DILTIAZEM CD CAPSULES 300MG (90 CT) (90 BOT) (NDC: 62584097790)
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 |
2 |
Non-Preferred Generic |
$7.00 | $14.00 | None | $34.21 |
Browse Plan Formulary |
Abrazo Advantage (HMO)
![Email Prescription and/or Health Benefit details for Abrazo Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None | $55.88 |
Browse Plan Formulary |
Aetna Medicare Select Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Select Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Preferred Generic |
$7.00 | $14.00 | None | $36.51 |
Browse Plan Formulary |
Blue Medicare Advantage Classic (HMO)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage Classic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Generic |
22% | 25% | None | $28.83 |
Browse Plan Formulary |
CareMore Breathe (HMO SNP)
![Email Prescription and/or Health Benefit details for CareMore Breathe (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
All Generics, Few Brands |
2 |
Non-Preferred Generic |
$5.00 | $12.50 | None | $38.29 |
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 |
CareMore Diabetes (HMO SNP)
![Email Prescription and/or Health Benefit details for CareMore Diabetes (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
All Generics, Few Brands |
2 |
Non-Preferred Generic |
$5.00 | $12.50 | None | $38.29 |
Browse Plan Formulary |
CareMore Heart (HMO SNP)
![Email Prescription and/or Health Benefit details for CareMore Heart (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
All Generics, Few Brands |
2 |
Non-Preferred Generic |
$5.00 | $12.50 | None | $38.29 |
Browse Plan Formulary |
CareMore Touch (HMO SNP)
![Email Prescription and/or Health Benefit details for CareMore Touch (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
All Generics, Few Brands |
2 |
Non-Preferred Generic |
$5.00 | $12.50 | None | $38.29 |
Browse Plan Formulary |
CareMore Value Plus (HMO)
![Email Prescription and/or Health Benefit details for CareMore Value Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
All Generics, Few Brands |
2 |
Non-Preferred Generic |
$5.00 | $12.50 | None | $38.29 |
Browse Plan Formulary |
Cigna Medicare Select Plus Rx-Diabetes Heart (HMO SNP)
![Email Prescription and/or Health Benefit details for Cigna Medicare Select Plus Rx-Diabetes Heart (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Many Generics |
2 |
Non-Preferred Generic |
$5.00 | $10.00 | None | $38.91 |
Browse Plan Formulary |
Cigna Medicare Select Plus Rx-Standard (HMO)
![Email Prescription and/or Health Benefit details for Cigna Medicare Select Plus Rx-Standard (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Many Generics |
2 |
Non-Preferred Generic |
$5.00 | $10.00 | None | $38.91 |
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 |
Health Net Jade (HMO SNP)
![Email Prescription and/or Health Benefit details for Health Net Jade (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Preferred Generic |
$0.00 | $0.00 | None | $59.90 |
Browse Plan Formulary |
Health Net Ruby 4 (HMO)
![Email Prescription and/or Health Benefit details for Health Net Ruby 4 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Preferred Generic |
$3.00 | $6.00 | None | $59.90 |
Browse Plan Formulary |
Health Net Ruby Select (HMO)
![Email Prescription and/or Health Benefit details for Health Net Ruby Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Preferred Generic |
$0.00 | $0.00 | None | $59.90 |
Browse Plan Formulary |
Humana Reader''s Digest Healthy Living Plan (HMO)
![Email Prescription and/or Health Benefit details for Humana Reader''s Digest Healthy Living Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Few Generics, Few Brands |
2 |
Non-Preferred Generic |
$10.00 | $0.00 | Q:30 /30Days | $27.32 |
Browse Plan Formulary |
Humana Reader''s Digest Healthy Living Plan (HMO)
![Email Prescription and/or Health Benefit details for Humana Reader''s Digest Healthy Living Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Few Generics, Few Brands |
2 |
Non-Preferred Generic |
$10.00 | $0.00 | Q:30 /30Days | $27.32 |
Browse Plan Formulary |
SCAN Classic (HMO)
![Email Prescription and/or Health Benefit details for SCAN Classic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None | $38.04 |
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 |
StartSmart with CareMore (HMO)
![Email Prescription and/or Health Benefit details for StartSmart with CareMore (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | None | $38.29 |
Browse Plan Formulary |
Blue Medicare Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Generic |
$4.00 | $12.00 | None | $28.83 |
Browse Plan Formulary |
Humana Reader''s Digest Healthy Living Plan (Regional PPO)
![Email Prescription and/or Health Benefit details for Humana Reader''s Digest Healthy Living Plan (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.10 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
25% | 25% | Q:30 /30Days | $27.32 |
Browse Plan Formulary |
Cigna Medicare Select Plus Rx-Premium (HMO)
![Email Prescription and/or Health Benefit details for Cigna Medicare Select Plus Rx-Premium (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
Many Generics |
2 |
Non-Preferred Generic |
$5.00 | $10.00 | None | $38.91 |
Browse Plan Formulary |
Advantage by Bridgeway Health Solutions (HMO SNP)
![Email Prescription and/or Health Benefit details for Advantage by Bridgeway Health Solutions (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
15% | 15% | Q:30 /30Days | $39.35 |
Browse Plan Formulary |
Mercy Care Advantage (HMO SNP)
![Email Prescription and/or Health Benefit details for Mercy Care Advantage (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.20 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
