METFORMIN HCL 500 MG TABLET (1000.000 EA ) (NDC: 23155010210)
2019 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 Choice (PPO)
|
$0.00 |
$150* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$3.00 | $0.00 | Q:150 /30Days | $4.01 |
Browse Plan Formulary |
AARP MedicareComplete Choice Plan 2 (Regional PPO)
|
$0.00 |
$395* |
to be determined |
1* |
Preferred Generic |
$3.00 | $0.00 | Q:150 /30Days | $4.15 |
Browse Plan Formulary |
Aetna Medicare Choice Plan (HMO-POS)
|
$0.00 |
$195* |
Yes, but No Gap Coverage for this drug. |
1* |
Preferred Generic |
$0.00 | $0.00 | None | $7.41 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
|
$0.00 |
$295* |
Yes, but No Gap Coverage for this drug. |
1* |
Preferred Generic |
$0.00 | $0.00 | None | $7.26 |
Browse Plan Formulary |
Allwell Medicare (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
6 |
Select Care Drugs |
$0.00 | $0.00 | None | $2.12 |
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 |
BlueMedicare Classic (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
6 |
Select Care Drugs |
$0.00 | $0.00 | Q:150 /30Days | $5.00 |
Browse Plan Formulary |
BlueMedicare Classic Plus (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
6 |
Select Care Drugs |
$0.00 | $0.00 | Q:150 /30Days | $5.00 |
Browse Plan Formulary |
CareFree (HMO)
|
$0.00 |
$100* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$0.00 | $0.00 | None | $2.96 |
Browse Plan Formulary |
Coventry Medicare Summit Plan (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$0.00 | $0.00 | None | $6.32 |
Browse Plan Formulary |
Devoted Health Palm Beach (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:150 /30Days | $2.49 |
Browse Plan Formulary |
Freedom Medicare Plan Rx (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$0.00 | $0.00 | None | $6.91 |
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 |
Freedom VIP Care (HMO SNP)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$0.00 | $0.00 | None | $6.90 |
Browse Plan Formulary |
Freedom VIP Savings (HMO SNP)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$0.00 | $0.00 | None | $6.90 |
Browse Plan Formulary |
Freedom VIP Savings COPD (HMO SNP)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$0.00 | $0.00 | None | $6.90 |
Browse Plan Formulary |
Humana Gold Plus - Diabetes (HMO SNP)
|
$0.00 |
$150* |
Yes, but No Gap Coverage for this drug. |
1* |
Preferred Generic |
$0.00 | $0.00 | None | $2.95 |
Browse Plan Formulary |
Humana Gold Plus H1036-062C (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$0.00 | $0.00 | None | $2.95 |
Browse Plan Formulary |
Humana Gold Plus H1036-199 (HMO)
|
$0.00 |
$100* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$6.00 | $0.00 | None | $2.95 |
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 |
HumanaChoice Florida H5216-068 (PPO)
|
$0.00 |
$150* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$2.00 | $0.00 | None | $2.95 |
Browse Plan Formulary |
HumanaChoice R5826-074 (Regional PPO)
|
$0.00 |
$395* |
to be determined |
1* |
Preferred Generic |
$6.00 | $0.00 | None | $2.97 |
Browse Plan Formulary |
MMM - ELITE (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:150 /30Days | $1.84 |
Browse Plan Formulary |
MMM - EXTRA (HMO)
|
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:150 /30Days | $1.84 |
Browse Plan Formulary |
Preferred Choice Palm Beach (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:150 /30Days | $4.02 |
Browse Plan Formulary |
Simply Level (HMO SNP)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:150 /30Days | $4.32 |
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 |
