Actonel 35mg/1 36 DOSE PACK CASE / 1 TRAY DOSE PACK / 4 FILM COATED TABLETS in TRAY (36 DOSE PACK in 1 CASE / ) (NDC: 00430047203)
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 (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 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$42.00 | $116.00 | None | $149.31 |
Browse Plan Formulary |
AARP MedicareComplete Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $125.00 | None | $149.31 |
Browse Plan Formulary |
Advantra Elite (HMO)
![Email Prescription and/or Health Benefit details for Advantra Elite (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | S Q:4 /28Days | $151.10 |
Browse Plan Formulary |
Advantra Preferred (PPO)
![Email Prescription and/or Health Benefit details for Advantra Preferred (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | S Q:4 /28Days | $150.62 |
Browse Plan Formulary |
Advantra Silver (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantra Silver (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | S Q:4 /28Days | $150.72 |
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 |
BlueValue Basic (HMO)
![Email Prescription and/or Health Benefit details for BlueValue Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$60 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | S Q:4 /28Days | $157.71 |
Browse Plan Formulary |
Care Improvement Plus Copper RX (PPO SNP)
![Email Prescription and/or Health Benefit details for Care Improvement Plus Copper RX (PPO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | None | $151.45 |
Browse Plan Formulary |
Care Improvement Plus Copper RX (Regional PPO SNP)
![Email Prescription and/or Health Benefit details for Care Improvement Plus Copper RX (Regional PPO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | None | $151.54 |
Browse Plan Formulary |
Care Improvement Plus Gold Rx (PPO SNP)
![Email Prescription and/or Health Benefit details for Care Improvement Plus Gold Rx (PPO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | None | $151.45 |
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 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | None | $151.54 |
Browse Plan Formulary |
Care Improvement Plus Medicare Advantage (PPO)
![Email Prescription and/or Health Benefit details for Care Improvement Plus Medicare Advantage (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | None | $151.45 |
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 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) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Non-Preferred Brand |
$95.00 | $237.50 | None | $151.54 |
Browse Plan Formulary |
Humana Gold Plus H4141-001 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H4141-001 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Some Generics, Few Brands |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:4 /28Days | $153.85 |
Browse Plan Formulary |
Humana Gold Plus SNP-CVD/CHF/DM H4141-009 (HMO SNP)
![Email Prescription and/or Health Benefit details for Humana Gold Plus SNP-CVD/CHF/DM H4141-009 (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Some Generics, Few Brands |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:4 /28Days | $153.85 |
Browse Plan Formulary |
Kaiser Permanente Senior Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Kaiser Permanente Senior Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
All Generics, Few Brands |
4 |
Non-Preferred Brand |
$75.00 | $150.00 | None | $164.92 |
Browse Plan Formulary |
Humana Gold Plus SNP-DE H4141-003 (HMO SNP)
![Email Prescription and/or Health Benefit details for Humana Gold Plus SNP-DE H4141-003 (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.80 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$92.00 | $266.00 | Q:4 /28Days | $153.85 |
Browse Plan Formulary |
Medicare Preferred Core (PPO)
![Email Prescription and/or Health Benefit details for Medicare Preferred Core (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$91 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$93.00 | $232.50 | S Q:4 /28Days | $157.71 |
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 |
UnitedHealthcare Dual Complete (PPO SNP)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Dual Complete (PPO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.30 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
15% | 15% | None | $149.31 |
Browse Plan Formulary |
HumanaChoice R5826-077 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-077 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.60 |
$150 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$90.00 | $260.00 | Q:4 /28Days | $152.65 |
Browse Plan Formulary |
Senior Advantage Medicare Medicaid Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for Senior Advantage Medicare Medicaid Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.20 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$75.00 | $150.00 | None | $164.92 |
Browse Plan Formulary |
UnitedHealthcare Nursing Home Plan (PPO SNP)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Nursing Home Plan (PPO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $149.45 |
Browse Plan Formulary |
Advantage by Peach State Health Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for Advantage by Peach State Health Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$45.00 | $45.00 | Q:4 /28Days | $151.28 |
Browse Plan Formulary |
Care Improvement Plus Chrome RX (PPO SNP)
![Email Prescription and/or Health Benefit details for Care Improvement Plus Chrome RX (PPO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.20 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $151.45 |
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 (PPO SNP)
![Email Prescription and/or Health Benefit details for Care Improvement Plus Dual Advantage (PPO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.20 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
n/a | n/a | None | $151.45 |
Browse Plan Formulary |
Care Improvement Plus Silver Rx (PPO SNP)
![Email Prescription and/or Health Benefit details for Care Improvement Plus Silver Rx (PPO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.20 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $151.45 |
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) |
$36.30 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $151.54 |
Browse Plan Formulary |
Care Improvement Plus Chrome RX (Regional PPO SNP)
![Email Prescription and/or Health Benefit details for Care Improvement Plus Chrome RX (Regional PPO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.50 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $151.54 |
Browse Plan Formulary |
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) |
$36.50 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
n/a | n/a | None | $151.54 |
Browse Plan Formulary |
HumanaChoice H5214-003 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5214-003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.00 |
$0 |
Few Generics, Few Brands |
4 |
Non-Preferred Brand |
$90.00 | $260.00 | Q:4 /28Days | $153.72 |
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 |
BlueValue Secure (HMO)
![Email Prescription and/or Health Benefit details for BlueValue Secure (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.00 |
$60 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | S Q:4 /28Days | $157.71 |
Browse Plan Formulary |
Medicare Preferred Premier (PPO)
![Email Prescription and/or Health Benefit details for Medicare Preferred Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$60.00 |
$91 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$93.00 | $232.50 | S Q:4 /28Days | $157.71 |
Browse Plan Formulary |
Kaiser Permanente Senior Advantage Enhanced (HMO)
![Email Prescription and/or Health Benefit details for Kaiser Permanente Senior Advantage Enhanced (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$61.00 |
$0 |
All Generics, Few Brands |
4 |
Non-Preferred Brand |
$75.00 | $150.00 | None | $164.92 |
Browse Plan Formulary |
Today''s Options Advantage Plus 650B (PPO)
![Email Prescription and/or Health Benefit details for Today''s Options Advantage Plus 650B (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$64.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | None | $149.99 |
Browse Plan Formulary |
Advantra Silver Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantra Silver Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$69.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$85.00 | $212.50 | S Q:4 /28Days | $151.25 |
Browse Plan Formulary |
Humana Gold Choice H8145-079 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-079 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$72.00 |
$0 |
Few Generics, Few Brands |
4 |
Non-Preferred Brand |
$90.00 | $260.00 | Q:4 /28Days | $153.71 |
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 |
Today''s Options Premier Plus 650D (PFFS)
![Email Prescription and/or Health Benefit details for Today''s Options Premier Plus 650D (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$92.00 |
$85 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | None | $150.02 |
Browse Plan Formulary |
Today''s Options Advantage Plus 350A (PPO)
![Email Prescription and/or Health Benefit details for Today''s Options Advantage Plus 350A (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$127.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$80.00 | $160.00 | None | $149.99 |
Browse Plan Formulary |
Today''s Options Premier Plus 350A (PFFS)
![Email Prescription and/or Health Benefit details for Today''s Options Premier Plus 350A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$152.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$80.00 | $160.00 | None | $150.02 |
Browse Plan Formulary |