ABILIFY 2MG TABLET (30 BOX) (NDC: 59148000613)
2013 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 SecureHorizons (HMO)
|
$0.00 |
$0 | Some Generics | 4 |
Non-Preferred Brand |
$95.00 | $275.00 | None | $689.60 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
|
$0.00 |
$0 | Some Generics | 4 |
Non-Preferred Brand |
$95.00 | $190.00 | Q:1 /1Days | $706.03 |
Browse Plan Formulary |
Care Improvement Plus Copper RX (PPO SNP)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Non-Preferred Brand |
$95.00 | $237.50 | None | $701.76 |
Browse Plan Formulary |
Care Improvement Plus Copper RX (Regional PPO SNP)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Non-Preferred Brand |
$95.00 | $237.50 | None | $701.35 |
Browse Plan Formulary |
Care Improvement Plus Gold Rx (PPO SNP)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Non-Preferred Brand |
$95.00 | $237.50 | None | $701.76 |
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 Gold Rx (Regional PPO SNP)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Non-Preferred Brand |
$95.00 | $237.50 | None | $701.35 |
Browse Plan Formulary |
Care Improvement Plus Medicare Advantage (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Non-Preferred Brand |
$95.00 | $237.50 | None | $701.76 |
Browse Plan Formulary |
Care Improvement Plus Medicare Advantage (Regional PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Non-Preferred Brand |
$95.00 | $237.50 | None | $701.35 |
Browse Plan Formulary |
Care N'' Care Health Plan III (PPO)
|
$0.00 |
$0 | Many Generics | 4 |
Non-Preferred Brand |
$70.00 | $210.00 | None | $722.77 |
Browse Plan Formulary |
HealthSpring Achieve (HMO SNP)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$35.00 | $95.00 | Q:30 /30Days | $695.68 |
Browse Plan Formulary |
HealthSpring Preferred (HMO)
|
$0.00 |
$0 | Many Generics | 3 |
Preferred Brand |
$35.00 | $95.00 | Q:30 /30Days | $695.91 |
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 |
Humana Gold Plus H4510-018 (HMO)
|
$0.00 |
$125 | Few Generics, Few Brands | 4 |
Non-Preferred Brand |
$85.00 | $245.00 | Q:30 /30Days | $696.31 |
Browse Plan Formulary |
TexanPlus Classic (HMO)
|
$0.00 |
$0 | Many Generics, Few Brands | 3 |
Preferred Brand |
$40.00 | $80.00 | None | $692.09 |
Browse Plan Formulary |
UnitedHealthcare Dual Complete (HMO SNP)
|
$22.60 |
$325 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | None | $689.60 |
Browse Plan Formulary |
Care N'' Care Health Plan II (PPO)
|
$29.00 |
$0 | Many Generics | 4 |
Non-Preferred Brand |
$68.00 | $204.00 | None | $722.77 |
Browse Plan Formulary |
HumanaChoice R5826-012 (Regional PPO)
|
$29.00 |
$125 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Brand |
$89.00 | $257.00 | Q:30 /30Days | $694.71 |
Browse Plan Formulary |
UnitedHealthcare Nursing Home Plan (HMO SNP)
|
$29.10 |
$325 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
25% | 25% | None | $689.63 |
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 by Superior HealthPlan (HMO SNP)
|
$30.00 |
$325 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
$45.00 | $45.00 | Q:30 /30Days | $693.27 |
Browse Plan Formulary |
Molina Medicare Options Plus (HMO SNP)
|
$30.90 |
$325 | Many Generics, Few Brands | 2 |
Preferred Brand |
$45.00 | $135.00 | Q:30 /30Days | $683.82 |
Browse Plan Formulary |
Humana Gold Plus SNP-DE H4510-023 (HMO SNP)
|
$31.70 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
n/a | n/a | Q:30 /30Days | $696.41 |
Browse Plan Formulary |
Care Improvement Plus Chrome RX (PPO SNP)
|
$31.80 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | None | $701.76 |
Browse Plan Formulary |
Care Improvement Plus Chrome RX (Regional PPO SNP)
|
$31.80 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | None | $701.35 |
Browse Plan Formulary |
Care Improvement Plus Dual Advantage (PPO SNP)
|
$31.80 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
n/a | n/a | None | $701.76 |
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)
|
$31.80 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
n/a | n/a | None | $701.35 |
Browse Plan Formulary |
Care Improvement Plus Silver Rx (PPO SNP)
|
$31.80 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | None | $701.76 |
Browse Plan Formulary |
Care Improvement Plus Silver Rx (Regional PPO SNP)
|
$31.80 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | None | $701.35 |
Browse Plan Formulary |
HealthSpring TotalCare (HMO SNP)
|
$31.80 |
$325 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | Q:30 /30Days | $695.91 |
Browse Plan Formulary |
Today''s Options Advantage Plus 650B (PPO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $90.00 | None | $691.97 |
Browse Plan Formulary |
HealthSpring Preferred (PPO)
|
$35.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$30.00 | $80.00 | Q:30 /30Days | $694.08 |
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 |
Erickson Advantage Freedom (HMO-POS)
|
$48.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Brand |
$85.00 | $245.00 | None | $689.77 |
Browse Plan Formulary |
Aetna Medicare Value Plan (PPO)
|
$56.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Brand |
$95.00 | $190.00 | Q:1 /1Days | $706.03 |
Browse Plan Formulary |
Humana Prime Choice H4520-006 (PPO)
|
$57.00 |
$0 | Few Generics, Few Brands | 4 |
Non-Preferred Brand |
$83.00 | $239.00 | Q:30 /30Days | $694.85 |
Browse Plan Formulary |
Today''s Options Premier Plus 650B (PFFS)
|
$66.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $90.00 | None | $692.14 |
Browse Plan Formulary |
Blue Medicare Advantage (PPO)
|
$69.90 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$43.00 | $107.50 | Q:30 /30Days | $696.94 |
Browse Plan Formulary |
Care N'' Care Health Plan I (PPO)
|
$75.00 |
$0 | Many Generics | 4 |
Non-Preferred Brand |
$65.00 | $195.00 | None | $722.77 |
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 |
Humana Gold Choice H8145-084 (PFFS)
|
$87.00 |
$0 | Few Generics, Few Brands | 4 |
Non-Preferred Brand |
$80.00 | $230.00 | Q:30 /30Days | $695.11 |
Browse Plan Formulary |
Today''s Options Advantage Plus 350A (PPO)
|
$107.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$40.00 | $80.00 | None | $691.97 |
Browse Plan Formulary |
Today''s Options Premier Plus 350A (PFFS)
|
$122.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$40.00 | $80.00 | None | $692.14 |
Browse Plan Formulary |
Erickson Advantage Champion (HMO-POS SNP)
|
$176.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Brand |
$80.00 | $230.00 | None | $689.77 |
Browse Plan Formulary |
Erickson Advantage Signature with Drugs (HMO-POS)
|
$176.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Brand |
$80.00 | $230.00 | None | $689.77 |
Browse Plan Formulary |