ADVAIR DISKUS MIS 500/50 (60 BLPK) (NDC: 00173069700)
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 2 (HMO)
|
$0.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days | $383.77 |
Browse Plan Formulary |
AARP MedicareComplete SecureHorizons Premier (HMO)
|
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days | $383.77 |
Browse Plan Formulary |
Aetna Medicare Select Plan (HMO)
|
$0.00 |
$0 |
Few Generics |
2 |
Preferred Brand |
25% | 25% | Q:2 /1Days | $383.57 |
Browse Plan Formulary |
Blue Cross Senior Secure Plan I (HMO)
|
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$40.00 | $120.00 | Q:60 /30Days | $383.95 |
Browse Plan Formulary |
Blue Shield 65 Plus (HMO)
|
$0.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$45.00 | $90.00 | Q:60 /30Days | $382.28 |
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 |
Blue Shield 65 Plus Choice Plan (HMO)
|
$0.00 |
$0 |
Many Generics |
2 |
Preferred Brand |
$35.00 | $70.00 | Q:60 /30Days | $382.28 |
Browse Plan Formulary |
Brand New Day Dementia with Enhanced Drug Benefits (HMO SNP)
|
$0.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$45.00 | $135.00 | Q:60 /30Days | $391.06 |
Browse Plan Formulary |
Brand New Day Diabetes with Enhanced Drug Benefits (HMO SNP)
|
$0.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$45.00 | $135.00 | Q:60 /30Days | $391.06 |
Browse Plan Formulary |
Brand New Day Enhanced Drug Savings for So Cal (HMO)
|
$0.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$45.00 | $135.00 | Q:60 /30Days | $391.04 |
Browse Plan Formulary |
Care1st AdvantageOptimum Plan (HMO)
|
$0.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$30.00 | $60.00 | S Q:60 /30Days | $383.79 |
Browse Plan Formulary |
CareMore Breathe (HMO SNP)
|
$0.00 |
$0 |
Many Generics, Few Brands |
3 |
Preferred Brand |
$30.00 | $75.00 | Q:60 /30Days | $395.79 |
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 |
CareMore ESRD (HMO SNP)
|
$0.00 |
$0 |
Many Generics, Few Brands |
3 |
Preferred Brand |
$30.00 | $75.00 | Q:60 /30Days | $395.79 |
Browse Plan Formulary |
CareMore Heart (HMO SNP)
|
$0.00 |
$0 |
Many Generics, Few Brands |
3 |
Preferred Brand |
$30.00 | $75.00 | Q:60 /30Days | $395.79 |
Browse Plan Formulary |
CareMore Reliance (HMO SNP)
|
$0.00 |
$0 |
Many Generics, Few Brands |
3 |
Preferred Brand |
$30.00 | $75.00 | Q:60 /30Days | $395.79 |
Browse Plan Formulary |
CareMore StartSmart Plus (HMO)
|
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $112.50 | Q:60 /30Days | $395.75 |
Browse Plan Formulary |
CareMore Touch (HMO SNP)
|
$0.00 |
$0 |
Many Generics, Few Brands |
3 |
Preferred Brand |
$30.00 | $75.00 | Q:60 /30Days | $395.79 |
Browse Plan Formulary |
CareMore Value Plus (HMO)
|
$0.00 |
$0 |
Many Generics, Few Brands |
3 |
Preferred Brand |
$30.00 | $75.00 | Q:60 /30Days | $393.85 |
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 |
Central Health Medicare Plan (HMO)
|
$0.00 |
$0 |
All Generics |
4 |
Non-Preferred Brand |
$50.00 | $100.00 | Q:60 /30Days | $393.85 |
Browse Plan Formulary |
Citizens Choice Healthplan (HMO)
|
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Preferred Brand |
$30.00 | $60.00 | Q:60 /30Days | $384.66 |
Browse Plan Formulary |
Easy Choice Best Plan (HMO)
|
$0.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$45.00 | $90.00 | Q:60 /30Days | $384.42 |
Browse Plan Formulary |
Golden State Medicare Health Plan, Golden (HMO)
|
$0.00 |
$0 |
Many Generics, Few Brands |
2 |
Preferred Brand |
$40.00 | $80.00 | Q:60 /30Days | $383.77 |
Browse Plan Formulary |
Health Net Gold Select (HMO)
|
$0.00 |
$0 |
Many Generics, Few Brands |
3 |
Preferred Brand |
$45.00 | $90.00 | Q:2 /1Days | $381.13 |
Browse Plan Formulary |
Health Net Gold Select (HMO)
|
$0.00 |
$0 |
Many Generics, Few Brands |
3 |
Preferred Brand |
$45.00 | $90.00 | Q:2 /1Days | $381.11 |
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 Healthy Heart (HMO)
|
$0.00 |
$0 |
Many Generics, Few Brands |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:2 /1Days | $381.13 |
Browse Plan Formulary |
Health Net Healthy Heart (HMO)
|
$0.00 |
$0 |
Many Generics, Few Brands |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:2 /1Days | $381.11 |
Browse Plan Formulary |
Health Net Jade (HMO SNP)
|
$0.00 |
$0 |
