Budesonide 3mg 100 CAPSULE BOTTLE (100 CAPSULE BOTTLE ) (NDC: 00378715501)
2012 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 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$88.00 | $254.00 | None | $1,003.79 |
Browse Plan Formulary |
AARP MedicareComplete Plus Plan 1 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Plus Plan 1 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$90.00 | $260.00 | None | $1,003.79 |
Browse Plan Formulary |
Anthem Medicare Preferred Core (PPO)
![Email Prescription and/or Health Benefit details for Anthem Medicare Preferred Core (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$60* |
to be determined |
1* |
Tier 1 |
$0.00 | $0.00 | None | $992.01 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$15.00 | $30.00 | None | $1,234.24 |
Browse Plan Formulary |
Care Improvement Plus Gold Rx (Regional PPO SNP)
![Email Prescription and/or Health Benefit details for Care Improvement Plus Gold Rx (Regional PPO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $20.00 | None | $1,234.24 |
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 |
Coventry Total Care (HMO-POS)
![Email Prescription and/or Health Benefit details for Coventry Total Care (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $240.00 | None | $1,239.80 |
Browse Plan Formulary |
Essence Advantage (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $15.00 | None | $1,146.42 |
Browse Plan Formulary |
Gold Advantage Option 1 (HMO)
![Email Prescription and/or Health Benefit details for Gold Advantage Option 1 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $240.00 | None | $1,239.80 |
Browse Plan Formulary |
Gold Advantage Option II (HMO)
![Email Prescription and/or Health Benefit details for Gold Advantage Option II (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $240.00 | None | $1,239.80 |
Browse Plan Formulary |
Humana Gold Plus H2649-023 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H2649-023 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,003.26 |
Browse Plan Formulary |
Universal Hassle-Free (PPO)
![Email Prescription and/or Health Benefit details for Universal Hassle-Free (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$15.00 | $30.00 | None | $1,234.24 |
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 |
WellCare Value (HMO-POS)
![Email Prescription and/or Health Benefit details for WellCare Value (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$3.00 | $7.50 | None | $1,271.05 |
Browse Plan Formulary |
Advantra (PPO)
![Email Prescription and/or Health Benefit details for Advantra (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $240.00 | None | $1,239.80 |
Browse Plan Formulary |
Advantra Option 1 (HMO)
![Email Prescription and/or Health Benefit details for Advantra Option 1 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $240.00 | None | $1,239.80 |
Browse Plan Formulary |
WellCare Access (HMO SNP)
![Email Prescription and/or Health Benefit details for WellCare Access (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.10 |
$320 |
to be determined |
3 |
Tier 3 |
$95.00 | $237.50 | None | $1,271.05 |
Browse Plan Formulary |
WindsorSterling Emerald Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Emerald Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$150* |
to be determined |
2* |
Tier 2 |
$10.00 | $30.00 | Q:90 /30Days | $1,335.99 |
Browse Plan Formulary |
WindsorSterling Emerald Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Emerald Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$150* |
to be determined |
2* |
Tier 2 |
$10.00 | $30.00 | Q:90 /30Days | $1,335.99 |
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 |
WindsorSterling Emerald Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Emerald Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$150* |
to be determined |
2* |
Tier 2 |
$10.00 | $30.00 | Q:90 /30Days | $1,335.99 |
Browse Plan Formulary |
WindsorSterling Emerald Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Emerald Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$150* |
to be determined |
2* |
Tier 2 |
$10.00 | $30.00 | Q:90 /30Days | $1,335.99 |
Browse Plan Formulary |
WindsorSterling Emerald Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Emerald Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$150* |
to be determined |
2* |
Tier 2 |
$10.00 | $30.00 | Q:90 /30Days | $1,335.99 |
Browse Plan Formulary |
WindsorSterling Emerald Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Emerald Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$150* |
to be determined |
2* |
Tier 2 |
$10.00 | $30.00 | Q:90 /30Days | $1,335.99 |
Browse Plan Formulary |
WindsorSterling Emerald Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Emerald Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$150* |
to be determined |
2* |
Tier 2 |
$10.00 | $30.00 | Q:90 /30Days | $1,335.99 |
Browse Plan Formulary |
WindsorSterling Emerald Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Emerald Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$150* |
to be determined |
2* |
Tier 2 |
$10.00 | $30.00 | Q:90 /30Days | $1,335.99 |
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 |
WindsorSterling Emerald Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Emerald Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$150* |
to be determined |
2* |
Tier 2 |
$10.00 | $30.00 | Q:90 /30Days | $1,335.99 |
Browse Plan Formulary |
WindsorSterling Emerald Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Emerald Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$150* |
to be determined |
2* |
Tier 2 |
$10.00 | $30.00 | Q:90 /30Days | $1,335.99 |
Browse Plan Formulary |
WindsorSterling Emerald Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Emerald Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$150* |
to be determined |
2* |
Tier 2 |
$10.00 | $30.00 | Q:90 /30Days | $1,335.99 |
Browse Plan Formulary |
WindsorSterling Emerald Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Emerald Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$150* |
to be determined |
2* |
Tier 2 |
$10.00 | $30.00 | Q:90 /30Days | $1,335.99 |
