Eurax Lotion and Cream 100mg/g 454 g in 1 BOTTLE (454 g in 1 BOTTLE ) (NDC: 10631009216)
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 | $605.03 |
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 | $605.53 |
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 | $602.99 |
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 | $600.49 |
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 | $599.67 |
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 | $602.99 |
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 | $605.53 |
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 | $602.45 |
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 | $600.22 |
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 | $599.67 |
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% | None | $579.62 |
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 MyChoice Wellness (HMO)
|
$33.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$45.00 | $112.50 | None | $608.03 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$39.00 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $600.22 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$39.00 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $599.67 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$39.00 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $602.99 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$39.00 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $605.53 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$39.00 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $602.45 |
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 |
PriorityMedicare Value (HMO-POS)
|
$41.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$45.00 | $112.50 | None | $594.28 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$51.50 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$45.00 | $112.50 | None | $597.69 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$51.50 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$45.00 | $112.50 | None | $596.82 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$51.50 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$45.00 | $112.50 | None | $595.96 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$51.50 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$45.00 | $112.50 | None | $595.05 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$51.50 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$45.00 | $112.50 | None | $599.55 |
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 H5216-010 (PPO)
|
$52.00 |
$0 |
Few Generics, Few Brands |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None | $582.03 |
Browse Plan Formulary |
Humana Gold Choice H8145-005 (PFFS)
|
$80.00 |
$0 |
Few Generics, Few Brands |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None | $582.07 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$85.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | None | $602.99 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$85.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | None | $600.49 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$85.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | None | $599.67 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$85.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | None | $605.03 |
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)
|
$85.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | None | $605.53 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$99.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $112.50 | None | $602.45 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$99.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $112.50 | None | $600.22 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$99.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $112.50 | None | $599.67 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$99.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $112.50 | None | $602.99 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$99.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $112.50 | None | $605.53 |
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)
|
$101.50 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$40.00 | $100.00 | None | $594.28 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$118.50 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$40.00 | $100.00 | None | $595.05 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$118.50 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$40.00 | $100.00 | None | $599.55 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$118.50 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$40.00 | $100.00 | None | $597.69 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$118.50 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$40.00 | $100.00 | None | $596.82 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$118.50 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$40.00 | $100.00 | None | $595.96 |
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)
|
$169.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | None | $605.53 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$169.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | None | $602.45 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$169.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | None | $600.22 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$169.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | None | $599.67 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$169.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$40.00 | $100.00 | None | $602.99 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$216.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$35.00 | $87.50 | None | $599.67 |
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)
|
$216.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$35.00 | $87.50 | None | $600.49 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$216.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$35.00 | $87.50 | None | $605.03 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$216.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$35.00 | $87.50 | None | $605.53 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$216.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$35.00 | $87.50 | None | $602.99 |
Browse Plan Formulary |