TRILIPIX DELAYED RELEASE CAPSULES 135MG (90 BOTPL) (NDC: 00074918990)
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 Mosaic (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Mosaic (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 |
$44.00 | $122.00 | None | $172.02 |
Browse Plan Formulary |
AARP MedicareComplete Plan 1 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Plan 1 (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 |
$44.00 | $122.00 | None | $172.02 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Plan 2 (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 |
$45.00 | $125.00 | None | $172.02 |
Browse Plan Formulary |
Access Medicare Gold (HMO)
![Email Prescription and/or Health Benefit details for Access Medicare Gold (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$30.00 | $45.00 | None | $210.39 |
Browse Plan Formulary |
Empire MediBlue Plus (HMO)
![Email Prescription and/or Health Benefit details for Empire MediBlue Plus (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 |
$45.00 | $112.50 | None | $181.76 |
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 |
Fidelis Medicare $0 Premium (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Medicare $0 Premium (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 |
$75.00 | $150.00 | None | $171.93 |
Browse Plan Formulary |
Healthfirst 65 Plus Plan (HMO)
![Email Prescription and/or Health Benefit details for Healthfirst 65 Plus Plan (HMO)](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 |
$80.00 | $200.00 | None | $171.26 |
Browse Plan Formulary |
Healthfirst Jade Benefits Plan (HMO)
![Email Prescription and/or Health Benefit details for Healthfirst Jade Benefits Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Many Generics, Few Brands |
3 |
Non-Preferred Brand |
$80.00 | $200.00 | None | $171.26 |
Browse Plan Formulary |
Liberty Health Advantage Preferred Choice (HMO)
![Email Prescription and/or Health Benefit details for Liberty Health Advantage Preferred Choice (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
All Generics |
3 |
Preferred Brand |
$25.00 | $75.00 | Q:30 /30Days | $178.06 |
Browse Plan Formulary |
PPO II (PPO)
![Email Prescription and/or Health Benefit details for PPO II (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$35.00 | $70.00 | None | $181.76 |
Browse Plan Formulary |
Touchstone Health Medicare Freedom (HMO-POS)
![Email Prescription and/or Health Benefit details for Touchstone Health Medicare Freedom (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$40.00 | $100.00 | S Q:30 /30Days | $178.06 |
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 |
Touchstone Health Medicare Power (HMO)
![Email Prescription and/or Health Benefit details for Touchstone Health Medicare Power (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$45.00 | $112.50 | S Q:30 /30Days | $178.06 |
Browse Plan Formulary |
UnitedHealthcare MedicareComplete Choice (Regional PPO)
![Email Prescription and/or Health Benefit details for UnitedHealthcare MedicareComplete Choice (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 |
Preferred Brand |
$45.00 | $125.00 | None | $172.08 |
Browse Plan Formulary |
VIP (HMO)
![Email Prescription and/or Health Benefit details for VIP (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$35.00 | $70.00 | None | $181.76 |
Browse Plan Formulary |
VIP (HMO)
![Email Prescription and/or Health Benefit details for VIP (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$35.00 | $70.00 | None | $181.76 |
Browse Plan Formulary |
VIP (HMO)
![Email Prescription and/or Health Benefit details for VIP (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$35.00 | $70.00 | None | $181.76 |
Browse Plan Formulary |
VIP Essential (HMO)
![Email Prescription and/or Health Benefit details for VIP Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$35.00 | $70.00 | None | $181.76 |
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 |
VIP Essential (HMO)
![Email Prescription and/or Health Benefit details for VIP Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$35.00 | $70.00 | None | $181.76 |
Browse Plan Formulary |
VIP Essential (HMO)
![Email Prescription and/or Health Benefit details for VIP Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$35.00 | $70.00 | None | $181.76 |
Browse Plan Formulary |
VNSNY CHOICE Medicare Enhanced (HMO)
![Email Prescription and/or Health Benefit details for VNSNY CHOICE Medicare Enhanced (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 |
$90.00 | $225.00 | None | $171.26 |
Browse Plan Formulary |
Healthfirst Increased Benefits Plan (HMO)
![Email Prescription and/or Health Benefit details for Healthfirst Increased Benefits Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $171.26 |
Browse Plan Formulary |
UnitedHealthcare Nursing Home Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Nursing Home Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $172.06 |
Browse Plan Formulary |
Touchstone Health Medicare Total (HMO)
![Email Prescription and/or Health Benefit details for Touchstone Health Medicare Total (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.60 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$30.00 | $75.00 | S Q:30 /30Days | $178.06 |
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 |
VNSNY CHOICE Medicare Preferred (HMO SNP)
![Email Prescription and/or Health Benefit details for VNSNY CHOICE Medicare Preferred (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.10 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
15% | 15% | None | $171.26 |
Browse Plan Formulary |
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) |
$41.20 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
n/a | n/a | None | $172.05 |
Browse Plan Formulary |
GuildNet Health Advantage (HMO-POS SNP)
![Email Prescription and/or Health Benefit details for GuildNet Health Advantage (HMO-POS SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$41.60 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
15% | 15% | None | $181.76 |
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) |
$42.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
15% | 15% | None | $172.02 |
Browse Plan Formulary |
Healthfirst AssuredCare (HMO SNP)
![Email Prescription and/or Health Benefit details for Healthfirst AssuredCare (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $171.26 |
Browse Plan Formulary |
Healthfirst CompleteCare (HMO SNP)
![Email Prescription and/or Health Benefit details for Healthfirst CompleteCare (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
n/a | n/a | None | $171.26 |
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 |
Healthfirst Life Improvement Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for Healthfirst Life Improvement Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
