Anagrelide Hydrochloride 1mg/1 100 CAPSULE BOTTLE (100 CAPSULE in 1 BOTTLE ) (NDC: 00172524060)
2021 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 |
Aetna Medicare Premier (HMO)
|
$0.00 |
$0 |
No |
3 |
Preferred Brand |
$47.00 | $141.00 | None | $578.40 |
Browse Plan Formulary |
Aetna Medicare Value (PPO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$47.00 | $141.00 | None | $578.40 |
Browse Plan Formulary |
BCN Advantage Prime Value (HMO-POS)
|
$0.00 |
$50* |
No |
2* |
Generic |
$11.00 | $0.00 | None | $243.60 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
BCN Advantage Prime Value (HMO-POS)
|
$0.00 |
$50* |
No |
2* |
Generic |
$11.00 | $0.00 | None | $292.80 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
BCN Advantage Prime Value (HMO-POS)
|
$0.00 |
$50* |
No |
2* |
Generic |
$11.00 | $0.00 | None | $280.80 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
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 Prime Value (HMO-POS)
|
$0.00 |
$50* |
No |
2* |
Generic |
$11.00 | $0.00 | None | $255.60 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
BCN Advantage Prime Value (HMO-POS)
|
$0.00 |
$50* |
No |
2* |
Generic |
$11.00 | $0.00 | None | $284.40 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
HAP Senior Plus (HMO)
|
$0.00 |
$0 |
No |
2 |
Generic |
$10.00 | $0.00 | None | $261.60 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
HAP Senior Plus Option 1 (PPO)
|
$0.00 |
$0 |
No |
2 |
Generic |
$10.00 | $0.00 | None | $255.60 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
Medicare Plus Blue PPO Essential (PPO)
|
$0.00 |
$100* |
No |
2* |
Generic |
$11.00 | $0.00 | None | $223.20 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$0.00 |
$100* |
No |
2* |
Generic |
$11.00 | $0.00 | None | $208.80 |
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 Plus Blue PPO Essential (PPO)
|
$0.00 |
$100* |
No |
2* |
Generic |
$11.00 | $0.00 | None | $228.00 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$0.00 |
$100* |
No |
2* |
Generic |
$11.00 | $0.00 | None | $216.00 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$0.00 |
$100* |
No |
2* |
Generic |
$11.00 | $0.00 | None | $208.80 |
Browse Plan Formulary |
Paramount Elite - Standard Medical & Drug (HMO)
|
$0.00 |
$50* |
No |
2* |
Generic |
$20.00 | $40.00 | None | $2,166.00 |
Browse Plan Formulary |
PriorityMedicare Compass (PPO)
|
$0.00 |
$100* |
No |
2* |
Generic |
$15.00 | $0.00 | None | $328.80 |
Browse Plan Formulary |
PriorityMedicare Compass (PPO)
|
$0.00 |
$100* |
No |
2* |
Generic |
$15.00 | $0.00 | None | $331.20 |
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 |
$100* |
No |
2* |
Generic |
$15.00 | $0.00 | None | $336.00 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$100* |
No |
2* |
Generic |
$15.00 | $0.00 | None | $328.80 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$100* |
No |
2* |
Generic |
$15.00 | $0.00 | None | $331.20 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$100* |
No |
2* |
Generic |
$15.00 | $0.00 | None | $328.80 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$100* |
No |
2* |
Generic |
$15.00 | $0.00 | None | $336.00 |
Browse Plan Formulary |
Reliance Principle Plan (HMO)
|
$0.00 |
$125* |
No |
2* |
Generic |
$10.00 | $30.00 | None | $577.20 |
Browse Plan Formulary select insulin pay $10 copay but not this drug |
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 Dividend (HMO)
|
$0.00 |
$445 |
No |
4 |
Non-Preferred Drug |
50% | 50% | None | $2,166.00 |
Browse Plan Formulary |
WellCare Essential (HMO-POS)
|
$0.00 |
$0 |
No |
2 |
Generic |
$15.00 | $0.00 | None | $2,166.00 |
Browse Plan Formulary |
WellCare Explore (HMO-POS)
|
$0.00 |
$0 |
No |
2 |
Generic |
$10.00 | $0.00 | None | $2,166.00 |
Browse Plan Formulary |
WellCare Elite Smile (HMO-POS)
|
$14.10 |
$0 |
No |
2 |
Generic |
$10.00 | $0.00 | None | $2,166.00 |
Browse Plan Formulary |
HumanaChoice H8087-001 (PPO)
|
$20.00 |
$75 |
No |
3 |
Preferred Brand |
$47.00 | $131.00 | None | $193.20 |
Browse Plan Formulary |
Humana Value Plus H8087-002 (PPO)
|
$22.50 |
$260 |
No |
3 |
Preferred Brand |
$47.00 | $131.00 | None | $193.20 |
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)
|
$25.00 |
$125* |
No |
2* |
Generic |
$13.00 | $0.00 | None | $336.00 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$25.00 |
$125* |
No |
2* |
Generic |
$13.00 | $0.00 | None | $328.80 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$25.00 |
$125* |
No |
2* |
Generic |
$13.00 | $0.00 | None | $331.20 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$25.00 |
$125* |
No |
2* |
Generic |
$13.00 | $0.00 | None | $328.80 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$25.00 |
$125* |
No |
2* |
Generic |
$13.00 | $0.00 | None | $336.00 |
Browse Plan Formulary |
Paramount Elite - Prime Medical & Drug (HMO)
|
$28.00 |
$0 |
No |
2 |
Generic |
$10.00 | $20.00 | None | $2,166.00 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
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 SNP-DE H8087-003 (PPO D-SNP)
|
$28.70 |
$445 |
No |
3 |
Preferred Brand |
$47.00 | $131.00 | None | $193.20 |
Browse Plan Formulary |
