ZYFLO CR 600 MG TABLET (120 EA ) (NDC: 10122090212)
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 |
4 |
Tier 4 |
25% | 25% | Q:136 /34Days | $2,078.27 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | Q:136 /34Days | $2,076.07 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | Q:136 /34Days | $2,075.94 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | Q:136 /34Days | $2,067.12 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | Q:136 /34Days | $2,076.63 |
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 |
HealthPlus MedicarePlus-AdvantageHMO-POS Option 0 (HMO-POS)
|
$0.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Non-Preferred Brand |
$64.00 | $128.00 | None | $2,028.23 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$12.50 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $2,070.54 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$12.50 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $2,082.11 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$12.50 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $2,075.94 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$12.50 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $2,066.35 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$12.50 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $2,076.63 |
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 |
HumanaChoice R5826-072 (Regional PPO)
|
$20.80 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | Q:120 /30Days | $2,063.48 |
Browse Plan Formulary |
HealthPlus MedicarePlus-Advantage D-SNP (HMO SNP)
|
$23.60 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
15% | 15% | None | $2,029.12 |
Browse Plan Formulary |
HumanaChoice R5826-006 (Regional PPO)
|
$37.50 |
$0 |
Few Generics, Few Brands |
3 |
Non-Preferred Brand |
$80.00 | $230.00 | Q:120 /30Days | $2,063.48 |
Browse Plan Formulary |
PriorityMedicare Value (HMO-POS)
|
$55.60 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$40.00 | $100.00 | None | $2,072.24 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$76.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $2,066.35 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$76.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $2,076.63 |
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)
|
$76.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $2,070.54 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$76.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $2,082.11 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$76.00 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $2,075.94 |
Browse Plan Formulary |
HealthPlus MedicarePlus-AdvantageHMO-POS Option 1 (HMO-POS)
|
$79.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Non-Preferred Brand |
$74.00 | $148.00 | None | $2,028.23 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$96.00 |
$0 |
Many Generics |
4 |
Non-Preferred Brand |
$80.00 | $200.00 | Q:136 /34Days | $2,075.94 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$96.00 |
$0 |
Many Generics |
4 |
Non-Preferred Brand |
$80.00 | $200.00 | Q:136 /34Days | $2,067.12 |
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)
|
$96.00 |
$0 |
Many Generics |
4 |
Non-Preferred Brand |
$80.00 | $200.00 | Q:136 /34Days | $2,076.63 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$96.00 |
$0 |
Many Generics |
4 |
Non-Preferred Brand |
$80.00 | $200.00 | Q:136 /34Days | $2,078.27 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$96.00 |
$0 |
Many Generics |
4 |
Non-Preferred Brand |
$80.00 | $200.00 | Q:136 /34Days | $2,076.07 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$97.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$45.00 | $112.50 | None | $2,067.85 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$97.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$45.00 | $112.50 | None | $2,072.24 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$97.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$45.00 | $112.50 | None | $2,070.47 |
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 |
HealthPlus MedicarePlus-AdvantageHMO-POS Option 2 (HMO-POS)
|
$125.00 |
$0 |
All Generics |
3 |
Non-Preferred Brand |
$70.00 | $140.00 | None | $2,028.23 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$132.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None | $2,075.94 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$132.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None | $2,066.35 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$132.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None | $2,076.63 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$132.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None | $2,070.54 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$132.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None | $2,082.11 |
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 |
HealthPlus MedicarePlus-AdvantagePPO Enhanced (PPO)
|
$136.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Non-Preferred Brand |
$70.00 | $140.00 | None | $2,029.75 |
Browse Plan Formulary |
PriorityMedicare (HMO-POS)
|
$136.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$35.00 | $87.50 | None | $2,072.24 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$154.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$40.00 | $100.00 | None | $2,072.24 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$213.00 |
$0 |
Many Generics |
4 |
Non-Preferred Brand |
$75.00 | $187.50 | Q:136 /34Days | $2,067.12 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$213.00 |
$0 |
Many Generics |
4 |
Non-Preferred Brand |
$75.00 | $187.50 | Q:136 /34Days | $2,076.63 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$213.00 |
$0 |
Many Generics |
4 |
Non-Preferred Brand |
$75.00 | $187.50 | Q:136 /34Days | $2,078.27 |
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 |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$213.00 |
$0 |
Many Generics |
4 |
Non-Preferred Brand |
$75.00 | $187.50 | Q:136 /34Days | $2,076.07 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$213.00 |
$0 |
Many Generics |
4 |
Non-Preferred Brand |
$75.00 | $187.50 | Q:136 /34Days | $2,075.94 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$240.00 |
$0 |
Many Generics |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None | $2,082.11 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$240.00 |
$0 |
Many Generics |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None | $2,075.94 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$240.00 |
$0 |
Many Generics |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None | $2,066.35 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$240.00 |
$0 |
Many Generics |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None | $2,076.63 |
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)
|
$240.00 |
$0 |
Many Generics |
4 |
Non-Preferred Brand |
$95.00 | $237.50 | None | $2,070.54 |
Browse Plan Formulary |