ELIGARD 1 KIT per CARTON (1 KIT in 1 CARTON ) (NDC: 00024079375)
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 |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P | $423.54 |
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 |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P | $423.54 |
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 |
3 |
Non-Preferred Brand |
50% | 50% | P | $422.23 |
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 |
Many Generics |
5 |
Injectable Drugs |
25% | 25% | None | $418.62 |
Browse Plan Formulary |
Blue Shield 65 Plus Choice Plan (HMO)
![Email Prescription and/or Health Benefit details for Blue Shield 65 Plus Choice Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Many Generics |
4 |
Injectable Drugs |
25% | 25% | None | $418.62 |
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 |
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 |
4 |
Non-Preferred Brand |
$90.00 | $270.00 | Q:1 /28Days | $427.45 |
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 |
4 |
Non-Preferred Brand |
$90.00 | $270.00 | Q:1 /28Days | $427.45 |
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 |
4 |
Non-Preferred Brand |
$90.00 | $270.00 | Q:1 /28Days | $426.05 |
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 |
3 |
Preferred Brand |
$35.00 | $70.00 | P | $415.63 |
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 |
3 |
Preferred Brand |
$30.00 | $60.00 | P | $415.63 |
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 |
4 |
Injectable Drugs |
33% | 33% | None | $430.17 |
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 |
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 |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | Q:1 /28Days | $415.63 |
Browse Plan Formulary |
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 |
3 |
Non-Preferred Brand |
$80.00 | $160.00 | Q:1 /28Days | $423.54 |
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 |
4 |
Non-Preferred Brand |
$95.00 | $238.00 | None | $442.92 |
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 |
4 |
Non-Preferred Brand |
$95.00 | $238.00 | None | $419.57 |
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 |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None | $442.92 |
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 |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None | $419.57 |
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 |
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 |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None | $419.49 |
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) |
$0.00 |
$0 |
Many Generics, Few Brands |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None | $442.92 |
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) |
$0.00 |
$0 |
Many Generics, Few Brands |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None | $419.57 |
Browse Plan Formulary |
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 |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | None | $427.85 |
Browse Plan Formulary |
Humana Gold Plus H0108-011 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H0108-011 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Some Generics, Few Brands |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P | $415.42 |
Browse Plan Formulary |
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)
![Email Prescription and/or Health Benefit details for Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
All Generics, Few Brands |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | None | $449.08 |
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 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 |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | None | $427.85 |
Browse Plan Formulary |
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 |
4 |
Non-Preferred Brand |
$85.00 | $170.00 | None | $427.85 |
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 |
4 |
Non-Preferred Brand |
$85.00 | $170.00 | None | $427.85 |
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 |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | None | $449.08 |
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 |
4 |
Non-Preferred Brand |
$95.00 | $190.00 | None | $449.08 |
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 |
4 |
Tier 4 |
25% | 25% | P | $423.54 |
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 |
Care1st TotalDual Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for Care1st TotalDual Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.70 |
$310 |
Few Generics |
3 |
Preferred Brand |
25% | 25% | P | $415.63 |
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) |
$24.10 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
n/a | n/a | None | $427.85 |
Browse Plan Formulary |
Easy Choice Freedom Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for Easy Choice Freedom Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.40 |
$310 |
Call plan for details |
4 |
Non-Preferred Brand |
25% | 17% | Q:1 /28Days | $415.63 |
Browse Plan Formulary |
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 |
3 |
Preferred Brand |
25% | 25% | P | $415.63 |
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 |
4 |
Tier 4 |
25% | 25% | None | $427.85 |
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 |
4 |
Tier 4 |
25% | 25% | Q:1 /28Days | $427.45 |
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 |
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 |
4 |
Tier 4 |
25% | 25% | Q:1 /28Days | $427.45 |
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 |
4 |
Tier 4 |
15% | 15% | Q:1 /28Days | $427.45 |
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 |
4 |
Tier 4 |
25% | 25% | Q:1 /28Days | $427.45 |
Browse Plan Formulary |
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 |
4 |
Tier 4 |
25% | 25% | Q:1 /28Days | $427.45 |
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 |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None | $419.49 |
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 |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None | $419.49 |
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 |
L.A. Care Health Plan Medicare Advantage (HMO SNP)
![Email Prescription and/or Health Benefit details for L.A. Care Health Plan Medicare Advantage (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:1 /28Days | $426.05 |
Browse Plan Formulary |
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 |
4 |
Tier 4 |
n/a | n/a | None | $427.85 |
Browse Plan Formulary |
VillageHealth (HMO SNP)
![Email Prescription and/or Health Benefit details for VillageHealth (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.10 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $427.85 |
Browse Plan Formulary |