FLUTICASONE PROPIONATE 50MCG SPRAY SUSPENSION (16 G BOTSPR) (NDC: 00054327099)
2019 Medicare Prescription Drug Plan (MAPD) Information
Click here for the Chart Legend |
See your cost using a drug discount card: Compare prices at pharmacies near you |
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 Focus (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete SecureHorizons Focus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$9.00 | $0.00 | None | $12.38 |
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 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$12.00 | $0.00 | None | $12.38 |
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 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$0.00 | $0.00 | Q:16 /30Days | $12.57 |
Browse Plan Formulary |
Alignment Health Plan My Choice (HMO)
![Email Prescription and/or Health Benefit details for Alignment Health Plan My Choice (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$5.00 | $12.50 | Q:16 /30Days | $16.42 |
Browse Plan Formulary |
Alignment Health Plan Platinum (HMO)
![Email Prescription and/or Health Benefit details for Alignment Health Plan Platinum (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$5.00 | $15.00 | Q:16 /30Days | $17.19 |
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 MediBlue Plus (HMO)
![Email Prescription and/or Health Benefit details for Anthem MediBlue Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$7.00 | $21.00 | Q:16 /30Days | $17.87 |
Browse Plan Formulary |
Anthem MediBlue Plus (HMO)
![Email Prescription and/or Health Benefit details for Anthem MediBlue Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$7.00 | $21.00 | Q:16 /30Days | $17.83 |
Browse Plan Formulary |
Anthem MediBlue Select (HMO)
![Email Prescription and/or Health Benefit details for Anthem MediBlue Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$5.00 | $10.00 | Q:16 /30Days | $17.83 |
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 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$10.00 | $15.00 | Q:16 /30Days | $7.82 |
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 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$5.00 | $7.50 | Q:16 /30Days | $8.15 |
Browse Plan Formulary |
Brand New Day Bridges Care Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Bridges Care Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$0.00 | $0.00 | None | $6.54 |
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 |
Brand New Day Classic Care I Plan (HMO)
![Email Prescription and/or Health Benefit details for Brand New Day Classic Care I Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$0.00 | $0.00 | None | $6.54 |
Browse Plan Formulary |
Brand New Day Classic Care II Plan (HMO)
![Email Prescription and/or Health Benefit details for Brand New Day Classic Care II Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$0.00 | $0.00 | None | $6.54 |
Browse Plan Formulary |
Brand New Day Embrace Care Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Embrace Care Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$0.00 | $0.00 | None | $6.54 |
Browse Plan Formulary |
Brand New Day Embrace Care Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Embrace Care Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$0.00 | $0.00 | None | $6.54 |
Browse Plan Formulary |
Brand New Day Harmony Care Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Harmony Care Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$0.00 | $0.00 | None | $6.54 |
Browse Plan Formulary |
Central Health Medicare Plan (HMO)
![Email Prescription and/or Health Benefit details for Central Health Medicare Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$0.00 | $0.00 | None | $6.40 |
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 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$10.00 | $0.00 | Q:16 /30Days | $11.70 |
Browse Plan Formulary |
Golden State (HMO)
![Email Prescription and/or Health Benefit details for Golden State (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$5.00 | $10.00 | None | $12.65 |
Browse Plan Formulary |
Golden State (HMO)
![Email Prescription and/or Health Benefit details for Golden State (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$5.00 | $10.00 | None | $13.66 |
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 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$10.00 | $20.00 | None | $18.74 |
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 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$10.00 | $20.00 | None | $18.19 |
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 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$7.00 | $0.00 | Q:32 /30Days | $6.50 |
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 Community (HMO)
![Email Prescription and/or Health Benefit details for Humana Community (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$5.00 | $0.00 | Q:16 /30Days | $6.66 |
Browse Plan Formulary |
Humana Gold Plus H5619-039 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5619-039 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$5.00 | $0.00 | Q:16 /30Days | $6.61 |
Browse Plan Formulary |
Humana Gold Plus H5619-039 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5619-039 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$5.00 | $0.00 | Q:16 /30Days | $6.66 |
Browse Plan Formulary |
IEHP DualChoice (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for IEHP DualChoice (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% | 0% | None | $19.89 |
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 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$9.00 | $27.00 | Q:16 /30Days | $8.90 |
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 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:16 /25Days | $8.96 |
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 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 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$15.00 | $30.00 | None | $10.40 |
Browse Plan Formulary |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (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% | 0% | Q:16 /30Days | $19.16 |
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 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$7.00 | $0.00 | Q:32 /30Days | $6.50 |
Browse Plan Formulary |
SCAN Classic II (HMO)
![Email Prescription and/or Health Benefit details for SCAN Classic II (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$7.00 | $0.00 | Q:32 /30Days | $6.50 |
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 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$5.00 | $0.00 | Q:32 /30Days | $6.59 |
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) |
$12.50 |
$0 |
to be determined |
2 |
Generic |
$15.00 | $30.00 | None | $10.64 |
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 |
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) |
$15.20 |
$415 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$8.00 | $24.00 | Q:16 /30Days | $20.77 |
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) |
$16.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$10.00 | $20.00 | None | $18.74 |
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) |
$16.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$10.00 | $20.00 | None | $18.19 |
Browse Plan Formulary |
UnitedHealthcare MedicareComplete Assure (HMO)
