ASACOL HD 800mg/1 12 BOTTLE CASE / 180 TABLET, DELAYED RELEASE in 1 BOTTLE (12 BOTTLE in 1 CASE / 180 ) (NDC: 00430078327)
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 |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $786.75 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $786.20 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $791.76 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $794.51 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $783.57 |
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 |
Medicare Plus Blue PPO Essential (PPO)
|
$12.50 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $786.11 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$12.50 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $786.75 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$12.50 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $789.27 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$12.50 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $793.74 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$12.50 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $783.71 |
Browse Plan Formulary |
HumanaChoice R5826-072 (Regional PPO)
|
$20.80 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | Q:180 /30Days | $783.49 |
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 |
PriorityMedicare Value (HMO-POS)
|
$32.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$40.00 | $100.00 | None | $788.18 |
Browse Plan Formulary |
HumanaChoice R5826-006 (Regional PPO)
|
$37.50 |
$0 |
Few Generics, Few Brands |
3 |
Non-Preferred Brand |
$80.00 | $230.00 | Q:180 /30Days | $783.49 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$41.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $783.71 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$41.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $786.11 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$41.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $786.75 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$41.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $789.27 |
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 |
Medicare Plus Blue PPO Vitality (PPO)
|
$41.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $793.74 |
Browse Plan Formulary |
HumanaChoice H5470-005 (PPO)
|
$62.00 |
$0 |
Few Generics, Few Brands |
3 |
Non-Preferred Brand |
$90.00 | $260.00 | Q:180 /30Days | $782.03 |
Browse Plan Formulary |
Humana Gold Choice H8145-005 (PFFS)
|
$72.00 |
$0 |
Few Generics, Few Brands |
3 |
Non-Preferred Brand |
$80.00 | $230.00 | Q:180 /30Days | $782.59 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$75.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | None | $794.51 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$75.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | None | $783.57 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$75.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | None | $786.20 |
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 |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$75.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | None | $786.75 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$75.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | None | $791.76 |
Browse Plan Formulary |
PriorityMedicare (HMO-POS)
|
$89.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$35.00 | $87.50 | None | $788.18 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$96.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $112.50 | None | $793.74 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$96.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $112.50 | None | $783.71 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$96.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $112.50 | None | $786.11 |
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 |
Medicare Plus Blue PPO Signature (PPO)
|
$96.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $112.50 | None | $786.75 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$96.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $112.50 | None | $789.27 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$97.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$40.00 | $100.00 | None | $788.86 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$151.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | None | $786.38 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$151.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | None | $786.47 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$151.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | None | $783.71 |
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 |
Medicare Plus Blue PPO Assure (PPO)
|
$151.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | None | $786.11 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$151.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | None | $784.83 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$203.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$35.00 | $87.50 | None | $783.57 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$203.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$35.00 | $87.50 | None | $786.20 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$203.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$35.00 | $87.50 | None | $786.75 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$203.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$35.00 | $87.50 | None | $791.76 |
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 |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$203.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$35.00 | $87.50 | None | $794.51 |
Browse Plan Formulary |