15% | 15% | None | $171.26 |
Browse Plan Formulary |
Healthfirst Maximum Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for Healthfirst Maximum Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
n/a | n/a | None | $171.26 |
Browse Plan Formulary |
Access Medicare Pearl (HMO SNP)
![Email Prescription and/or Health Benefit details for Access Medicare Pearl (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.20 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
15% | 15% | None | $210.39 |
Browse Plan Formulary |
Access Medicare Platinum (HMO)
![Email Prescription and/or Health Benefit details for Access Medicare Platinum (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.20 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
25% | 25% | None | $210.39 |
Browse Plan Formulary |
Access Medicare Silver (HMO SNP)
![Email Prescription and/or Health Benefit details for Access Medicare Silver (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.20 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
25% | 25% | None | $210.39 |
Browse Plan Formulary |
ArchCare - Inst and IE SNP - All Counties (HMO SNP)
![Email Prescription and/or Health Benefit details for ArchCare - Inst and IE SNP - All Counties (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.20 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $172.58 |
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 |
CenterLight Direct Complete Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for CenterLight Direct Complete Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.20 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$42.00 | $126.00 | None | $176.96 |
Browse Plan Formulary |
CenterLight Direct Total Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for CenterLight Direct Total Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.20 |
$185 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$45.00 | $135.00 | None | $176.96 |
Browse Plan Formulary |
Dual Eligible (HMO SNP)
![Email Prescription and/or Health Benefit details for Dual Eligible (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.20 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
25% | 25% | None | $181.76 |
Browse Plan Formulary |
Dual Eligible (PPO SNP)
![Email Prescription and/or Health Benefit details for Dual Eligible (PPO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.20 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
25% | 25% | None | $181.76 |
Browse Plan Formulary |
Fidelis Dual Advantage (HMO SNP)
![Email Prescription and/or Health Benefit details for Fidelis Dual Advantage (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.20 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | None | $171.93 |
Browse Plan Formulary |
Fidelis Dual Advantage Flex (HMO SNP)
![Email Prescription and/or Health Benefit details for Fidelis Dual Advantage Flex (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.20 |
$320 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | None | $171.97 |
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 |
Fidelis Long Term Care Advantage (HMO SNP)
![Email Prescription and/or Health Benefit details for Fidelis Long Term Care Advantage (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.20 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $171.97 |
Browse Plan Formulary |
Fidelis Medicaid Advantage Plus (HMO SNP)
![Email Prescription and/or Health Benefit details for Fidelis Medicaid Advantage Plus (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.20 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$91.00 | $182.00 | None | $171.91 |
Browse Plan Formulary |
Fidelis Medicare Advantage Flex (HMO-POS)
![Email Prescription and/or Health Benefit details for Fidelis Medicare Advantage Flex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.20 |
$320 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$70.00 | $140.00 | None | $171.97 |
Browse Plan Formulary |
GuildNet Gold (HMO-POS SNP)
![Email Prescription and/or Health Benefit details for GuildNet Gold (HMO-POS SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.20 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
n/a | n/a | None | $181.76 |
Browse Plan Formulary |
Liberty Health Advantage Dual Power (HMO SNP)
![Email Prescription and/or Health Benefit details for Liberty Health Advantage Dual Power (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.20 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
15% | 15% | Q:30 /30Days | $191.86 |
Browse Plan Formulary |
Aetna Medicare Value Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Value Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $90.00 | None | $173.26 |
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 |
PPO III (PPO)
![Email Prescription and/or Health Benefit details for PPO III (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$54.50 |
$0 |
All Generics |
2 |
Preferred Brand |
$35.00 | $70.00 | None | $181.76 |
Browse Plan Formulary |
VNSNY CHOICE Medicare Maximum (HMO SNP)
![Email Prescription and/or Health Benefit details for VNSNY CHOICE Medicare Maximum (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$78.50 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
n/a | n/a | None | $171.26 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$45.00 | $90.00 | None | $173.26 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$85.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $90.00 | None | $173.25 |
Browse Plan Formulary |
VNSNY CHOICE Total (HMO SNP)
![Email Prescription and/or Health Benefit details for VNSNY CHOICE Total (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$95.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
n/a | n/a | None | $171.26 |
Browse Plan Formulary |
PPO High Option (PPO)
![Email Prescription and/or Health Benefit details for PPO High Option (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$132.50 |
$0 |
All Generics |
2 |
Preferred Brand |
$35.00 | $70.00 | None | $181.76 |
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 |
VIP High Option (HMO)
![Email Prescription and/or Health Benefit details for VIP High Option (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$157.50 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$35.00 | $70.00 | None | $181.76 |
Browse Plan Formulary |
VIP High Option (HMO)
![Email Prescription and/or Health Benefit details for VIP High Option (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$157.50 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$35.00 | $70.00 | None | $181.76 |
Browse Plan Formulary |
VIP High Option (HMO)
![Email Prescription and/or Health Benefit details for VIP High Option (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$157.50 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$35.00 | $70.00 | None | $181.76 |
Browse Plan Formulary |