ALINIA 500 MG TABLET (30 EA ) (NDC: 67546011112)
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 |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$310 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | None | $1,757.28 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$310 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | None | $1,752.93 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$310 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | None | $1,761.45 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$310 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | None | $1,768.69 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$310 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | None | $1,784.85 |
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 Essential (PPO)
|
$17.50 |
$310 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | None | $1,757.28 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$17.50 |
$310 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | None | $1,768.00 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$17.50 |
$310 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | None | $1,750.64 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$17.50 |
$310 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | None | $1,766.84 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$17.50 |
$310 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | None | $1,770.92 |
Browse Plan Formulary |
HumanaChoice R5826-006 P (Regional PPO)
|
$30.60 |
$310 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
25% | 25% | Q:40 /30Days | $1,564.15 |
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 |
McLarenAdvantage (HMO SNP)
|
$32.50 |
$310 | No additional gap coverage, only the Donut Hole Discount | 3 |
Non-Preferred Brand |
$95.00 | $285.00 | Q:20 /30Days | $1,603.74 |
Browse Plan Formulary |
PriorityMedicare Value (HMO-POS)
|
$60.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
$45.00 | $112.50 | None | $1,608.23 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$94.00 |
$310 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | None | $1,770.92 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$94.00 |
$310 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | None | $1,757.28 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$94.00 |
$310 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | None | $1,768.00 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$94.00 |
$310 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | None | $1,750.64 |
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)
|
$94.00 |
$310 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | None | $1,766.84 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$99.50 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
$45.00 | $112.50 | None | $1,612.34 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$99.50 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
$45.00 | $112.50 | None | $1,605.59 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$99.50 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
$45.00 | $112.50 | None | $1,603.56 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$99.50 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
$45.00 | $112.50 | None | $1,608.23 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$99.50 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
$45.00 | $112.50 | None | $1,599.63 |
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 |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$113.00 |
$0 | Some Generics | 3 |
Preferred Brand |
$40.00 | $100.00 | None | $1,784.85 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$113.00 |
$0 | Some Generics | 3 |
Preferred Brand |
$40.00 | $100.00 | None | $1,768.69 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$113.00 |
$0 | Some Generics | 3 |
Preferred Brand |
$40.00 | $100.00 | None | $1,761.45 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$113.00 |
$0 | Some Generics | 3 |
Preferred Brand |
$40.00 | $100.00 | None | $1,752.93 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$113.00 |
$0 | Some Generics | 3 |
Preferred Brand |
$40.00 | $100.00 | None | $1,757.28 |
Browse Plan Formulary |
McLarenAdvantage (HMO)
|
$128.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Non-Preferred Brand |
$70.00 | $140.00 | Q:20 /30Days | $1,603.74 |
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 |
PriorityMedicare (HMO-POS)
|
$138.50 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
$40.00 | $100.00 | None | $1,608.23 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$155.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $112.50 | None | $1,766.84 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$155.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $112.50 | None | $1,757.28 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$155.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $112.50 | None | $1,768.00 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$155.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $112.50 | None | $1,770.92 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$155.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $112.50 | None | $1,750.64 |
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 Select (PPO)
|
$165.50 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
$40.00 | $100.00 | None | $1,608.23 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$165.50 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
$40.00 | $100.00 | None | $1,599.63 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$165.50 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
$40.00 | $100.00 | None | $1,612.34 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$165.50 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
$40.00 | $100.00 | None | $1,605.59 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$165.50 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
$40.00 | $100.00 | None | $1,603.56 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$241.00 |
$0 | Some Generics | 3 |
Preferred Brand |
$35.00 | $87.50 | None | $1,752.93 |
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)
|
$241.00 |
$0 | Some Generics | 3 |
Preferred Brand |
$35.00 | $87.50 | None | $1,784.85 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$241.00 |
$0 | Some Generics | 3 |
Preferred Brand |
$35.00 | $87.50 | None | $1,768.69 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$241.00 |
$0 | Some Generics | 3 |
Preferred Brand |
$35.00 | $87.50 | None | $1,761.45 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$241.00 |
$0 | Some Generics | 3 |
Preferred Brand |
$35.00 | $87.50 | None | $1,757.28 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$268.00 |
$0 | Some Generics | 3 |
Preferred Brand |
$40.00 | $100.00 | None | $1,770.92 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$268.00 |
$0 | Some Generics | 3 |
Preferred Brand |
$40.00 | $100.00 | None | $1,766.84 |
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)
|
$268.00 |
$0 | Some Generics | 3 |
Preferred Brand |
$40.00 | $100.00 | None | $1,750.64 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$268.00 |
$0 | Some Generics | 3 |
Preferred Brand |
$40.00 | $100.00 | None | $1,768.00 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$268.00 |
$0 | Some Generics | 3 |
Preferred Brand |
$40.00 | $100.00 | None | $1,757.28 |
Browse Plan Formulary |