Actonel 30mg/1 12 BOTTLE CASE / 30 FILM COATED TABLETS in BOTTLE (12 BOTTLE in 1 CASE / 30 ) (NDC: 00430047015)
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% | Q:34 /34Days | $1,146.23 |
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% | Q:34 /34Days | $1,122.57 |
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% | Q:34 /34Days | $1,123.85 |
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% | Q:34 /34Days | $1,121.72 |
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% | Q:34 /34Days | $1,126.40 |
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 |
PriorityMedicare Value (HMO-POS)
|
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$40.00 | $100.00 | Q:31 /31Days | $1,116.37 |
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% | S Q:31 /31Days | $1,135.08 |
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% | S Q:31 /31Days | $1,122.57 |
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% | S Q:31 /31Days | $1,123.85 |
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% | S Q:31 /31Days | $1,121.59 |
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% | S Q:31 /31Days | $1,125.86 |
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 |
HumanaChoice R5826-072 (Regional PPO)
|
$20.80 |
$325 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | Q:30 /30Days | $1,117.55 |
Browse Plan Formulary |
HumanaChoice R5826-006 (Regional PPO)
|
$37.50 |
$0 |
Few Generics, Few Brands |
3 |
Non-Preferred Brand |
$80.00 | $230.00 | Q:30 /30Days | $1,117.55 |
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% | S Q:31 /31Days | $1,125.86 |
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% | S Q:31 /31Days | $1,135.08 |
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% | S Q:31 /31Days | $1,122.57 |
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% | S Q:31 /31Days | $1,123.85 |
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% | S Q:31 /31Days | $1,121.59 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$75.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | Q:34 /34Days | $1,121.72 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$75.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | Q:34 /34Days | $1,126.40 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$75.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | Q:34 /34Days | $1,146.23 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$75.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | Q:34 /34Days | $1,122.57 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$75.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | Q:34 /34Days | $1,123.85 |
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 (HMO-POS)
|
$81.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$35.00 | $87.50 | Q:31 /31Days | $1,116.37 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$90.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$40.00 | $100.00 | Q:31 /31Days | $1,116.37 |
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 | S Q:31 /31Days | $1,121.59 |
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 | S Q:31 /31Days | $1,125.86 |
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 | S Q:31 /31Days | $1,135.08 |
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 | S Q:31 /31Days | $1,122.57 |
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 Signature (PPO)
|
$96.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $112.50 | S Q:31 /31Days | $1,123.85 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$151.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | S Q:31 /31Days | $1,123.85 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$151.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | S Q:31 /31Days | $1,122.57 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$151.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | S Q:31 /31Days | $1,121.59 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$151.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | S Q:31 /31Days | $1,125.86 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$151.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | S Q:31 /31Days | $1,135.08 |
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 | Q:34 /34Days | $1,126.40 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$203.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$35.00 | $87.50 | Q:34 /34Days | $1,146.23 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$203.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$35.00 | $87.50 | Q:34 /34Days | $1,122.57 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$203.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$35.00 | $87.50 | Q:34 /34Days | $1,123.85 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$203.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$35.00 | $87.50 | Q:34 /34Days | $1,121.72 |
Browse Plan Formulary |