Simply More (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:150 /30Days | $4.32 |
Browse Plan Formulary |
Solis Health Plans (HMO)
|
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Preferred Generic |
$0.00 | $0.00 | None | $6.85 |
Browse Plan Formulary |
UnitedHealthcare Dual Complete RP ONE (Regional PPO SNP)
|
$0.00 |
$415 |
to be determined |
1 |
All Formulary Drugs |
$0.00 | $0.00 | Q:150 /30Days | $4.15 |
Browse Plan Formulary |
WellCare Dividend (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:150 /30Days | $2.46 |
Browse Plan Formulary |
WellCare Dividend (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:150 /30Days | $2.46 |
Browse Plan Formulary |
WellCare Dividend Prime (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:150 /30Days | $2.46 |
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 |
WellCare Elite (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:150 /30Days | $2.46 |
Browse Plan Formulary |
WellCare Premier (PPO)
|
$0.00 |
$100* |
Yes, but No Gap Coverage for this drug. |
1* |
Preferred Generic |
$0.00 | $0.00 | Q:150 /30Days | $2.46 |
Browse Plan Formulary |
CareExtra (HMO)
|
$11.90 |
$415 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Preferred Generic |
24% | 24% | None | $2.96 |
Browse Plan Formulary |
UnitedHealthcare Sync (PPO)
|
$14.00 |
$150* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$3.00 | $0.00 | Q:150 /30Days | $4.02 |
Browse Plan Formulary |
CareNeeds PLUS (HMO SNP)
|
$18.00 |
$415* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$0.00 | $0.00 | None | $2.96 |
Browse Plan Formulary |
CareNeeds (HMO SNP)
|
$18.20 |
$415* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$0.00 | $0.00 | None | $2.96 |
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 |
Humana Gold Plus SNP-DE H1036-259 (HMO SNP)
|
$22.70 |
$415* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$0.00 | $0.00 | None | $2.95 |
Browse Plan Formulary |
WellCare Access (HMO SNP)
|
$23.80 |
$415* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$0.00 | $0.00 | Q:150 /30Days | $2.46 |
Browse Plan Formulary |
UnitedHealthcare Dual Complete RP (Regional PPO SNP)
|
$25.30 |
$415 |
to be determined |
1 |
All Formulary Drugs |
15% | 15% | Q:150 /30Days | $4.15 |
Browse Plan Formulary |
Coventry Medicare Summit Plan (HMO SNP)
|
$25.40 |
$415* |
Yes, but No Gap Coverage for this drug. |
1* |
Preferred Generic |
$0.00 | $0.00 | None | $1.04 |
Browse Plan Formulary |
WellCare Select (HMO SNP)
|
$25.40 |
$415* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$0.00 | $0.00 | Q:150 /30Days | $2.46 |
Browse Plan Formulary |
Preferred Medicare Assist Palm Beach (HMO SNP)
|
$26.20 |
$415* |
Yes, but No Gap Coverage for this drug. |
1* |
Preferred Generic |
$0.00 | $0.00 | Q:150 /30Days | $4.02 |
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 |
WellCare Liberty (HMO SNP)
|
$26.60 |
$415* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$0.00 | $0.00 | Q:150 /30Days | $2.46 |
Browse Plan Formulary |
Humana Gold Plus SNP-DE H1036-104A (HMO SNP)
|
$26.70 |
$415* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$0.00 | $0.00 | None | $2.95 |
Browse Plan Formulary |
WellCare Reserve (HMO SNP)
|
$26.80 |
$415* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$0.00 | $0.00 | Q:150 /30Days | $2.46 |
Browse Plan Formulary |
UnitedHealthcare Assisted Living Plan (PPO SNP)
|
$27.70 |
$200* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$2.00 | $0.00 | Q:150 /30Days | $4.10 |
Browse Plan Formulary |
Molina Medicare Options Plus (HMO SNP)
|
$30.20 |
