duramorph 0.5 mg/ml ampule (NDC: 00641602010)
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 Plan 1 (HMO)
|
$0.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$45.00 | $125.00 | None | $169.98 |
Browse Plan Formulary |
AARP MedicareComplete SecureHorizons Plan 2 (HMO)
|
$0.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$45.00 | $125.00 | None | $169.98 |
Browse Plan Formulary |
AARP MedicareComplete SecureHorizons Plan 4 (HMO)
|
$0.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$45.00 | $125.00 | None | $169.98 |
Browse Plan Formulary |
Blue Cross Senior Secure Plan I (HMO)
|
$0.00 |
$0 |
Many Generics |
5 |
Injectable Drugs |
$95.00 | $237.50 | None | $181.83 |
Browse Plan Formulary |
Blue Cross Senior Secure Plan I (HMO)
|
$0.00 |
$0 |
Many Generics |
5 |
Injectable Drugs |
33% | 33% | None | $181.83 |
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 |
Blue Cross Senior Secure Plan II (HMO)
|
$0.00 |
$0 |
Many Generics |
5 |
Injectable Drugs |
33% | 33% | None | $181.83 |
Browse Plan Formulary |
Blue Shield 65 Plus (HMO)
|
$0.00 |
$0 |
Many Generics |
4 |
Injectable Drugs |
25% | 25% | P | $179.30 |
Browse Plan Formulary |
Blue Shield 65 Plus (HMO)
|
$0.00 |
$0 |
Many Generics |
4 |
Injectable Drugs |
25% | 25% | P | $179.30 |
Browse Plan Formulary |
Blue Shield 65 Plus Choice Plan (HMO)
|
$0.00 |
$0 |
Many Generics |
4 |
Injectable Drugs |
25% | 25% | P | $179.30 |
Browse Plan Formulary |
CareMore Breathe (HMO SNP)
|
$0.00 |
$0 |
All Generics, All Brands |
2 |
Non-Preferred Generic |
$5.00 | $12.50 | P | $48.32 |
Browse Plan Formulary |
CareMore Connect (HMO SNP)
|
$0.00 |
$325* |
All Generics, Few Brands |
2* |
Non-Preferred Generic |
$0.00 | $0.00 | P | $48.32 |
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 |
CareMore ESRD (HMO SNP)
|
$0.00 |
$0 |
All Generics, All Brands |
2 |
Non-Preferred Generic |
$5.00 | $12.50 | P | $48.32 |
Browse Plan Formulary |
CareMore Heart (HMO SNP)
|
$0.00 |
$0 |
All Generics, All Brands |
2 |
Non-Preferred Generic |
$5.00 | $12.50 | P | $48.32 |
Browse Plan Formulary |
CareMore Reliance (HMO SNP)
|
$0.00 |
$0 |
All Generics, All Brands |
2 |
Non-Preferred Generic |
$5.00 | $12.50 | P | $48.32 |
Browse Plan Formulary |
CareMore Touch (HMO SNP)
|
$0.00 |
$0 |
All Generics, All Brands |
2 |
Non-Preferred Generic |
$5.00 | $12.50 | P | $48.32 |
Browse Plan Formulary |
CareMore Value Plus (HMO)
|
$0.00 |
$0 |
All Generics, All Brands |
2 |
Non-Preferred Generic |
$5.00 | $12.50 | P | $48.32 |
Browse Plan Formulary |
Citizens Choice Healthplan (HMO)
|
$0.00 |
$0 |
Many Generics |
4 |
Injectable Drugs |
25% | 25% | P | $164.86 |
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 Gold Select (HMO)
|
$0.00 |
$0 |
Many Generics |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None | $177.48 |
Browse Plan Formulary |
Health Net Healthy Heart (HMO)
|
$0.00 |
$0 |
Many Generics |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None | $177.48 |
Browse Plan Formulary |
Health Net Healthy Heart Plan 1 (HMO)
|
$0.00 |
$0 |
Many Generics |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None | $177.48 |
Browse Plan Formulary |
Health Net Jade (HMO SNP)
|
$0.00 |
$0 |
Many Generics |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None | $177.48 |
Browse Plan Formulary |
Health Net Seniority Plus Ruby Plan 1 (HMO)
|
$0.00 |
$0 |
Many Generics |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None | $177.48 |
Browse Plan Formulary |
Heart First (HMO SNP)
|
$0.00 |
$0 |
Many Generics, Few Brands |
2 |
Non-Preferred Generic |
$5.00 | $10.00 | None | $179.36 |
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 H0108-008 (HMO)
|
$0.00 |
$0 |
Some Generics, Few Brands |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:7200 /30Days | $179.44 |
Browse Plan Formulary |
Kaiser Permanente Senior Advantage B Only South (HMO)
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$8.00 | $16.00 | None | $170.84 |
Browse Plan Formulary |
Kaiser Permanente Senior Advantage B Only South (HMO)
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$8.00 | $16.00 | None | $170.84 |
Browse Plan Formulary |
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)
|
$0.00 |
$0 |
All Generics, Few Brands |
2 |
Non-Preferred Generic |
$7.00 | $14.00 | None | $170.84 |
Browse Plan Formulary |
Kaiser Permanente Senior Advantage San Diego (HMO)
|
$0.00 |
$0 |
All Generics, Few Brands |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None | $170.84 |