Browse Plan Formulary |
Care Improvement Plus Medicare Advantage (Regional PPO)
![Email Prescription and/or Health Benefit details for Care Improvement Plus Medicare Advantage (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.90 |
$215 |
to be determined |
1 |
Tier 1 |
$10.00 | $25.00 | None | $1,234.24 |
Browse Plan Formulary |
Care Improvement Plus Silver Rx (Regional PPO SNP)
![Email Prescription and/or Health Benefit details for Care Improvement Plus Silver Rx (Regional PPO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.80 |
$150 |
to be determined |
1 |
Tier 1 |
$10.00 | $25.00 | None | $1,234.24 |
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 |
Care Improvement Plus Dual Advantage (Regional PPO SNP)
![Email Prescription and/or Health Benefit details for Care Improvement Plus Dual Advantage (Regional PPO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.90 |
$240 |
to be determined |
1 |
Tier 1 |
$10.00 | $25.00 | None | $1,234.24 |
Browse Plan Formulary |
Humana Gold Choice H8145-125 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-125 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,003.26 |
Browse Plan Formulary |
HumanaChoice R5826-010 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-010 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.20 |
$320 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,003.26 |
Browse Plan Formulary |
HumanaChoice H1716-020 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H1716-020 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.00 |
$320 |
to be determined |
4 |
Tier 4 |
30% | 30% | None | $1,003.26 |
Browse Plan Formulary |
AARP MedicareComplete Choice (PPO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$42.00 |
$0 |
to be determined |
4 |
Tier 4 |
$88.00 | $254.00 | None | $1,003.79 |
Browse Plan Formulary |
Essence Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$46.00 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $15.00 | None | $1,146.42 |
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 |
WindsorSterling Gold Plus Plan (PPO)
![Email Prescription and/or Health Benefit details for WindsorSterling Gold Plus Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.00 |
$0 |
to be determined |
2 |
Tier 2 |
$16.00 | $48.00 | Q:90 /30Days | $1,335.99 |
Browse Plan Formulary |
WindsorSterling Gold Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Gold Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$59.00 |
$50* |
to be determined |
2* |
Tier 2 |
$15.00 | $45.00 | Q:90 /30Days | $1,335.99 |
Browse Plan Formulary |
WindsorSterling Gold Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Gold Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$59.00 |
$50* |
to be determined |
2* |
Tier 2 |
$15.00 | $45.00 | Q:90 /30Days | $1,335.99 |
Browse Plan Formulary |
WindsorSterling Gold Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Gold Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$59.00 |
$50* |
to be determined |
2* |
Tier 2 |
$15.00 | $45.00 | Q:90 /30Days | $1,335.99 |
Browse Plan Formulary |
WindsorSterling Gold Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Gold Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$59.00 |
$50* |
to be determined |
2* |
Tier 2 |
$15.00 | $45.00 | Q:90 /30Days | $1,335.99 |
Browse Plan Formulary |
WindsorSterling Gold Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Gold Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$59.00 |
$50* |
to be determined |
2* |
Tier 2 |
$15.00 | $45.00 | Q:90 /30Days | $1,335.99 |
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 |
WindsorSterling Gold Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Gold Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$59.00 |
$50* |
to be determined |
2* |
Tier 2 |
$15.00 | $45.00 | Q:90 /30Days | $1,335.99 |
Browse Plan Formulary |
WindsorSterling Gold Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Gold Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$59.00 |
$50* |
to be determined |
2* |
Tier 2 |
$15.00 | $45.00 | Q:90 /30Days | $1,335.99 |
Browse Plan Formulary |
WindsorSterling Gold Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Gold Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$59.00 |
$50* |
to be determined |
2* |
Tier 2 |
$15.00 | $45.00 | Q:90 /30Days | $1,335.99 |
Browse Plan Formulary |
WindsorSterling Gold Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Gold Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$59.00 |
$50* |
to be determined |
2* |
Tier 2 |
$15.00 | $45.00 | Q:90 /30Days | $1,335.99 |
Browse Plan Formulary |
WindsorSterling Gold Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Gold Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$59.00 |
$50* |
to be determined |
2* |
Tier 2 |
$15.00 | $45.00 | Q:90 /30Days | $1,335.99 |
Browse Plan Formulary |
WindsorSterling Gold Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Gold Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$59.00 |
$50* |
to be determined |
2* |
Tier 2 |
$15.00 | $45.00 | Q:90 /30Days | $1,335.99 |
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 |
WindsorSterling Gold Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Gold Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$59.00 |
$50* |
to be determined |
2* |
Tier 2 |
$15.00 | $45.00 | Q:90 /30Days | $1,335.99 |
Browse Plan Formulary |
WindsorSterling Gold Connect Plan (PFFS)
![Email Prescription and/or Health Benefit details for WindsorSterling Gold Connect Plan (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$59.00 |
$50* |
to be determined |
2* |
Tier 2 |
$15.00 | $45.00 | Q:90 /30Days | $1,335.99 |
Browse Plan Formulary |
HumanaChoice H1716-006 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H1716-006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$73.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,003.26 |
Browse Plan Formulary |
Advantra Option 2 (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantra Option 2 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$88.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $240.00 | None | $1,239.80 |
Browse Plan Formulary |