Voriconazole 200mg/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC (30 TABLET, FILM COATED in ) (NDC: 00378164093)
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 SecureHorizons Plan 1 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete SecureHorizons Plan 1 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Some Generics |
5 |
Specialty Tier |
33% | 33% | None | $1,481.08 |
Browse Plan Formulary |
AARP MedicareComplete SecureHorizons Plan 2 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete SecureHorizons Plan 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Some Generics |
5 |
Specialty Tier |
33% | 33% | None | $1,481.08 |
Browse Plan Formulary |
Aetna Medicare Select Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Select Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Few Generics |
4 |
Specialty Tier |
33% | 33% | P | $2,035.67 |
Browse Plan Formulary |
Blue Cross Senior Secure Plan I (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Senior Secure Plan I (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
6 |
Specialty Tier |
33% | n/a | P | $2,323.19 |
Browse Plan Formulary |
Blue Shield 65 Plus (HMO)
![Email Prescription and/or Health Benefit details for Blue Shield 65 Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Some Generics |
5 |
Specialty Tier |
33% | 33% | P | $1,547.00 |
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 |
Brand New Day Dementia with Enhanced Drug Benefits (HMO SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Dementia with Enhanced Drug Benefits (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Many Generics |
5 |
Specialty Tier |
33% | 33% | None | $1,737.35 |
Browse Plan Formulary |
Brand New Day Diabetes with Enhanced Drug Benefits (HMO SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Diabetes with Enhanced Drug Benefits (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Many Generics |
5 |
Specialty Tier |
33% | 33% | None | $1,737.35 |
Browse Plan Formulary |
Brand New Day Enhanced Drug Savings for So Cal (HMO)
![Email Prescription and/or Health Benefit details for Brand New Day Enhanced Drug Savings for So Cal (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Many Generics |
5 |
Specialty Tier |
33% | 33% | None | $1,756.69 |
Browse Plan Formulary |
Care1st AdvantageOptimum Plan (HMO)
![Email Prescription and/or Health Benefit details for Care1st AdvantageOptimum Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Many Generics |
5 |
Specialty Tier |
30% | 30% | P | $1,977.21 |
Browse Plan Formulary |
Citizens Choice Healthplan (HMO)
![Email Prescription and/or Health Benefit details for Citizens Choice Healthplan (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% | n/a | None | $1,640.01 |
Browse Plan Formulary |
Easy Choice Best Plan (HMO)
![Email Prescription and/or Health Benefit details for Easy Choice Best Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Many Generics |
5 |
Specialty Tier |
33% | n/a | None | $1,763.32 |
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 |
Golden State Medicare Health Plan, Golden (HMO)
![Email Prescription and/or Health Benefit details for Golden State Medicare Health Plan, Golden (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Many Generics, Few Brands |
4 |
Specialty Tier |
33% | 33% | None | $1,532.12 |
Browse Plan Formulary |
Health Net Gold Select (HMO)
![Email Prescription and/or Health Benefit details for Health Net Gold Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Many Generics, Few Brands |
5 |
Specialty Tier |
33% | 33% | None | $1,877.66 |
Browse Plan Formulary |
Health Net Gold Select (HMO)
![Email Prescription and/or Health Benefit details for Health Net Gold Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Many Generics, Few Brands |
5 |
Specialty Tier |
33% | 33% | None | $1,851.93 |
Browse Plan Formulary |
Health Net Healthy Heart (HMO)
![Email Prescription and/or Health Benefit details for Health Net Healthy Heart (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Many Generics, Few Brands |
5 |
Specialty Tier |
33% | 33% | None | $1,877.66 |
Browse Plan Formulary |
Health Net Healthy Heart (HMO)
![Email Prescription and/or Health Benefit details for Health Net Healthy Heart (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Many Generics, Few Brands |
5 |
Specialty Tier |
33% | 33% | None | $1,851.93 |
Browse Plan Formulary |
Health Net Jade (HMO SNP)
![Email Prescription and/or Health Benefit details for Health Net Jade (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Many Generics, Few Brands |
5 |
Specialty Tier |
33% | 33% | None | $1,858.26 |
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 |
Heart First (HMO SNP)
![Email Prescription and/or Health Benefit details for Heart First (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Many Generics, Few Brands |
5 |
Specialty Tier |
33% | n/a | None | $1,633.86 |
Browse Plan Formulary |
Humana Gold Plus H0108-005 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H0108-005 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Some Generics, Few Brands |
5 |
Specialty Tier |
33% | n/a | P Q:120 /30Days | $1,694.99 |
Browse Plan Formulary |
Inter Valley Health Plan Desert Preferred Choice (HMO)
![Email Prescription and/or Health Benefit details for Inter Valley Health Plan Desert Preferred Choice (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
All Generics |
5 |
Specialty Tier |
30% | n/a | P | $1,849.75 |
Browse Plan Formulary |
Inter Valley Health Plan Service To Seniors (HMO)
![Email Prescription and/or Health Benefit details for Inter Valley Health Plan Service To Seniors (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Some Generics |
4 |
Non-Preferred Brand |
$79.00 | $158.00 | P | $1,849.75 |
Browse Plan Formulary |
Kaiser Permanente Senior Advantage Inland Empire (HMO)
![Email Prescription and/or Health Benefit details for Kaiser Permanente Senior Advantage Inland Empire (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
All Generics, Few Brands |
2 |
Non-Preferred Generic |
$12.00 | $24.00 | None | $1,468.58 |
Browse Plan Formulary |
SCAN Balance (HMO SNP)
![Email Prescription and/or Health Benefit details for SCAN Balance (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Many Generics, Few Brands |
5 |
Specialty Tier |
33% | n/a | None | $1,633.86 |
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 |
SCAN Classic (HMO)
![Email Prescription and/or Health Benefit details for SCAN Classic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Many Generics |
5 |
Specialty Tier |
33% | n/a | None | $1,639.26 |
Browse Plan Formulary |
SCAN Healthy at Home (HMO SNP)