![Email Prescription and/or Health Benefit details for UnitedHealthcare MedicareComplete Assure (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.10 |
$415 |
No additional gap coverage, only the Donut Hole Discount |
2 |
All Formulary Drugs |
25% | 25% | None | $12.44 |
Browse Plan Formulary |
AARP MedicareComplete SecureHorizons Premier (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete SecureHorizons Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.70 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$9.00 | $0.00 | None | $12.38 |
Browse Plan Formulary |
SCAN Prime (HMO)
![Email Prescription and/or Health Benefit details for SCAN Prime (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$7.00 | $0.00 | Q:32 /30Days | $6.50 |
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)
![Email Prescription and/or Health Benefit details for Easy Choice Plus Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$415 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$20.00 | $0.00 | Q:16 /30Days | $11.12 |
Browse Plan Formulary |
Alignment Health Plan CalPlus (HMO)
![Email Prescription and/or Health Benefit details for Alignment Health Plan CalPlus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$415 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$10.00 | $30.00 | Q:16 /30Days | $16.35 |
Browse Plan Formulary |
Humana Value Plus H5619-037 (HMO)
![Email Prescription and/or Health Benefit details for Humana Value Plus H5619-037 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$415 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$19.00 | $0.00 | Q:16 /30Days | $6.43 |
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) |
$33.40 |
$415 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
25% | 25% | Q:32 /30Days | $6.61 |
Browse Plan Formulary |
Anthem MediBlue Coordination Plus (HMO)
![Email Prescription and/or Health Benefit details for Anthem MediBlue Coordination Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.80 |
$415 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$8.00 | $24.00 | Q:16 /30Days | $17.78 |
Browse Plan Formulary |
Brand New Day Bridges Choice Medi-Medi Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Bridges Choice Medi-Medi Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.80 |
$415* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
0% | 0% | None | $6.54 |
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 |
Brand New Day Classic Choice Medi-Medi Plan (HMO)
![Email Prescription and/or Health Benefit details for Brand New Day Classic Choice Medi-Medi Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.80 |
$415* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
0% | 0% | None | $6.54 |
Browse Plan Formulary |
Brand New Day Dual Access Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Dual Access Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.80 |
$415* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
0% | 0% | None | $6.54 |
Browse Plan Formulary |
Brand New Day Embrace Choice Medi-Medi Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Embrace Choice Medi-Medi Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.80 |
$415* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
0% | 0% | None | $6.54 |
Browse Plan Formulary |
Brand New Day Embrace Choice Medi-Medi Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Embrace Choice Medi-Medi Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.80 |
$415* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
0% | 0% | None | $6.54 |
Browse Plan Formulary |
Brand New Day Harmony Choice Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Harmony Choice Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.80 |
$415* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
0% | 0% | None | $6.54 |
Browse Plan Formulary |
Brand New Day Select Care Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Select Care Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.80 |
$415* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
0% | 0% | None | $6.54 |
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 |
Central Health Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Central Health Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.80 |
$415* |
Yes, but No Gap Coverage for this drug. |
1* |
Preferred Generic |
$0.00 | $0.00 | None | $6.40 |
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) |
$34.80 |
$320 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$20.00 | $60.00 | None | $17.41 |
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) |
$34.80 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$20.00 | $60.00 | None | $18.07 |
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) |
$34.80 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$20.00 | $60.00 | None | $18.07 |
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) |
$34.80 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$20.00 | $60.00 | None | $17.30 |
Browse Plan Formulary |
Health Net Seniority Plus Sapphire (HMO)
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Sapphire (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.80 |
$340 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$20.00 | $60.00 | None | $17.24 |
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 Seniority Plus Sapphire (HMO)
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Sapphire (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.80 |
$340 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$20.00 | $60.00 | None | $18.07 |
Browse Plan Formulary |
Health Net Seniority Plus Sapphire (HMO)
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Sapphire (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.80 |
$340 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$20.00 | $60.00 | None | $18.07 |
Browse Plan Formulary |
Health Net Seniority Plus Sapphire Premier (HMO)
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Sapphire Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.80 |
$200 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$20.00 | $60.00 | None | $18.07 |
Browse Plan Formulary |
Health Net Seniority Plus Sapphire Premier II (HMO)
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Sapphire Premier II (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.80 |
$250 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$20.00 | $60.00 | None | $18.07 |
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) |
$34.80 |
$415 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
25% | 25% | Q:32 /30Days | $6.50 |
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) |
$34.80 |
$415 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
25% | 25% | Q:32 /30Days | $6.58 |
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 |
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) |
$34.80 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$17.00 | $34.00 | None | $10.64 |
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) |
$34.80 |
$370 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$3.00 | $9.00 | Q:32 /30Days | $6.50 |
Browse Plan Formulary |
Aetna Medicare Choice Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Choice Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$81.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$0.00 | $0.00 | Q:16 /30Days | $12.57 |
Browse Plan Formulary |