ABILIFY DISCMELT 10MG TABLET (3 X 10 CRTN) (NDC: 59148064023)
2014 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 |
Commonwealth Care Alliance (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Commonwealth Care Alliance (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
All Generics, All Brands |
2 |
Tier 2 |
0% | 0% | None | $996.25 |
Browse Plan Formulary |
Fallon Senior Plan Super Saver Rx (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Super Saver Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | Q:90 /30Days | $942.57 |
Browse Plan Formulary |
Fallon Senior Plan Super Saver Rx (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Super Saver Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | Q:90 /30Days | $940.73 |
Browse Plan Formulary |
Fallon Senior Plan Super Saver Rx (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Super Saver Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | Q:90 /30Days | $990.59 |
Browse Plan Formulary |
Fallon Senior Plan Super Saver Rx (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Super Saver Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | Q:90 /30Days | $945.16 |
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 |
Fallon Senior Plan Super Saver Rx (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Super Saver Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | Q:90 /30Days | $940.73 |
Browse Plan Formulary |
Fallon Total Care (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Fallon Total Care (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
All Generics, All Brands |
2 |
Tier 2 |
0% | 0% | Q:60 /30Days | $940.87 |
Browse Plan Formulary |
Medicare PPO Blue SaverRx (PPO)
![Email Prescription and/or Health Benefit details for Medicare PPO Blue SaverRx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | None | $948.59 |
Browse Plan Formulary |
Network Health Unify (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Network Health Unify (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
All Generics, All Brands |
2 |
Tier 2 |
0% | 0% | S | $947.92 |
Browse Plan Formulary |
Tufts Medicare Preferred HMO Saver Rx (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Saver Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$95.00 | $285.00 | S | $947.92 |
Browse Plan Formulary |
UnitedHealthcare Senior Care Options (HMO SNP)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Senior Care Options (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.50 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
n/a | n/a | Q:90 /30Days | $943.89 |
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 |
AARP MedicareComplete Choice (Regional PPO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Choice (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.20 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | 33% | Q:90 /30Days | $953.69 |
Browse Plan Formulary |
Tufts Health Plan Senior Care Options (HMO SNP)
![Email Prescription and/or Health Benefit details for Tufts Health Plan Senior Care Options (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
n/a | n/a | S | $947.92 |
Browse Plan Formulary |
Erickson Advantage Guardian (HMO-POS SNP)
![Email Prescription and/or Health Benefit details for Erickson Advantage Guardian (HMO-POS SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | 33% | Q:90 /30Days | $948.78 |
Browse Plan Formulary |
Medicare HMO Blue ValueRx (HMO)
![Email Prescription and/or Health Benefit details for Medicare HMO Blue ValueRx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | None | $948.59 |
Browse Plan Formulary |
UnitedHealthcare Nursing Home Plan (PPO SNP)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Nursing Home Plan (PPO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | 25% | Q:90 /30Days | $943.89 |
Browse Plan Formulary |
NaviCare (HMO SNP)
![Email Prescription and/or Health Benefit details for NaviCare (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Non-Preferred Brand |
25% | 25% | Q:90 /30Days | $942.74 |
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 Whole Health (HMO SNP)
![Email Prescription and/or Health Benefit details for Senior Whole Health (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$310 |
Call plan for details |
2 |
Preferred Brand |
25% | 25% | Q:270 /90Days | $947.33 |
Browse Plan Formulary |
Senior Whole Health NHC (HMO SNP)
![Email Prescription and/or Health Benefit details for Senior Whole Health NHC (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$310 |
Call plan for details |
2 |
Preferred Brand |
25% | 25% | Q:270 /90Days | $947.33 |
Browse Plan Formulary |
Senior Care Options Program (HMO SNP)
![Email Prescription and/or Health Benefit details for Senior Care Options Program (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
n/a | n/a | None | $988.65 |
Browse Plan Formulary |
Tufts Medicare Preferred HMO Basic Rx (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Basic Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.90 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$93.00 | $279.00 | S | $947.92 |
Browse Plan Formulary |
Tufts Medicare Preferred HMO Basic Rx (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Basic Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.90 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$93.00 | $279.00 | S | $1,018.70 |
Browse Plan Formulary |
Tufts Medicare Preferred HMO Basic Rx (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Basic Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.90 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$93.00 | $279.00 | S | $947.92 |
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 |
Fallon Senior Plan Saver Enhanced RX (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Saver Enhanced RX (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | Q:90 /30Days | $940.73 |
Browse Plan Formulary |
Fallon Senior Plan Saver Enhanced RX (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Saver Enhanced RX (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | Q:90 /30Days | $942.57 |