![Email Prescription and/or Health Benefit details for SCAN Healthy at Home (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Many Generics |
5 |
Specialty Tier |
33% | n/a | None | $1,659.01 |
Browse Plan Formulary |
Kaiser Permanente Senior Advantage B Only South (HMO)
![Email Prescription and/or Health Benefit details for Kaiser Permanente Senior Advantage B Only South (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
2 |
Non-Preferred Generic |
$12.00 | $24.00 | None | $1,482.50 |
Browse Plan Formulary |
Senior Advantage Medicare Medi-Cal Plan South (HMO SNP)
![Email Prescription and/or Health Benefit details for Senior Advantage Medicare Medi-Cal Plan South (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.40 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Non-Preferred Generic |
$12.00 | $24.00 | None | $1,482.50 |
Browse Plan Formulary |
AARP MedicareComplete SecureHorizons Plan 3 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete SecureHorizons Plan 3 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.20 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | 25% | None | $1,535.25 |
Browse Plan Formulary |
Molina Medicare Options Plus (HMO SNP)
![Email Prescription and/or Health Benefit details for Molina Medicare Options Plus (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.60 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Specialty Tier |
25% | n/a | None | $2,111.82 |
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 |
Coordinated Choice Plan (HMO)
![Email Prescription and/or Health Benefit details for Coordinated Choice Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.30 |
$310 |
Few Generics |
5 |
Specialty Tier |
25% | 25% | P | $1,842.46 |
Browse Plan Formulary |
SCAN Plus (HMO)
![Email Prescription and/or Health Benefit details for SCAN Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | 25% | None | $1,659.18 |
Browse Plan Formulary |
Brand New Day Dementia with Extra Care (HMO SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Dementia with Extra Care (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.10 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | 25% | None | $1,737.35 |
Browse Plan Formulary |
Brand New Day Diabetes with Extra Care (HMO SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Diabetes with Extra Care (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.10 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | 25% | None | $1,737.35 |
Browse Plan Formulary |
Brand New Day Dual Coverage (HMO SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Dual Coverage (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.10 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
15% | 15% | None | $1,737.35 |
Browse Plan Formulary |
Brand New Day Extra Care (HMO)
![Email Prescription and/or Health Benefit details for Brand New Day Extra Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.10 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | 25% | None | $1,741.76 |
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 |
Brand New Day for Mental Illness (HMO SNP)
![Email Prescription and/or Health Benefit details for Brand New Day for Mental Illness (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.10 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | 25% | None | $1,741.76 |
Browse Plan Formulary |
Easy Choice Plus Plan (HMO)
![Email Prescription and/or Health Benefit details for Easy Choice Plus Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.10 |
$310 |
Call plan for details |
5 |
Specialty Tier |
25% | n/a | None | $1,918.84 |
Browse Plan Formulary |
Health Net Seniority Plus Amber I (HMO SNP)
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Amber I (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.10 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
25% | 25% | None | $1,858.26 |
Browse Plan Formulary |
Health Net Seniority Plus Amber II (HMO SNP)
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Amber II (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.10 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
25% | 25% | None | $1,852.24 |
Browse Plan Formulary |
IEHP Medicare DualChoice (HMO SNP)
![Email Prescription and/or Health Benefit details for IEHP Medicare DualChoice (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.10 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
n/a | n/a | Q:62 /31Days | $1,820.08 |
Browse Plan Formulary |
SCAN Connections (HMO SNP)
![Email Prescription and/or Health Benefit details for SCAN Connections (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.10 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
n/a | n/a | None | $1,639.26 |
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 |
SCAN Connections at Home (HMO SNP)
![Email Prescription and/or Health Benefit details for SCAN Connections at Home (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.10 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
n/a | n/a | None | $1,639.26 |
Browse Plan Formulary |
VillageHealth (HMO-POS SNP)
![Email Prescription and/or Health Benefit details for VillageHealth (HMO-POS SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.10 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | 25% | None | $1,633.86 |
Browse Plan Formulary |
Inter Valley Health Plan Total Fit (HMO)
![Email Prescription and/or Health Benefit details for Inter Valley Health Plan Total Fit (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Brand |
$79.00 | $237.00 | P | $1,849.75 |
Browse Plan Formulary |
Humana Gold Plus H0108-006 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H0108-006 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
Some Generics, Few Brands |
5 |
Specialty Tier |
33% | n/a | P Q:120 /30Days | $1,694.99 |
Browse Plan Formulary |
Health Net Seniority Plus Ruby (HMO)
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Ruby (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Many Generics, Few Brands |
5 |
Specialty Tier |
33% | 33% | None | $1,877.66 |
Browse Plan Formulary |
Health Net Seniority Plus Ruby (HMO)
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Ruby (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Many Generics, Few Brands |
5 |
Specialty Tier |
33% | 33% | None | $1,851.93 |
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 |
Anthem Medicare Preferred Standard (PPO)
![Email Prescription and/or Health Benefit details for Anthem Medicare Preferred Standard (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$127.00 |
$179* |
No additional gap coverage, only the Donut Hole Discount |
6* |
Specialty Tier |
33% | n/a | P | $2,327.04 |
Browse Plan Formulary |