ABRAXANE 100MG VIAL (1 X 100 MG VIALSD) (NDC: 68817013450)
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 |
AARP MedicareComplete Mosaic (HMO)
|
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | 33% | P | $1,035.25 |
Browse Plan Formulary |
AARP MedicareComplete Plan 1 (HMO)
|
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | 33% | P | $1,035.25 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | 33% | P | $1,035.25 |
Browse Plan Formulary |
Access Medicare Gold (HMO)
|
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
30% | 30% | None | $1,045.25 |
Browse Plan Formulary |
Aetna Medicare Value Plan (HMO)
|
$0.00 |
$0 |
Few Generics |
4 |
Specialty Tier |
33% | 33% | None | $1,033.97 |
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 |
AlphaCare Renew (HMO)
|
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | n/a | None | $1,023.93 |
Browse Plan Formulary |
Amida Care True Life Plus (HMO)
|
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Specialty Tier |
33% | 33% | None | $1,026.72 |
Browse Plan Formulary |
CPHL Advantage Care (HMO)
|
$0.00 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | 25% | None | $1,023.93 |
Browse Plan Formulary |
Elderplan Classic: Zero Premium (HMO)
|
$0.00 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Specialty Tier |
25% | 25% | P | $1,029.59 |
Browse Plan Formulary |
Empire MediBlue Plus (HMO)
|
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
6 |
Specialty Tier |
33% | n/a | P | $1,026.72 |
Browse Plan Formulary |
Fidelis Medicare $0 Premium (HMO)
|
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
25% | 25% | P | $1,034.76 |
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 |
Humana Gold Plus H3533-009 (HMO)
|
$0.00 |
$0 |
Few Generics, Few Brands |
5 |
Specialty Tier |
33% | n/a | P Q:900 /21Days | $1,018.54 |
Browse Plan Formulary |
Liberty Health Advantage Dual Power (HMO SNP)
|
$0.00 |
$310 |
to be determined |
4 |
Tier 4 |
15% | 15% | P | $1,061.80 |
Browse Plan Formulary |
Liberty Health Advantage Preferred Choice (HMO)
|
$0.00 |
$0 |
All Generics |
4 |
Non-Preferred Brand |
$75.00 | $225.00 | P | $1,061.80 |
Browse Plan Formulary |
UnitedHealthcare MedicareComplete Choice (Regional PPO)
|
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | 33% | P | $1,035.44 |
Browse Plan Formulary |
VNSNY CHOICE Medicare Enhanced (HMO)
|
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
25% | 25% | P | $1,028.75 |
Browse Plan Formulary |
Humana Gold Plus HMO-SNP-DE H3533-004 (HMO SNP)
|
$12.20 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
29% | n/a | P Q:900 /21Days | $1,030.15 |
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)
|
$24.10 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
n/a | n/a | P | $1,035.22 |
Browse Plan Formulary |
UnitedHealthcare Nursing Home Plan (HMO SNP)
|
$28.30 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | 25% | P | $1,035.44 |
Browse Plan Formulary |
VNSNY CHOICE Medicare Maximum (HMO SNP)
|
$31.50 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
n/a | n/a | P | $1,028.75 |
Browse Plan Formulary |
CenterLight Direct Total Plan (HMO SNP)
|
$33.90 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Specialty Tier |
25% | 25% | None | $1,037.43 |
Browse Plan Formulary |
CenterLight Healthcare Direct Complete Plan (HMO SNP)
|
$34.00 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Specialty Tier |
25% | 25% | None | $1,037.43 |
Browse Plan Formulary |
Access Medicare Pearl (HMO SNP)
|
$37.20 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
15% | 15% | None | $1,045.25 |
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 |
Access Medicare Platinum (HMO)
|
$37.20 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | 25% | None | $1,045.25 |
Browse Plan Formulary |
AlphaCare Resilience (HMO SNP)
|
$37.20 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | n/a | None | $1,023.93 |
Browse Plan Formulary |
AlphaCare Total (HMO SNP)
|
$37.20 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
15% | n/a | None | $1,023.93 |
Browse Plan Formulary |
Amida Care Live Life Advantage (HMO SNP)
|
$37.20 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $1,026.72 |
Browse Plan Formulary |
Amida Care True Life Advantage (HMO SNP)
|
$37.20 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
15% | 15% | None | $1,026.72 |
Browse Plan Formulary |
Elderplan Advantage For Nursing Home Residents (HMO SNP)
|
$37.20 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | 25% | P | $1,028.07 |
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 |
Elderplan Extra Help (HMO)
|
$37.20 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | 25% | P | $1,028.07 |
Browse Plan Formulary |
Elderplan For Medicaid Beneficiaries (HMO SNP)
|
$37.20 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
15% | 15% | P | $1,028.07 |
Browse Plan Formulary |
Elderplan Plus Long Term Care (HMO SNP)
|
$37.20 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
15% | 15% | P | $1,028.07 |
Browse Plan Formulary |
Fidelis Dual Advantage (HMO SNP)
|
$37.20 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
25% | 25% | P | $1,034.76 |
Browse Plan Formulary |
Fidelis Dual Advantage Flex (HMO SNP)
|
$37.20 |
$310 |
Some Generics |
5 |
Specialty Tier |
25% | 25% | P | $1,034.68 |
Browse Plan Formulary |
Fidelis Medicaid Advantage Plus (HMO SNP)
|
$37.20 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
25% | 25% | P | $1,034.78 |
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 |
Fidelis Medicare Advantage Flex (HMO-POS)
|
$37.20 |
$240 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
25% | 25% | P | $1,034.68 |
Browse Plan Formulary |
Senior Whole Health of New York (HMO SNP)
|
$37.20 |
$310 |
Call plan for details |
3 |
Specialty Tier |
25% | 25% | None | $1,026.72 |
Browse Plan Formulary |
Senior Whole Health of New York NHC (HMO SNP)
|
$37.20 |
$310 |
Call plan for details |
3 |
Specialty Tier |
25% | 25% | None | $1,026.72 |
Browse Plan Formulary |
VNSNY CHOICE Medicare Classic (HMO)
|
$37.20 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | 25% | P | $1,028.75 |
Browse Plan Formulary |
VNSNY CHOICE Medicare Preferred (HMO SNP)
|
$37.20 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
15% | 15% | P | $1,028.75 |
Browse Plan Formulary |
VNSNY CHOICE Total (HMO SNP)
|
$37.20 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
n/a | n/a | P | $1,028.75 |
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 |
Elderplan Medicaid Advantage (HMO SNP)
|
$37.40 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
15% | 15% | P | $1,028.07 |
Browse Plan Formulary |
Fidelis Long Term Care Advantage (HMO SNP)
|
$44.50 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | 25% | P | $1,034.68 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
|
$87.00 |
$0 |
Few Generics |
4 |
Specialty Tier |
33% | 33% | None | $1,033.97 |
Browse Plan Formulary |