Many Generics, Few Brands |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:2 /1Days | $381.13 |
Browse Plan Formulary |
Health Net Seniority Plus Ruby (HMO)
|
$0.00 |
$0 |
Many Generics, Few Brands |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:2 /1Days | $381.13 |
Browse Plan Formulary |
Health Net Seniority Plus Ruby (HMO)
|
$0.00 |
$0 |
Many Generics, Few Brands |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:2 /1Days | $381.11 |
Browse Plan Formulary |
Heart First (HMO SNP)
|
$0.00 |
$0 |
Many Generics, Few Brands |
3 |
Preferred Brand |
$40.00 | $80.00 | None | $383.95 |
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 |
Humana Gold Plus H0108-013 (HMO)
|
$0.00 |
$0 |
Some Generics, Few Brands |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days | $377.19 |
Browse Plan Formulary |
Inter Valley Health Plan OC Preferred (HMO)
|
$0.00 |
$0 |
Some Generics |
3 |
Preferred Brand |
$39.00 | $78.00 | Q:60 /30Days | $393.85 |
Browse Plan Formulary |
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)
|
$0.00 |
$0 |
All Generics, Few Brands |
3 |
Preferred Brand |
$45.00 | $90.00 | None | $419.91 |
Browse Plan Formulary |
SCAN Balance (HMO SNP)
|
$0.00 |
$0 |
Many Generics, Few Brands |
3 |
Preferred Brand |
$40.00 | $80.00 | None | $383.95 |
Browse Plan Formulary |
SCAN Classic (HMO)
|
$0.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$40.00 | $80.00 | None | $383.30 |
Browse Plan Formulary |
SCAN Healthy at Home (HMO SNP)
|
$0.00 |
$0 |
Many Generics |
3 |
Preferred Brand |
$39.00 | $78.00 | None | $383.68 |
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 |
Kaiser Permanente Senior Advantage B Only South (HMO)
|
$4.00 |
$0 |
to be determined |
3 |
Preferred Brand |
$45.00 | $90.00 | None | $419.56 |
Browse Plan Formulary |
Senior Advantage Medicare Medi-Cal Plan South (HMO SNP)
|
$14.40 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $90.00 | None | $419.56 |
Browse Plan Formulary |
AARP MedicareComplete SecureHorizons Plan 3 (HMO)
|
$16.20 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | Q:60 /30Days | $383.75 |
Browse Plan Formulary |
Care1st TotalDual Plan (HMO SNP)
|
$21.90 |
$310 |
Few Generics |
3 |
Preferred Brand |
25% | 25% | S Q:60 /30Days | $386.22 |
Browse Plan Formulary |
SCAN Plus (HMO)
|
$24.90 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $383.30 |
Browse Plan Formulary |
Coordinated Choice Plan (HMO)
|
$26.30 |
$310 |
Few Generics |
3 |
Preferred Brand |
25% | 25% | S Q:60 /30Days | $385.16 |
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 Extra Care (HMO SNP)
|
$28.10 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | Q:60 /30Days | $391.06 |
Browse Plan Formulary |
Brand New Day Diabetes with Extra Care (HMO SNP)
|
$28.10 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | Q:60 /30Days | $391.06 |
Browse Plan Formulary |
Brand New Day Dual Coverage (HMO SNP)
|
$28.10 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
15% | 15% | Q:60 /30Days | $391.06 |
Browse Plan Formulary |
Brand New Day Extra Care (HMO)
|
$28.10 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | Q:60 /30Days | $391.07 |
Browse Plan Formulary |
Brand New Day for Mental Illness (HMO SNP)
|
$28.10 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | Q:60 /30Days | $391.07 |
Browse Plan Formulary |
Central Health Premier Plan (HMO)
|
$28.10 |
$310 |
Many Generics |
4 |
Non-Preferred Brand |
25% | 25% | Q:60 /30Days | $393.85 |
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 |
Easy Choice Plus Plan (HMO)
|
$28.10 |
$310 |
Call plan for details |
3 |
Preferred Brand |
25% | 17% | Q:60 /30Days | $386.90 |
Browse Plan Formulary |
Health Net Seniority Plus Amber I (HMO SNP)
|
$28.10 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$41.00 | $113.00 | Q:2 /1Days | $381.13 |
Browse Plan Formulary |
Health Net Seniority Plus Amber II (HMO SNP)
|
$28.10 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:2 /1Days | $381.14 |
Browse Plan Formulary |
VillageHealth (HMO SNP)
|
$28.10 |
$310 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | None | $383.95 |
Browse Plan Formulary |
Anthem Medicare Preferred Standard (PPO)
|
$100.00 |
$135 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$40.00 | $120.00 | Q:60 /30Days | $383.30 |
Browse Plan Formulary |