Ethambutol Hydrochloride 100mg/1 (NDC: 68180028001)
2018 Medicare Prescription Drug Plan (MAPD) Information
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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 Plan 1 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Plan 1 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$280 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $125.00 | None | $62.82 |
Browse Plan Formulary |
Aetna Medicare Value Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Value Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None | $71.89 |
Browse Plan Formulary |
Commonwealth Care Alliance (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Commonwealth Care Alliance (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Generic Drugs |
0% | n/a | None | $151.96 |
Browse Plan Formulary |
Fallon Senior Plan Flex Enhanced Rx (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Flex Enhanced Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$300* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$7.00 | $21.00 | None | $67.80 |
Browse Plan Formulary |
Fallon Senior Plan Flex Enhanced Rx (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Flex Enhanced Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$300* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$7.00 | $21.00 | None | $67.80 |
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 |
Fallon Senior Plan Flex Enhanced Rx (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Flex Enhanced Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$300* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$7.00 | $21.00 | None | $67.80 |
Browse Plan Formulary |
Fallon Senior Plan Flex Enhanced Rx (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Flex Enhanced Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$300* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$7.00 | $21.00 | None | $67.80 |
Browse Plan Formulary |
Medicare PPO Blue SaverRx (PPO)
![Email Prescription and/or Health Benefit details for Medicare PPO Blue SaverRx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$405* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$11.00 | n/a | None | $51.32 |
Browse Plan Formulary |
Tufts Health Unify (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Tufts Health Unify (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
1 |
Generic Drugs |
0% | n/a | None | $61.79 |
Browse Plan Formulary |
Tufts Medicare Preferred HMO Saver Rx (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Saver Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$400* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$12.00 | n/a | None | $61.80 |
Browse Plan Formulary |
Fallon Senior Plan Super Saver Rx (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Super Saver Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.00 |
$405 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$9.00 | $27.00 | None | $67.80 |
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 |
Fallon Senior Plan Super Saver Rx (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Super Saver Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.00 |
$405 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$9.00 | $27.00 | None | $67.80 |
Browse Plan Formulary |
Fallon Senior Plan Super Saver Rx (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Super Saver Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.00 |
$405 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$9.00 | $27.00 | None | $67.80 |
Browse Plan Formulary |
Fallon Senior Plan Super Saver Rx (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Super Saver Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.00 |
$405 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$9.00 | $27.00 | None | $69.42 |
Browse Plan Formulary |
Fallon Senior Plan Super Saver Rx (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Super Saver Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.00 |
$405 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$9.00 | $27.00 | None | $67.80 |
Browse Plan Formulary |
Fallon Senior Plan Super Saver Rx (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Super Saver Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.00 |
$405 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$9.00 | $27.00 | None | $69.42 |
Browse Plan Formulary |
AARP MedicareComplete Choice (Regional PPO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Choice (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$295 |
to be determined |
3 |
Preferred Brand |
$47.00 | $131.00 | None | $61.86 |
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 |
UnitedHealthcare Senior Care Options (HMO SNP)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Senior Care Options (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.30 |
$405 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
$0.00 | n/a | None | $62.83 |
Browse Plan Formulary |
Harvard Pilgrim Stride Basic Rx (HMO)
![Email Prescription and/or Health Benefit details for Harvard Pilgrim Stride Basic Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$405* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$15.00 | n/a | None | $63.67 |
Browse Plan Formulary |
UnitedHealthcare Nursing Home Plan (PPO SNP)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Nursing Home Plan (PPO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.00 |
$405 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | n/a | None | $62.83 |
Browse Plan Formulary |
Erickson Advantage Guardian (HMO-POS SNP)
![Email Prescription and/or Health Benefit details for Erickson Advantage Guardian (HMO-POS SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$28.00 | $74.00 | None | $61.79 |
Browse Plan Formulary |
Aetna Medicare Freedom Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Freedom Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None | $71.89 |
Browse Plan Formulary |
BMC HealthNet Plan Senior Care Options (HMO SNP)
![Email Prescription and/or Health Benefit details for BMC HealthNet Plan Senior Care Options (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.60 |
