FANAPT 8 MG TABLET (60 EA ) (NDC: 43068010802)
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 |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$405 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | S | $1,426.48 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$405 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | S | $1,421.86 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$405 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | S | $1,377.71 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$405 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | S | $1,394.84 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$405 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | S | $1,417.12 |
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 |
HAP Senior Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
33% | n/a | P | $1,419.39 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$125 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
30% | n/a | S Q:60 /30Days | $1,420.99 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$125 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
30% | n/a | S Q:60 /30Days | $1,406.49 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$125 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
30% | n/a | S Q:60 /30Days | $1,394.41 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$125 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
30% | n/a | S Q:60 /30Days | $1,459.77 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$125 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
30% | n/a | S Q:60 /30Days | $1,434.56 |
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)
|
$14.00 |
$405 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $1,417.11 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$14.00 |
$405 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $1,404.67 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$14.00 |
$405 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $1,377.70 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$14.00 |
$405 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $1,426.47 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$14.00 |
$405 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $1,401.78 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$14.00 |
$125 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
30% | n/a | S Q:60 /30Days | $1,459.77 |
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 Ideal (PPO)
|
$14.00 |
$125 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
30% | n/a | S Q:60 /30Days | $1,420.99 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$14.00 |
$125 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
30% | n/a | S Q:60 /30Days | $1,406.49 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$14.00 |
$125 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
30% | n/a | S Q:60 /30Days | $1,394.41 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$14.00 |
$125 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
30% | n/a | S Q:60 /30Days | $1,434.56 |
Browse Plan Formulary |
HAP Senior Plus Option 1 (PPO)
|
$15.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
33% | n/a | P | $1,419.39 |
Browse Plan Formulary |
HumanaChoice H8087-001 (PPO)
|
$20.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
29% | n/a | P Q:60 /30Days | $1,521.30 |
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 |
HumanaChoice R3887-002 (Regional PPO)
|
$20.50 |
$150 | to be determined | 5 |
Specialty Tier |
30% | n/a | P Q:60 /30Days | $1,521.30 |
Browse Plan Formulary |
Humana Value Plus H8087-002 (PPO)
|
$23.90 |
$260 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
28% | n/a | P Q:60 /30Days | $1,521.30 |
Browse Plan Formulary |
UnitedHealthcare Dual Complete (HMO SNP)
|
$24.50 |
$415 | No additional gap coverage, only the Donut Hole Discount | 5 |
All Formulary Drugs |
$0.00 | $0.00 | S Q:60 /30Days | $1,533.45 |
Browse Plan Formulary |
PriorityMedicare Value (HMO-POS)
|
$27.00 |
$75 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
31% | n/a | S Q:60 /30Days | $1,406.49 |
Browse Plan Formulary |
Molina Medicare Options Plus (HMO SNP)
|
$30.10 |
$415 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
42% | 42% | Q:60 /30Days | $1,430.52 |
Browse Plan Formulary |
HAP Senior Plus Option 1 (HMO-POS)
|
$45.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
33% | n/a | P | $1,419.39 |
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 |
HAP Senior Plus Option 2 (PPO)
|
$55.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
33% | n/a | P | $1,419.39 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$62.00 |
$75 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
31% | n/a | S Q:60 /30Days | $1,394.41 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$62.00 |
$75 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
31% | n/a | S Q:60 /30Days | $1,459.77 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$62.00 |
$75 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
31% | n/a | S Q:60 /30Days | $1,434.56 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$62.00 |
$75 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
31% | n/a | S Q:60 /30Days | $1,420.99 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$62.00 |
$75 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
31% | n/a | S Q:60 /30Days | $1,406.49 |
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)
|
$73.00 |
$350 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $1,377.70 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$73.00 |
$350 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $1,404.67 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$73.00 |
$350 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $1,426.47 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$73.00 |
$350 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $1,401.78 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$73.00 |
$350 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $1,417.11 |
Browse Plan Formulary |
HAP Senior Plus Option 2 (HMO-POS)
|
$75.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
33% | n/a | P | $1,419.39 |
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 |
HumanaChoice H5216-009 (PPO)
|
$75.00 |
$105 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
31% | n/a | P Q:60 /30Days | $1,521.30 |
Browse Plan Formulary |
Humana Gold Choice H8145-006 (PFFS)
|
$94.00 |
$415 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
25% | n/a | P Q:60 /30Days | $1,521.30 |
Browse Plan Formulary |
PriorityMedicare (HMO-POS)
|
$98.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
33% | n/a | S Q:60 /30Days | $1,406.49 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$110.40 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | S | $1,417.12 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$110.40 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | S | $1,421.86 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$110.40 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | S | $1,426.48 |
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)
|
$110.40 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | S | $1,377.71 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$110.40 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | S | $1,394.84 |
Browse Plan Formulary |
HAP Senior Plus Option 3 (PPO)
|
$118.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
33% | n/a | P | $1,419.39 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$150.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
33% | n/a | S Q:60 /30Days | $1,420.99 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$150.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
33% | n/a | S Q:60 /30Days | $1,406.49 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$150.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
33% | n/a | S Q:60 /30Days | $1,394.41 |
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 Select (PPO)
|
$150.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
33% | n/a | S Q:60 /30Days | $1,459.77 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$150.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 5 |
Specialty Tier |
33% | n/a | S Q:60 /30Days | $1,434.56 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$160.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
48% | 48% | None | $1,401.78 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$160.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
48% | 48% | None | $1,426.47 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$160.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
48% | 48% | None | $1,377.70 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$160.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
48% | 48% | None | $1,404.67 |
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)
|
$160.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
48% | 48% | None | $1,417.11 |
Browse Plan Formulary |
HAP Senior Plus Option 3 (HMO-POS)
|
$170.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Specialty Tier |
33% | n/a | P | $1,419.39 |
Browse Plan Formulary |
HAP Senior Plus Option 4 (PPO)
|
$190.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Specialty Tier |
33% | n/a | P | $1,419.39 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$270.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | None | $1,417.11 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$270.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | None | $1,404.67 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$270.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | None | $1,377.70 |
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 Assure (PPO)
|
$270.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | None | $1,426.47 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$270.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | None | $1,401.78 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$287.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | S | $1,417.12 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$287.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | S | $1,394.84 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$287.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | S | $1,377.71 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$287.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | S | $1,426.48 |
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)
|
$287.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | S | $1,421.86 |
Browse Plan Formulary |