15% | 15% | None | $35.33 |
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 |
Mercy Care Advantage (HMO SNP)
![Email Prescription and/or Health Benefit details for Mercy Care Advantage (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.20 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
15% | 15% | None | $35.33 |
Browse Plan Formulary |
Mercy Care Advantage (HMO SNP)
![Email Prescription and/or Health Benefit details for Mercy Care Advantage (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.20 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
15% | 15% | None | $35.33 |
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) |
$27.20 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
25% | 25% | None | $34.06 |
Browse Plan Formulary |
Cigna Medicare Select Plus Rx-Dual (HMO SNP)
![Email Prescription and/or Health Benefit details for Cigna Medicare Select Plus Rx-Dual (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
15% | 15% | None | $38.91 |
Browse Plan Formulary |
UnitedHealthcare Dual Complete LP (HMO SNP)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Dual Complete LP (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.20 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
15% | 15% | None | $34.06 |
Browse Plan Formulary |
UnitedHealthcare Dual Complete LP (HMO SNP)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Dual Complete LP (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.20 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
15% | 15% | None | $34.06 |
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 |
UnitedHealthcare Dual Complete (HMO SNP)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Dual Complete (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.30 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
15% | 15% | None | $34.03 |
Browse Plan Formulary |
Abrazo Advantage Plus (HMO SNP)
![Email Prescription and/or Health Benefit details for Abrazo Advantage Plus (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.40 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
15% | 15% | None | $55.88 |
Browse Plan Formulary |
Health Choice Generations (HMO SNP)
![Email Prescription and/or Health Benefit details for Health Choice Generations (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.40 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
15% | 15% | None | $37.72 |
Browse Plan Formulary |
Health Choice Generations (HMO SNP)
![Email Prescription and/or Health Benefit details for Health Choice Generations (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.40 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
15% | 15% | None | $37.44 |
Browse Plan Formulary |
Health Net Amber (HMO SNP)
![Email Prescription and/or Health Benefit details for Health Net Amber (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.40 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Preferred Generic |
$0.00 | $0.00 | None | $59.90 |
Browse Plan Formulary |
ONECare by Care1st Health Plan Arizona, Inc. (HMO SNP)
![Email Prescription and/or Health Benefit details for ONECare by Care1st Health Plan Arizona, Inc. (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.40 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
15% | n/a | None | $31.20 |
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 |
SCAN Connections (HMO SNP)
![Email Prescription and/or Health Benefit details for SCAN Connections (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.40 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
n/a | n/a | None | $38.04 |
Browse Plan Formulary |
University Care Advantage (HMO SNP)
![Email Prescription and/or Health Benefit details for University Care Advantage (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.40 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
15% | 15% | None | $31.20 |
Browse Plan Formulary |
Blue Medicare Advantage Premier (HMO)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$45.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Generic |
$4.00 | $12.00 | None | $28.83 |
Browse Plan Formulary |
Health Net Ruby 1 (HMO)
![Email Prescription and/or Health Benefit details for Health Net Ruby 1 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Preferred Generic |
$3.00 | $6.00 | None | $59.90 |
Browse Plan Formulary |
Humana Reader''s Digest Healthy Living Plan (HMO-POS)
![Email Prescription and/or Health Benefit details for Humana Reader''s Digest Healthy Living Plan (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$62.00 |
$0 |
Few Generics, Few Brands |
2 |
Non-Preferred Generic |
$10.00 | $0.00 | Q:30 /30Days | $27.32 |
Browse Plan Formulary |
Humana Reader''s Digest Healthy Living Plan (PPO)
![Email Prescription and/or Health Benefit details for Humana Reader''s Digest Healthy Living Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$102.00 |
$0 |
Few Generics, Few Brands |
2 |
Non-Preferred Generic |
$10.00 | $0.00 | Q:30 /30Days | $27.32 |
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 Reader''s Digest Healthy Living Plan (Regional PPO)
![Email Prescription and/or Health Benefit details for Humana Reader''s Digest Healthy Living Plan (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$142.10 |
$0 |
Few Generics, Few Brands |
2 |
Non-Preferred Generic |
$10.00 | $0.00 | Q:30 /30Days | $27.32 |
Browse Plan Formulary |
Humana Gold Choice H8145-103 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-103 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$177.00 |
$0 |
Few Generics, Few Brands |
2 |
Non-Preferred Generic |
$10.00 | $0.00 | Q:30 /30Days | $27.32 |
Browse Plan Formulary |