ARANESP 100ug/mL 4 VIAL, SINGLE-DOSE in 1 PACKAGE / 1 mL in 1 VIAL, SINGLE-DOSE (4 VIAL, SINGLE-DOSE in 1 ) (NDC: 55513000504)
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 Plan 1 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Plan 1 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | 33% | P | $2,794.48 |
Browse Plan Formulary |
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% | P | $2,823.16 |
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 | P | $2,748.59 |
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 | P | $2,756.98 |
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 | P | $2,748.45 |
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 | P | $2,748.59 |
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 | P | $2,894.40 |
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% | P | $2,755.12 |
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 |
5 |
Specialty Tier |
25% | 25% | P Q:4 /30Days | $2,822.88 |
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% | Q:4 /30Days | $2,787.29 |
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 |
3 |
Preferred Brand |
$45.00 | $135.00 | Q:4 /30Days | $2,787.29 |
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 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 | P | $2,794.57 |
Browse Plan Formulary |
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% | P | $2,790.02 |
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 |
3 |
Tier 3 |
n/a | n/a | Q:4 /30Days | $2,787.29 |
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 |
5 |
Specialty Tier |
25% | 25% | P Q:4 /30Days | $2,822.88 |
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% | P | $2,794.57 |
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% | P | $2,755.06 |
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 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 |
3 |
Tier 3 |
n/a | n/a | P | $2,823.85 |
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 |
3 |
Preferred Brand |
$35.00 | $105.00 | Q:4 /30Days | $2,976.60 |
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 |
3 |
Preferred Brand |
$35.00 | $105.00 | Q:4 /30Days | $2,792.59 |
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 |
3 |
Preferred Brand |
$35.00 | $105.00 | Q:4 /30Days | $2,767.66 |
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 | P | $2,894.40 |
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 | P | $2,748.59 |
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 |
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 | P | $2,756.98 |
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 | P | $2,748.45 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Plan 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$45.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | 33% | P | $2,794.48 |
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 |
5 |
Specialty Tier |
25% | 25% | P Q:4 /30Days | $2,822.88 |
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 |
3 |
Preferred Brand |
$35.00 | $105.00 | Q:4 /30Days | $2,792.59 |
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 |
3 |
Preferred Brand |
$35.00 | $105.00 | Q:4 /30Days | $2,767.66 |
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 |
3 |
Preferred Brand |
$35.00 | $105.00 | Q:4 /30Days | $2,976.60 |
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 |
5 |
Specialty Tier |
30% | 30% | P Q:4 /30Days | $2,822.88 |
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 | P | $2,894.40 |
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 | P | $2,748.59 |
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 | P | $2,756.98 |
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 | P | $2,748.45 |
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 | P | $2,748.59 |
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 |
3 |
Preferred Brand |
$35.00 | $105.00 | Q:4 /30Days | $2,767.66 |
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 |
3 |
Preferred Brand |
$35.00 | $105.00 | Q:4 /30Days | $2,976.60 |
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 |
3 |
Preferred Brand |
$35.00 | $105.00 | Q:4 /30Days | $2,792.59 |
Browse Plan Formulary |
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 |
5 |
Specialty Tier |
30% | 30% | P Q:4 /30Days | $2,822.88 |
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 |
3 |
Preferred Brand |
$30.00 | $90.00 | Q:4 /30Days | $2,976.60 |
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 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 |
3 |
Preferred Brand |
$30.00 | $90.00 | Q:4 /30Days | $2,792.59 |
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 |
3 |
Preferred Brand |
$30.00 | $90.00 | Q:4 /30Days | $2,767.66 |
Browse Plan Formulary |