$405 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
$0.00 | n/a | None | $67.53 |
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 |
NaviCare (HMO SNP)
![Email Prescription and/or Health Benefit details for NaviCare (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.60 |
$405 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
$0.00 | n/a | None | $67.41 |
Browse Plan Formulary |
Senior Care Options Program (HMO SNP)
![Email Prescription and/or Health Benefit details for Senior Care Options Program (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.60 |
$405 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
$0.00 | n/a | None | $151.96 |
Browse Plan Formulary |
Senior Whole Health (HMO SNP)
![Email Prescription and/or Health Benefit details for Senior Whole Health (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.60 |
$405 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
15% | n/a | None | $65.61 |
Browse Plan Formulary |
Senior Whole Health NHC (HMO SNP)
![Email Prescription and/or Health Benefit details for Senior Whole Health NHC (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.60 |
$405 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
15% | n/a | None | $65.61 |
Browse Plan Formulary |
Tufts Health Plan Senior Care Options (HMO SNP)
![Email Prescription and/or Health Benefit details for Tufts Health Plan Senior Care Options (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.60 |
$405 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
$0.00 | n/a | None | $61.80 |
Browse Plan Formulary |
Medicare HMO Blue ValueRx (HMO)
![Email Prescription and/or Health Benefit details for Medicare HMO Blue ValueRx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.00 |
$320* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$7.00 | n/a | None | $69.52 |
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 HMO Blue ValueRx (HMO)
![Email Prescription and/or Health Benefit details for Medicare HMO Blue ValueRx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.00 |
$320* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$7.00 | n/a | None | $45.29 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Plan 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.00 |
$205 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $125.00 | None | $62.82 |
Browse Plan Formulary |
Tufts Medicare Preferred HMO Basic Rx (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Basic Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$46.00 |
$350* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$8.00 | n/a | None | $61.80 |
Browse Plan Formulary |
Tufts Medicare Preferred HMO Basic Rx (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Basic Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$46.00 |
$350* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$8.00 | n/a | None | $61.80 |
Browse Plan Formulary |
Tufts Medicare Preferred HMO Basic Rx (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Basic Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$46.00 |
$350* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$8.00 | n/a | None | $61.80 |
Browse Plan Formulary |
Erickson Advantage Freedom (HMO-POS)
![Email Prescription and/or Health Benefit details for Erickson Advantage Freedom (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $125.00 | None | $61.79 |
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 |
Harvard Pilgrim Stride Value Rx (HMO)
![Email Prescription and/or Health Benefit details for Harvard Pilgrim Stride Value Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$61.00 |
$320* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$10.00 | n/a | None | $63.37 |
Browse Plan Formulary |
Fallon Senior Plan Saver Enhanced RX (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Saver Enhanced RX (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$67.00 |
$300* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$7.00 | $21.00 | None | $69.42 |
Browse Plan Formulary |
Fallon Senior Plan Saver Enhanced RX (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Saver Enhanced RX (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$67.00 |
$300* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$7.00 | $21.00 | None | $67.80 |
Browse Plan Formulary |
Fallon Senior Plan Saver Enhanced RX (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Saver Enhanced RX (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$67.00 |
$300* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$7.00 | $21.00 | None | $67.80 |
Browse Plan Formulary |
Fallon Senior Plan Saver Enhanced RX (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Saver Enhanced RX (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$67.00 |
$300* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$7.00 | $21.00 | None | $69.42 |
Browse Plan Formulary |
Fallon Senior Plan Saver Enhanced RX (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Saver Enhanced RX (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$67.00 |
$300* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$7.00 | $21.00 | None | $67.80 |
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 PPO Blue ValueRx (PPO)
![Email Prescription and/or Health Benefit details for Medicare PPO Blue ValueRx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$76.00 |
$320* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$7.00 | n/a | None | $69.52 |
Browse Plan Formulary |
Medicare PPO Blue ValueRx (PPO)
![Email Prescription and/or Health Benefit details for Medicare PPO Blue ValueRx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$76.00 |
$320* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$7.00 | n/a | None | $45.29 |
Browse Plan Formulary |
AARP MedicareComplete Plan 3 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Plan 3 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$77.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $125.00 | None | $62.82 |
Browse Plan Formulary |
Medicare HMO Blue FlexRx (HMO-POS)
