Anagrelide Hydrochloride 1mg/1 100 CAPSULE BOTTLE (100 CAPSULE in 1 BOTTLE ) (NDC: 00172524060)
2016 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 |
Aetna Better Health Premier Plan (Medicare-Medicaid Plan)
|
$0.00 |
$0 |
to be determined |
1 |
Generic Drugs |
0% | 0% | None | $2,167.18 |
Browse Plan Formulary |
AmeriHealth Caritas VIP Care PLUS (Medicare-Medicaid Plan)
|
$0.00 |
$0 |
to be determined |
1 |
Generic Drugs |
0% | 0% | None | $475.88 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $212.30 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $212.30 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $212.30 |
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 Basic (HMO-POS)
|
$0.00 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $212.30 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $212.30 |
Browse Plan Formulary |
Fidelis SecureLife (Medicare-Medicaid Plan)
|
$0.00 |
$0 |
to be determined |
1 |
Generic Drugs |
0% | 0% | None | $208.56 |
Browse Plan Formulary |
HAP Midwest MI Health Link (Medicare-Medicaid Plan)
|
$0.00 |
$0 |
to be determined |
1 |
Generic Drugs |
0% | n/a | None | $2,264.25 |
Browse Plan Formulary |
Harbor Medicare (HMO)
|
$0.00 |
$240 |
to be determined |
2 |
Generic |
$20.00 | $40.00 | None | $1,956.30 |
Browse Plan Formulary |
HealthPlus MedicarePlus Option 0 (HMO)
|
$0.00 |
$360 |
to be determined |
2 |
Generic |
$11.00 | $27.50 | None | $220.90 |
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 |
Meridian Prime (HMO)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $1,333.69 |
Browse Plan Formulary |
Molina Dual Options (Medicare-Medicaid Plan)
|
$0.00 |
$0 |
to be determined |
1 |
Generic Drugs |
0% | 0% | None | $2,167.18 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $316.39 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $396.76 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $281.54 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $349.06 |
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 |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $390.21 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$15.00 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $390.21 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$15.00 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $316.39 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$15.00 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $396.76 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$15.00 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $281.54 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$15.00 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $349.06 |
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 |
Medicare Plus Blue PPO Essential (PPO)
|
$20.50 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $212.30 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$20.50 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $212.30 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$20.50 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $212.30 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$20.50 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $212.30 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$20.50 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $212.30 |
Browse Plan Formulary |
Molina Medicare Options Plus (HMO SNP)
|
$33.00 |
$360 |
to be determined |
2 |
Generic |
$15.00 | $45.00 | None | $2,167.18 |
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 |
HAP Midwest Health Plan (HMO SNP)
|
$33.50 |
$360 |
to be determined |
1 |
Generic |
$7.00 | n/a | None | $2,250.74 |
Browse Plan Formulary |
Meridian Advantage Plan of Michigan (HMO SNP)
|
$33.50 |
$360 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $1,333.69 |
Browse Plan Formulary |
BCN Advantage HMO ConnectedCare (HMO)
|
$47.00 |
$0 |
to be determined |
2 |
Generic |
$15.00 | $37.50 | None | $212.30 |
Browse Plan Formulary |
Harbor Medicare Select (HMO)
|
$47.00 |
$0 |
to be determined |
2 |
Generic |
$10.00 | $20.00 | None | $1,956.30 |
Browse Plan Formulary |
HAP Senior Plus - Expanded Network (HMO-POS)
|
$59.00 |
$0 |
to be determined |
2 |
Generic |
$11.00 | $27.50 | None | $214.61 |
Browse Plan Formulary |
PriorityMedicare Value (HMO-POS)
|
$66.00 |
$75 |
to be determined |
2 |
Tier 2 |
$12.00 | $0.00 | None | $349.06 |
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 |
HAP Senior Plus - Henry Ford (HMO)
|
$79.00 |
$200* |
to be determined |
2* |
Generic |
$15.00 | $37.50 | None | $214.61 |
Browse Plan Formulary |
McLaren Advantage Sapphire (HMO)
|
$81.00 |
$150 |
to be determined |
1 |
Generic |
$5.00 | n/a | None | $2,245.01 |
Browse Plan Formulary |
McLaren Advantage Sapphire (HMO)
|
$81.00 |
$150 |
to be determined |
1 |
Generic |
$5.00 | n/a | None | $2,200.89 |
Browse Plan Formulary |
Humana Gold Plus H8908-001 (HMO)
|
$89.00 |
$0 |
to be determined |
3 |
Preferred Brand |
$47.00 | $131.00 | None | $235.48 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$95.00 |
$75* |
to be determined |
2* |
Tier 2 |
$12.00 | $0.00 | None | $390.21 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$95.00 |
$75* |
to be determined |
2* |
Tier 2 |
$12.00 | $0.00 | None | $316.39 |
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 Merit (PPO)
|
$95.00 |
$75* |
to be determined |
2* |
Tier 2 |
$12.00 | $0.00 | None | $396.76 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$95.00 |
$75* |
to be determined |
2* |
Tier 2 |