$415* |
Yes, but No Gap Coverage for this drug. |
1* |
Preferred Generic |
$0.00 | $0.00 | Q:150 /30Days | $2.17 |
Browse Plan Formulary |
Allwell Dual Medicare (HMO SNP)
|
$30.30 |
$415* |
Yes, but No Gap Coverage for this drug. |
6* |
Select Care Drugs |
$0.00 | $0.00 | None | $2.06 |
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 |
BlueMedicare Complete (HMO SNP)
|
$30.30 |
$415* |
Yes, but No Gap Coverage for this drug. |
1* |
Preferred Generic |
$0.00 | $0.00 | Q:150 /30Days | $4.85 |
Browse Plan Formulary |
Devoted Health Prime Palm Beach (HMO)
|
$30.30 |
$415* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$0.00 | $0.00 | Q:150 /30Days | $2.49 |
Browse Plan Formulary |
Freedom Medi-Medi Full (HMO SNP)
|
$30.30 |
$415* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$0.00 | $0.00 | None | $6.90 |
Browse Plan Formulary |
Freedom Medi-Medi Partial (HMO SNP)
|
$30.30 |
$415* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$0.00 | $0.00 | None | $6.90 |
Browse Plan Formulary |
MMM - PLATINUM (HMO SNP)
|
$30.30 |
$415* |
Yes, but No Gap Coverage for this drug. |
1* |
Preferred Generic |
$0.00 | $0.00 | Q:150 /30Days | $4.42 |
Browse Plan Formulary |
Optimum Emerald Full (HMO SNP)
|
$30.30 |
$415* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$0.00 | $0.00 | None | $6.90 |
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 |
Optimum Emerald Partial (HMO SNP)
|
$30.30 |
$415* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$0.00 | $0.00 | None | $6.90 |
Browse Plan Formulary |
Simply Advantage (HMO SNP)
|
$30.30 |
$415* |
Yes, but No Gap Coverage for this drug. |
1* |
Preferred Generic |
$0.00 | $0.00 | Q:150 /30Days | $4.32 |
Browse Plan Formulary |
Simply Care (HMO SNP)
|
$30.30 |
$415 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Preferred Generic |
$5.00 | n/a | Q:150 /30Days | $4.32 |
Browse Plan Formulary |
Simply Comfort (HMO SNP)
|
$30.30 |
$415* |
Yes, but No Gap Coverage for this drug. |
1* |
Preferred Generic |
$0.00 | n/a | Q:150 /30Days | $4.32 |
Browse Plan Formulary |
Simply Complete (HMO SNP)
|
$30.30 |
$415* |
Yes, but No Gap Coverage for this drug. |
1* |
Preferred Generic |
$0.00 | $0.00 | Q:150 /30Days | $4.32 |
Browse Plan Formulary |
Simply Select (HMO)
|
$30.30 |
$415* |
Yes, but No Gap Coverage for this drug. |
1* |
Preferred Generic |
$0.00 | $0.00 | Q:150 /30Days | $4.32 |
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 Nursing Home Plan (PPO SNP)
|
$30.30 |
$415 |
No additional gap coverage, only the Donut Hole Discount |
1 |
All Formulary Drugs |
25% | 25% | Q:150 /30Days | $4.10 |
Browse Plan Formulary |
HumanaChoice R5826-005 (Regional PPO)
|
$31.30 |
$100* |
to be determined |
1* |
Preferred Generic |
$5.00 | $0.00 | None | $2.97 |
Browse Plan Formulary |
WellCare Prime (PPO)
|
$40.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:150 /30Days | $2.46 |
Browse Plan Formulary |
BlueMedicare Choice (Regional PPO)
|
$41.00 |
$250* |
to be determined |
6* |
Select Care Drugs |
$0.00 | $0.00 | Q:150 /30Days | $4.93 |
Browse Plan Formulary |
HumanaChoice H5216-065 (PPO)
|
$57.00 |
$350* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$5.00 | $0.00 | None | $2.95 |
Browse Plan Formulary |
Humana Gold Choice H8145-061 (PFFS)
|
$117.00 |
$200* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$7.00 | $0.00 | None | $2.96 |
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 |
BlueMedicare Select (PPO)
|
$147.80 |
$305* |
Yes, but No Gap Coverage for this drug. |
6* |
Select Care Drugs |
$0.00 | $0.00 | Q:150 /30Days | $4.93 |
Browse Plan Formulary |