ADVAIR HFA 230; 21ug/1; ug/1 120 AEROSOL, METERED in 1 INHALER (120 AEROSOL, METERED in 1 ) (NDC: 00173071720)
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)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $125.00 | None | $361.99 |
Browse Plan Formulary |
Abrazo Advantage (HMO)
|
$0.00 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$35.00 | $105.00 | P Q:24 /34Days | $382.91 |
Browse Plan Formulary |
Aetna Medicare Select Plan (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $90.00 | None | $363.46 |
Browse Plan Formulary |
Blue Medicare Advantage Classic (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
22% | 25% | Q:24 /30Days | $358.25 |
Browse Plan Formulary |
CareMore Breathe (HMO SNP)
|
$0.00 |
$0 | All Generics, Few Brands | 3 |
Preferred Brand |
$35.00 | $87.50 | Q:12 /30Days | $402.59 |
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)
|
$0.00 |
$0 | All Generics, Few Brands | 3 |
Preferred Brand |
$35.00 | $87.50 | Q:12 /30Days | $402.59 |
Browse Plan Formulary |
CareMore Heart (HMO SNP)
|
$0.00 |
$0 | All Generics, Few Brands | 3 |
Preferred Brand |
$35.00 | $87.50 | Q:12 /30Days | $402.59 |
Browse Plan Formulary |
CareMore Touch (HMO SNP)
|
$0.00 |
$0 | All Generics, Few Brands | 3 |
Preferred Brand |
$35.00 | $87.50 | Q:12 /30Days | $402.59 |
Browse Plan Formulary |
CareMore Value Plus (HMO)
|
$0.00 |
$0 | All Generics, Few Brands | 3 |
Preferred Brand |
$35.00 | $87.50 | Q:12 /30Days | $402.59 |
Browse Plan Formulary |
Cigna Medicare Select Plus Rx-Diabetes Heart (HMO SNP)
|
$0.00 |
$0 | Many Generics | 3 |
Preferred Brand |
$45.00 | $90.00 | None | $372.70 |
Browse Plan Formulary |
Cigna Medicare Select Plus Rx-Standard (HMO)
|
$0.00 |
$0 | Many Generics | 3 |
Preferred Brand |
$45.00 | $90.00 | None | $372.70 |
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)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$44.00 | $122.00 | Q:4 /1Days | $361.93 |
Browse Plan Formulary |
Health Net Ruby 4 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $125.00 | Q:4 /1Days | $361.95 |
Browse Plan Formulary |
Health Net Ruby Select (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$44.00 | $122.00 | Q:4 /1Days | $361.95 |
Browse Plan Formulary |
Humana Reader''s Digest Healthy Living Plan (HMO)
|
$0.00 |
$0 | Few Generics, Few Brands | 3 |
Preferred Brand |
$45.00 | $125.00 | Q:12 /30Days | $363.31 |
Browse Plan Formulary |
Humana Reader''s Digest Healthy Living Plan (HMO)
|
$0.00 |
$0 | Few Generics, Few Brands | 3 |
Preferred Brand |
$45.00 | $125.00 | Q:12 /30Days | $363.11 |
Browse Plan Formulary |
SCAN Classic (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $90.00 | None | $382.92 |
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)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $112.50 | Q:12 /30Days | $402.59 |
Browse Plan Formulary |
Blue Medicare Advantage Plus (HMO)
|
$14.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
$40.00 | $120.00 | Q:24 /30Days | $358.25 |
Browse Plan Formulary |
Humana Reader''s Digest Healthy Living Plan (Regional PPO)
|
$23.10 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:12 /30Days | $363.41 |
Browse Plan Formulary |
Cigna Medicare Select Plus Rx-Premium (HMO)
|
$25.00 |
$0 | Many Generics | 3 |
Preferred Brand |
$35.00 | $70.00 | None | $372.70 |
Browse Plan Formulary |
Advantage by Bridgeway Health Solutions (HMO SNP)
|
$27.00 |
$325 | No additional gap coverage, only the Donut Hole Discount | 2 |
Tier 2 |