![Email Prescription and/or Health Benefit details for Medicare HMO Blue FlexRx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$96.00 |
$260* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$5.00 | n/a | None | $69.52 |
Browse Plan Formulary |
Medicare HMO Blue FlexRx (HMO-POS)
![Email Prescription and/or Health Benefit details for Medicare HMO Blue FlexRx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$96.00 |
$260* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$5.00 | n/a | None | $45.29 |
Browse Plan Formulary |
Tufts Medicare Preferred HMO Value Rx (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Value Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$132.00 |
$300* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$8.00 | n/a | None | $61.80 |
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 |
Tufts Medicare Preferred HMO Value Rx (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Value Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$132.00 |
$300* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$8.00 | n/a | None | $61.80 |
Browse Plan Formulary |
Tufts Medicare Preferred HMO Value Rx (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Value Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$132.00 |
$300* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$8.00 | n/a | None | $61.80 |
Browse Plan Formulary |
Harvard Pilgrim Stride Value Rx Plus (HMO)
![Email Prescription and/or Health Benefit details for Harvard Pilgrim Stride Value Rx Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$157.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$10.00 | n/a | None | $63.22 |
Browse Plan Formulary |
Fallon Senior Plan Plus Enhanced RX (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Plus Enhanced RX (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$164.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$7.00 | $21.00 | None | $67.80 |
Browse Plan Formulary |
Fallon Senior Plan Plus Enhanced RX (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Plus Enhanced RX (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$164.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$7.00 | $21.00 | None | $69.42 |
Browse Plan Formulary |
Fallon Senior Plan Plus Enhanced RX (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Plus Enhanced RX (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$164.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$7.00 | $21.00 | None | $67.80 |
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 |
Fallon Senior Plan Plus Enhanced RX (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Plus Enhanced RX (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$164.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$7.00 | $21.00 | None | $67.80 |
Browse Plan Formulary |
Fallon Senior Plan Plus Enhanced RX (HMO)
![Email Prescription and/or Health Benefit details for Fallon Senior Plan Plus Enhanced RX (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$164.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$7.00 | $21.00 | None | $69.42 |
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Tufts Medicare Preferred HMO Prime Rx (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Prime Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$166.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$8.00 | n/a | None | $61.80 |
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Tufts Medicare Preferred HMO Prime Rx (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Prime Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$166.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$8.00 | n/a | None | $61.80 |
Browse Plan Formulary |
Tufts Medicare Preferred HMO Prime Rx (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Prime Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$166.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$8.00 | n/a | None | $61.80 |
Browse Plan Formulary |
Erickson Advantage Champion (HMO-POS SNP)
![Email Prescription and/or Health Benefit details for Erickson Advantage Champion (HMO-POS SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$196.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $125.00 | None | $61.79 |
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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 |
Erickson Advantage Signature with Drugs (HMO-POS)
![Email Prescription and/or Health Benefit details for Erickson Advantage Signature with Drugs (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$196.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $125.00 | None | $61.79 |
Browse Plan Formulary |
Tufts Medicare Preferred HMO Prime Rx Plus (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Prime Rx Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$200.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$4.00 | n/a | None | $61.80 |
Browse Plan Formulary |
Tufts Medicare Preferred HMO Prime Rx Plus (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Prime Rx Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$200.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$4.00 | n/a | None | $61.80 |
Browse Plan Formulary |
Tufts Medicare Preferred HMO Prime Rx Plus (HMO)
![Email Prescription and/or Health Benefit details for Tufts Medicare Preferred HMO Prime Rx Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$200.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$4.00 | n/a | None | $61.80 |
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Medicare PPO Blue PlusRx (PPO)
![Email Prescription and/or Health Benefit details for Medicare PPO Blue PlusRx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$262.00 |
$200* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$5.00 | n/a | None | $51.32 |
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Medicare HMO Blue PlusRx (HMO)
![Email Prescription and/or Health Benefit details for Medicare HMO Blue PlusRx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$292.00 |
$200* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$5.00 | n/a | None | $51.32 |
Browse Plan Formulary |