$12.00 | $0.00 | None | $281.54 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$95.00 |
$75* |
to be determined |
2* |
Tier 2 |
$12.00 | $0.00 | None | $349.06 |
Browse Plan Formulary |
HealthPlus MedicarePlus Option 1 (HMO)
|
$98.00 |
$100* |
to be determined |
2* |
Generic |
$15.00 | $37.50 | None | $220.90 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$106.00 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $212.30 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$106.00 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $212.30 |
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 Vitality (PPO)
|
$106.00 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $212.30 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$106.00 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $212.30 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$106.00 |
$360 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $212.30 |
Browse Plan Formulary |
HAP Senior Plus - Expanded Network (HMO-POS)
|
$109.00 |
$100* |
to be determined |
2* |
Generic |
$15.00 | $37.50 | None | $214.61 |
Browse Plan Formulary |
McLaren Advantage Diamond (HMO)
|
$117.00 |
$150 |
to be determined |
1 |
Generic |
$5.00 | n/a | None | $2,200.89 |
Browse Plan Formulary |
McLaren Advantage Diamond (HMO)
|
$117.00 |
$150 |
to be determined |
1 |
Generic |
$5.00 | n/a | None | $2,245.01 |
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 R5826-006 (Regional PPO)
|
$121.00 |
$360 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $242.00 |
Browse Plan Formulary |
Alliance Medicare PPO (PPO)
|
$126.00 |
$0 |
to be determined |
2 |
Generic |
$15.00 | $37.50 | None | $214.61 |
Browse Plan Formulary |
PriorityMedicare (HMO-POS)
|
$146.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $0.00 | None | $349.06 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$154.00 |
$0 |
to be determined |
2 |
Generic |
$10.00 | $25.00 | None | $212.30 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$154.00 |
$0 |
to be determined |
2 |
Generic |
$10.00 | $25.00 | None | $212.30 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$154.00 |
$0 |
to be determined |
2 |
Generic |
$10.00 | $25.00 | None | $212.30 |
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)
|
$154.00 |
$0 |
to be determined |
2 |
Generic |
$10.00 | $25.00 | None | $212.30 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$154.00 |
$0 |
to be determined |
2 |
Generic |
$10.00 | $25.00 | None | $212.30 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$169.00 |
$100* |
to be determined |
2* |
Generic |
$15.00 | $37.50 | None | $212.30 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$169.00 |
$100* |
to be determined |
2* |
Generic |
$15.00 | $37.50 | None | $212.30 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$169.00 |
$100* |
to be determined |
2* |
Generic |
$15.00 | $37.50 | None | $212.30 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$169.00 |
$100* |
to be determined |
2* |
Generic |
$15.00 | $37.50 | None | $212.30 |
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 Signature (PPO)
|
$169.00 |
$100* |
to be determined |
2* |
Generic |
$15.00 | $37.50 | None | $212.30 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$193.00 |
$0 |
to be determined |
2 |
Tier 2 |
$9.00 | $0.00 | None | $281.54 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$193.00 |
$0 |
to be determined |
2 |
Tier 2 |
$9.00 | $0.00 | None | $349.06 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$193.00 |
$0 |
to be determined |
2 |
Tier 2 |
$9.00 | $0.00 | None | $390.21 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$193.00 |
$0 |
to be determined |
2 |
Tier 2 |
$9.00 | $0.00 | None | $316.39 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$193.00 |
$0 |
to be determined |
2 |
Tier 2 |
$9.00 | $0.00 | None | $396.76 |
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 |
Alliance Medicare PPO (PPO)
|
$210.00 |
$150* |
to be determined |
2* |
Generic |
$10.00 | $25.00 | None | $214.61 |
Browse Plan Formulary |
HAP Senior Plus - Expanded Network (HMO-POS)
|
$220.00 |
$50* |
to be determined |
2* |
Generic |
$10.00 | $25.00 | None | $214.61 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$283.00 |
$0 |
to be determined |
2 |
Generic |
$10.00 | $25.00 | None | $212.30 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$283.00 |
$0 |
to be determined |
2 |
Generic |
$10.00 | $25.00 | None | $212.30 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$283.00 |
$0 |
to be determined |
2 |
Generic |
$10.00 | $25.00 | None | $212.30 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$283.00 |
$0 |
to be determined |
2 |
Generic |
$10.00 | $25.00 | None | $212.30 |
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)
|
$283.00 |
$0 |
to be determined |
2 |
Generic |
$10.00 | $25.00 | None | $212.30 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$294.00 |
$0 |
to be determined |
2 |
Generic |
$14.00 | $35.00 | None | $212.30 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$294.00 |
$0 |
to be determined |
2 |
Generic |
$14.00 | $35.00 | None | $212.30 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$294.00 |
$0 |
to be determined |
2 |
Generic |
$14.00 | $35.00 | None | $212.30 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$294.00 |
$0 |
to be determined |
2 |
Generic |
$14.00 | $35.00 | None | $212.30 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$294.00 |
$0 |
to be determined |
2 |
Generic |
$14.00 | $35.00 | None | $212.30 |
Browse Plan Formulary |