Browse Plan Formulary |
Fallon Senior Plan Saver Enhanced RX (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Saver Enhanced RX (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | Q:90 /30Days | $990.59 |
Browse Plan Formulary |
Fallon Senior Plan Saver Enhanced RX (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Saver Enhanced RX (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | Q:90 /30Days | $945.16 |
Browse Plan Formulary |
Erickson Advantage Freedom (HMO-POS)
![Email Prescription and/or Health Benefit details for Erickson Advantage Freedom (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | 33% | Q:90 /30Days | $951.83 |
Browse Plan Formulary |
Medicare PPO Blue ValueRx (PPO)
![Email Prescription and/or Health Benefit details for Medicare PPO Blue ValueRx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$51.00 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | None | $948.59 |
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 |
Tufts Medicare Preferred HMO Value Rx (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Value Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$117.90 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$93.00 | $279.00 | S | $1,018.70 |
Browse Plan Formulary |
Tufts Medicare Preferred HMO Value Rx (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Value Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$117.90 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$93.00 | $279.00 | S | $947.92 |
Browse Plan Formulary |
Tufts Medicare Preferred HMO Value Rx (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Value Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$117.90 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$93.00 | $279.00 | S | $947.92 |
Browse Plan Formulary |
Medicare PPO Blue PlusRx (PPO)
![Email Prescription and/or Health Benefit details for Medicare PPO Blue PlusRx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$124.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | None | $948.59 |
Browse Plan Formulary |
Fallon Senior Plan Plus Enhanced RX (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Plus Enhanced RX (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$143.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | Q:90 /30Days | $940.73 |
Browse Plan Formulary |
Fallon Senior Plan Plus Enhanced RX (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Plus Enhanced RX (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$143.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | Q:90 /30Days | $942.57 |
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 |
Fallon Senior Plan Plus Enhanced RX (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Plus Enhanced RX (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$143.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | Q:90 /30Days | $940.73 |
Browse Plan Formulary |
Fallon Senior Plan Plus Enhanced RX (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Plus Enhanced RX (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$143.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | Q:90 /30Days | $990.59 |
Browse Plan Formulary |
Fallon Senior Plan Plus Enhanced RX (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Plus Enhanced RX (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$143.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | Q:90 /30Days | $945.16 |
Browse Plan Formulary |
Tufts Medicare Preferred HMO Prime Rx (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Prime Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$151.90 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$93.00 | $279.00 | S | $1,018.70 |
Browse Plan Formulary |
Tufts Medicare Preferred HMO Prime Rx (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Prime Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$151.90 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$93.00 | $279.00 | S | $947.92 |
Browse Plan Formulary |
Tufts Medicare Preferred HMO Prime Rx (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Prime Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$151.90 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$93.00 | $279.00 | S | $947.92 |
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 |
Medicare HMO Blue PlusRx (HMO)
![Email Prescription and/or Health Benefit details for Medicare HMO Blue PlusRx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$167.00 |
$120 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | None | $948.59 |
Browse Plan Formulary |
Tufts Medicare Preferred HMO Prime Rx Plus (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Prime Rx Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$185.70 |
$0 |
Many Generics |
4 |
Non-Preferred Brand |
$75.00 | $225.00 | S | $947.92 |
Browse Plan Formulary |
Tufts Medicare Preferred HMO Prime Rx Plus (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Prime Rx Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$185.70 |
$0 |
Many Generics |
4 |
Non-Preferred Brand |
$75.00 | $225.00 | S | $947.92 |
Browse Plan Formulary |
Tufts Medicare Preferred HMO Prime Rx Plus (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Prime Rx Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$185.70 |
$0 |
Many Generics |
4 |
Non-Preferred Brand |
$75.00 | $225.00 | S | $1,018.70 |
Browse Plan Formulary |
Erickson Advantage Champion (HMO-POS SNP)
![Email Prescription and/or Health Benefit details for Erickson Advantage Champion (HMO-POS SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$189.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | 33% | Q:90 /30Days | $951.83 |
Browse Plan Formulary |
Erickson Advantage Signature with Drugs (HMO-POS)
![Email Prescription and/or Health Benefit details for Erickson Advantage Signature with Drugs (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$189.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | 33% | Q:90 /30Days | $951.83 |
Browse Plan Formulary |