Browse Plan Formulary |
SCAN Balance (HMO SNP)
|
$0.00 |
$0 |
Many Generics, Few Brands |
2 |
Non-Preferred Generic |
$5.00 | $10.00 | None | $179.36 |
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 Classic (HMO)
|
$0.00 |
$0 |
Many Generics |
2 |
Non-Preferred Generic |
$8.00 | $16.00 | None | $179.36 |
Browse Plan Formulary |
SCAN Classic (HMO)
|
$0.00 |
$0 |
Many Generics |
2 |
Non-Preferred Generic |
$8.00 | $16.00 | None | $179.36 |
Browse Plan Formulary |
SCAN Healthy at Home (HMO SNP)
|
$0.00 |
$0 |
Many Generics |
2 |
Non-Preferred Generic |
$8.00 | $16.00 | None | $179.36 |
Browse Plan Formulary |
Sharp SecureHorizons Plan by UnitedHealthcare (HMO)
|
$0.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$45.00 | $125.00 | None | $169.98 |
Browse Plan Formulary |
StartSmart with CareMore (HMO)
|
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Non-Preferred Generic |
$10.00 | $25.00 | P | $48.32 |
Browse Plan Formulary |
Senior Advantage Medicare Medi-Cal Plan South (HMO SNP)
|
$11.40 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None | $170.84 |
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 |
Senior Advantage Medicare Medi-Cal Plan South (HMO SNP)
|
$11.40 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None | $170.84 |
Browse Plan Formulary |
Health Net Healthy Heart Plan 2 (HMO)
|
$23.90 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None | $177.48 |
Browse Plan Formulary |
AARP MedicareComplete SecureHorizons Value (HMO)
|
$25.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$45.00 | $125.00 | None | $169.98 |
Browse Plan Formulary |
UnitedHealthcare Dual Complete (HMO SNP)
|
$26.90 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
15% | 15% | None | $169.98 |
Browse Plan Formulary |
SCAN Plus (HMO)
|
$27.50 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Non-Preferred Generic |
$0.00 | $0.00 | None | $179.36 |
Browse Plan Formulary |
Anthem Medicare Preferred Standard (PPO)
|
$28.00 |
$90* |
No additional gap coverage, only the Donut Hole Discount |
5* |
Injectable Drugs |
33% | 33% | None | $181.83 |
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 Seniority Plus Amber I (HMO SNP)
|
$29.80 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
15% | 15% | None | $177.48 |
Browse Plan Formulary |
Health Net Seniority Plus Amber II (HMO SNP)
|
$29.80 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
15% | 15% | None | $177.48 |
Browse Plan Formulary |
Health Net Seniority Plus Amber II (HMO SNP)
|
$29.80 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
15% | 15% | None | $177.48 |
Browse Plan Formulary |
Molina Medicare Options Plus (HMO SNP)
|
$29.80 |
$325* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Generic |
$0.00 | $0.00 | P | $172.76 |
Browse Plan Formulary |
Molina Medicare Options Plus (HMO SNP)
|
$29.80 |
$325* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Generic |
$0.00 | $0.00 | P | $172.76 |
Browse Plan Formulary |
SCAN Connections (HMO SNP)
|
$29.90 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
n/a | n/a | None | $179.36 |
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 at Home (HMO SNP)
|
$29.90 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
n/a | n/a | None | $179.36 |
Browse Plan Formulary |
Humana Gold Plus H0108-009 (HMO-POS)
|
$39.00 |
$0 |
Few Generics, Few Brands |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:7200 /30Days | $179.44 |
Browse Plan Formulary |
AARP MedicareComplete SecureHorizons Premier (HMO)
|
$69.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$42.00 | $116.00 | None | $169.98 |
Browse Plan Formulary |
Health Net Seniority Plus Ruby Plan 2 (HMO)
|
$69.00 |
$0 |
Many Generics |
2 |
Non-Preferred Generic |
$15.00 | $30.00 | None | $177.48 |
Browse Plan Formulary |
SCAN Signature (HMO)
|
$69.00 |
$0 |
Many Generics |
2 |
Non-Preferred Generic |
$8.00 | $16.00 | None | $179.36 |
Browse Plan Formulary |
Anthem Medicare Preferred Standard (PPO)
|
$70.00 |
$95* |
No additional gap coverage, only the Donut Hole Discount |
5* |
Injectable Drugs |
33% | 33% | None | $181.83 |
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 Violet (PPO)
|
$82.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Non-Preferred Generic |
$25.00 | $50.00 | None | $177.48 |
Browse Plan Formulary |
Health Net Seniority Plus Ruby (HMO)
|
$182.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Non-Preferred Generic |
$10.00 | $20.00 | None | $177.48 |
Browse Plan Formulary |