to be determined |
2 |
Tier 2 |
n/a | n/a | None | $62.24 |
Browse Plan Formulary |
CareNeeds (HMO SNP)
|
$25.40 |
$310 |
to be determined |
2 |
Tier 2 |
$0.00 | $0.00 | None | $1,030.50 |
Browse Plan Formulary |
CareNeeds Plus (HMO SNP)
|
$25.40 |
$310 |
to be determined |
2 |
Tier 2 |
$0.00 | $0.00 | None | $1,030.50 |
Browse Plan Formulary |
Citrus Plus (HMO SNP)
|
$25.40 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $65.28 |
Browse Plan Formulary |
Evercare Plan IP (PPO SNP)
|
$25.40 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | None | $62.65 |
Browse Plan Formulary |
Evercare Plan RDP (Regional PPO SNP)
|
$25.40 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $62.74 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Masterpiece Premier SNP - Dual (HMO SNP)
|
$25.40 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | None | $60.98 |
Browse Plan Formulary |
Molina Medicare Options Plus (HMO SNP)
|
$25.40 |
$310* |
to be determined |
1* |
Tier 1 |
$0.00 | $0.00 | None | $59.15 |
Browse Plan Formulary |
Humana Gold Choice H8145-061 (PFFS)
|
$26.10 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $0.00 | None | n/a |
Browse Plan Formulary |
HumanaChoice R5826-005 (Regional PPO)
|
$28.50 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | None | $949.34 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
|
$37.80 |
$0 |
to be determined |
1 |
Tier 1: Preferred Generic Drugs |
$8.00 | $16.00 | Q:20 /1Days | $54.24 |
Browse Plan Formulary |