15% | 15% | Q:12 /30Days | $367.39 |
Browse Plan Formulary |
Mercy Care Advantage (HMO SNP)
|
$27.20 |
$325 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:24 /34Days | $361.40 |
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)
|
$27.20 |
$325 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:24 /34Days | $361.40 |
Browse Plan Formulary |
Mercy Care Advantage (HMO SNP)
|
$27.20 |
$325 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:24 /34Days | $361.40 |
Browse Plan Formulary |
UnitedHealthcare Nursing Home Plan (PPO SNP)
|
$27.20 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | None | $361.95 |
Browse Plan Formulary |
Cigna Medicare Select Plus Rx-Dual (HMO SNP)
|
$28.00 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | None | $372.70 |
Browse Plan Formulary |
UnitedHealthcare Dual Complete LP (HMO SNP)
|
$28.20 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | None | $361.95 |
Browse Plan Formulary |
UnitedHealthcare Dual Complete LP (HMO SNP)
|
$28.20 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | None | $361.95 |
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)
|
$29.30 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | None | $362.08 |
Browse Plan Formulary |
Abrazo Advantage Plus (HMO SNP)
|
$29.40 |
$325 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:24 /34Days | $382.91 |
Browse Plan Formulary |
Health Choice Generations (HMO SNP)
|
$29.40 |
$325 | No additional gap coverage, only the Donut Hole Discount | 2 |
Tier 2 |
15% | 15% | Q:8 /30Days | $369.37 |
Browse Plan Formulary |
Health Choice Generations (HMO SNP)
|
$29.40 |
$325 | No additional gap coverage, only the Donut Hole Discount | 2 |
Tier 2 |
15% | 15% | Q:8 /30Days | $369.32 |
Browse Plan Formulary |
Health Net Amber (HMO SNP)
|
$29.40 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$41.00 | $113.00 | Q:4 /1Days | $361.93 |
Browse Plan Formulary |
ONECare by Care1st Health Plan Arizona, Inc. (HMO SNP)
|
$29.40 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | n/a | S Q:12 /30Days | $366.44 |
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)
|
$29.40 |
$325 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
n/a | n/a | None | $382.92 |
Browse Plan Formulary |
University Care Advantage (HMO SNP)
|
$29.40 |
$325 | No additional gap coverage, only the Donut Hole Discount | 2 |
Tier 2 |
15% | 15% | Q:24 /34Days | $366.44 |
Browse Plan Formulary |
Blue Medicare Advantage Premier (HMO)
|
$45.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
$30.00 | $90.00 | Q:24 /30Days | $358.25 |
Browse Plan Formulary |
Health Net Ruby 1 (HMO)
|
$49.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $125.00 | Q:4 /1Days | $361.93 |
Browse Plan Formulary |
Humana Reader''s Digest Healthy Living Plan (HMO-POS)
|
$62.00 |
$0 | Few Generics, Few Brands | 3 |
Preferred Brand |
$45.00 | $125.00 | Q:12 /30Days | $363.11 |
Browse Plan Formulary |
Humana Reader''s Digest Healthy Living Plan (PPO)
|
$102.00 |
$0 | Few Generics, Few Brands | 3 |
Preferred Brand |
$45.00 | $125.00 | Q:12 /30Days | $363.04 |
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 |
Humana Reader''s Digest Healthy Living Plan (Regional PPO)
|
$142.10 |
$0 | Few Generics, Few Brands | 3 |
Preferred Brand |
$45.00 | $125.00 | Q:12 /30Days | $363.41 |
Browse Plan Formulary |
Humana Gold Choice H8145-103 (PFFS)
|
$177.00 |
$0 | Few Generics, Few Brands | 3 |
Preferred Brand |
$45.00 | $125.00 | Q:12 /30Days | $363.39 |
Browse Plan Formulary |