ALORA 0.1MG PATCH (8 CRTN) (NDC: 52544047308)
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 |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:11 /34Days | $71.28 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:11 /34Days | $72.06 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:11 /34Days | $72.62 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:11 /34Days | $72.08 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:11 /34Days | $71.79 |
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 Plus Blue PPO Essential (PPO)
|
$12.50 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:8 /28Days | $71.32 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$12.50 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:8 /28Days | $72.01 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$12.50 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:8 /28Days | $72.06 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$12.50 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:8 /28Days | $71.79 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$12.50 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:8 /28Days | $71.75 |
Browse Plan Formulary |
HumanaChoice R5826-072 (Regional PPO)
|
$20.80 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | P Q:8 /28Days | $71.03 |
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 |
HumanaChoice R5826-006 (Regional PPO)
|
$37.50 |
$0 | Few Generics, Few Brands | 3 |
Non-Preferred Brand |
$80.00 | $230.00 | P Q:8 /28Days | $71.03 |
Browse Plan Formulary |
PriorityMedicare Value (HMO-POS)
|
$43.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
$40.00 | $100.00 | None | $71.18 |
Browse Plan Formulary |
HAP Senior Plus - Expanded Network (HMO-POS)
|
$44.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $112.50 | None | $74.94 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$47.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
$45.00 | $112.50 | None | $71.56 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$47.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
$45.00 | $112.50 | None | $71.12 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$47.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
$45.00 | $112.50 | None | $71.18 |
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 Plus Blue PPO Vitality (PPO)
|
$56.00 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:8 /28Days | $71.75 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$56.00 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:8 /28Days | $72.06 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$56.00 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:8 /28Days | $72.01 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$56.00 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:8 /28Days | $71.32 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$56.00 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:8 /28Days | $71.79 |
Browse Plan Formulary |
HumanaChoice H5470-002 (PPO)
|
$62.00 |
$0 | Few Generics, Few Brands | 3 |
Non-Preferred Brand |
$83.00 | $239.00 | P Q:8 /28Days | $70.48 |
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 H8145-005 (PFFS)
|
$72.00 |
$0 | Few Generics, Few Brands | 3 |
Non-Preferred Brand |
$80.00 | $230.00 | P Q:8 /28Days | $70.79 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$88.00 |
$0 | Many Generics | 3 |
Preferred Brand |
$40.00 | $100.00 | Q:11 /34Days | $71.79 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$88.00 |
$0 | Many Generics | 3 |
Preferred Brand |
$40.00 | $100.00 | Q:11 /34Days | $72.08 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$88.00 |
$0 | Many Generics | 3 |
Preferred Brand |
$40.00 | $100.00 | Q:11 /34Days | $72.62 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$88.00 |
$0 | Many Generics | 3 |
Preferred Brand |
$40.00 | $100.00 | Q:11 /34Days | $72.06 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$88.00 |
$0 | Many Generics | 3 |
Preferred Brand |
$40.00 | $100.00 | Q:11 /34Days | $71.28 |
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 |
HAP Senior Plus - Expanded Network (HMO-POS)
|
$94.00 |
$25 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $112.50 | None | $74.94 |
Browse Plan Formulary |
Alliance Medicare PPO (PPO)
|
$103.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $112.50 | None | $74.97 |
Browse Plan Formulary |
PriorityMedicare (HMO-POS)
|
$107.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
$35.00 | $87.50 | None | $71.18 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$111.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
$40.00 | $100.00 | None | $71.18 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$128.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $112.50 | Q:8 /28Days | $71.75 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$128.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $112.50 | Q:8 /28Days | $72.06 |
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 Plus Blue PPO Signature (PPO)
|
$128.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $112.50 | Q:8 /28Days | $72.01 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$128.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $112.50 | Q:8 /28Days | $71.32 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$128.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $112.50 | Q:8 /28Days | $71.79 |
Browse Plan Formulary |
HAP Senior Plus - Expanded Network (HMO-POS)
|
$169.00 |
$25 | All Generics | 3 |
Preferred Brand |
$45.00 | $112.50 | None | $74.94 |
Browse Plan Formulary |
Alliance Medicare PPO (PPO)
|
$174.00 |
$50 | All Generics | 3 |
Preferred Brand |
$40.00 | $100.00 | None | $74.97 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$194.00 |
$0 | Many Generics | 3 |
Preferred Brand |
$40.00 | $100.00 | Q:8 /28Days | $71.75 |
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 Plus Blue PPO Assure (PPO)
|
$194.00 |
$0 | Many Generics | 3 |
Preferred Brand |
$40.00 | $100.00 | Q:8 /28Days | $71.79 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$194.00 |
$0 | Many Generics | 3 |
Preferred Brand |
$40.00 | $100.00 | Q:8 /28Days | $72.06 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$194.00 |
$0 | Many Generics | 3 |
Preferred Brand |
$40.00 | $100.00 | Q:8 /28Days | $72.01 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$194.00 |
$0 | Many Generics | 3 |
Preferred Brand |
$40.00 | $100.00 | Q:8 /28Days | $71.32 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$218.00 |
$0 | Many Generics | 3 |
Preferred Brand |
$35.00 | $87.50 | Q:11 /34Days | $71.79 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$218.00 |
$0 | Many Generics | 3 |
Preferred Brand |
$35.00 | $87.50 | Q:11 /34Days | $72.08 |
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 |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$218.00 |
$0 | Many Generics | 3 |
Preferred Brand |
$35.00 | $87.50 | Q:11 /34Days | $72.62 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$218.00 |
$0 | Many Generics | 3 |
Preferred Brand |
$35.00 | $87.50 | Q:11 /34Days | $72.06 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$218.00 |
$0 | Many Generics | 3 |
Preferred Brand |
$35.00 | $87.50 | Q:11 /34Days | $71.28 |
Browse Plan Formulary |