Longevity Health Plan (HMO I-SNP)
|
$30.10 |
$445 |
No |
1 |
Tier 1 |
25% | n/a | None | $207.60 |
Browse Plan Formulary |
Molina Medicare Complete Care (HMO D-SNP)
|
$30.10 |
$445 |
No |
4 |
Non-Preferred Drug |
33% | 33% | None | $319.20 |
Browse Plan Formulary |
PriorityMedicare D-SNP (HMO D-SNP)
|
$30.10 |
$445 |
No |
2 |
Tier 2 |
$0.00 | $0.00 | None | $334.80 |
Browse Plan Formulary |
WellCare Extra Plus (HMO-POS D-SNP)
|
$30.10 |
$445 |
No |
4 |
Non-Preferred Drug |
50% | 50% | None | $2,166.00 |
Browse Plan Formulary |
HumanaChoice R3887-002 (Regional PPO)
|
$32.40 |
$380 |
No |
3 |
Preferred Brand |
$47.00 | $131.00 | None | $193.20 |
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 |
Aetna Medicare Premier Plus (PPO)
|
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$47.00 | $141.00 | None | $578.40 |
Browse Plan Formulary |
Reliance Cardinal Plan (HMO)
|
$40.00 |
$0 |
No |
2 |
Generic |
$10.00 | $30.00 | None | $577.20 |
Browse Plan Formulary select insulin pay $10 copay but not this drug |
WellCare Elite (HMO-POS)
|
$47.00 |
$0 |
No |
2 |
Generic |
$10.00 | $0.00 | None | $2,166.00 |
Browse Plan Formulary |
HAP Senior Plus Option 2 (PPO)
|
$60.00 |
$0 |
No |
2 |
Generic |
$10.00 | $0.00 | None | $255.60 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
Paramount Elite - Enhanced Medical & Drug (HMO)
|
$68.00 |
$0 |
No |
2 |
Generic |
$15.00 | $30.00 | None | $2,166.00 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
HumanaChoice H5216-009 (PPO)
|
$70.00 |
$0 |
No |
3 |
Preferred Brand |
$47.00 | $131.00 | None | $193.20 |
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)
|
$70.00 |
$100* |
No |
2* |
Generic |
$11.00 | $0.00 | None | $228.00 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$70.00 |
$100* |
No |
2* |
Generic |
$11.00 | $0.00 | None | $216.00 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$70.00 |
$100* |
No |
2* |
Generic |
$11.00 | $0.00 | None | $208.80 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$70.00 |
$100* |
No |
2* |
Generic |
$11.00 | $0.00 | None | $223.20 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$70.00 |
$100* |
No |
2* |
Generic |
$11.00 | $0.00 | None | $208.80 |
Browse Plan Formulary |
PriorityMedicare Value (HMO-POS)
|
$73.00 |
$75* |
No |
2* |
Generic |
$10.00 | $0.00 | None | $336.00 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
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 Value (HMO-POS)
|
$73.00 |
$75* |
No |
2* |
Generic |
$10.00 | $0.00 | None | $328.80 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
PriorityMedicare Value (HMO-POS)
|
$73.00 |
$75* |
No |
2* |
Generic |
$10.00 | $0.00 | None | $331.20 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
PriorityMedicare Value (HMO-POS)
|
$73.00 |
$75* |
No |
2* |
Generic |
$10.00 | $0.00 | None | $328.80 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
PriorityMedicare Value (HMO-POS)
|
$73.00 |
$75* |
No |
2* |
Generic |
$10.00 | $0.00 | None | $336.00 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
HAP Senior Plus Option 1 (HMO-POS)
|
$85.00 |
$0 |
No |
2 |
Generic |
$10.00 | $0.00 | None | $255.60 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
PriorityMedicare Merit (PPO)
|
$100.00 |
$0 |
No |
2 |
Generic |
$10.00 | $0.00 | None | $328.80 |
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 |
PriorityMedicare Merit (PPO)
|
$100.00 |
$0 |
No |
2 |
Generic |
$10.00 | $0.00 | None | $336.00 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$100.00 |
$0 |
No |
2 |
Generic |
$10.00 | $0.00 | None | $336.00 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$100.00 |
$0 |
No |
2 |
Generic |
$10.00 | $0.00 | None | $328.80 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$100.00 |
$0 |
No |
2 |
Generic |
$10.00 | $0.00 | None | $331.20 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$112.00 |
$0 |
No |
2 |
Generic |
$7.00 | $0.00 | None | $255.60 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$112.00 |
$0 |
No |
2 |
Generic |
$7.00 | $0.00 | None | $284.40 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
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)
|
$112.00 |
$0 |
No |
2 |
Generic |
$7.00 | $0.00 | None | $243.60 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$112.00 |
$0 |
No |
2 |
Generic |
$7.00 | $0.00 | None | $292.80 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$112.00 |
$0 |
No |
2 |
Generic |
$7.00 | $0.00 | None | $280.80 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
Medicare Plus Blue PPO Signature (PPO)
|
$152.00 |
$0 |
No |
2 |
Generic |
$10.00 | $0.00 | None | $208.80 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$152.00 |
$0 |
No |
2 |
Generic |
$10.00 | $0.00 | None | $228.00 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$152.00 |
$0 |
No |
2 |
Generic |
$10.00 | $0.00 | None | $216.00 |
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)
|
$152.00 |
$0 |
No |
2 |
Generic |
$10.00 | $0.00 | None | $208.80 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$152.00 |
$0 |
No |
2 |
Generic |
$10.00 | $0.00 | None | $223.20 |
Browse Plan Formulary |
HAP Senior Plus Option 3 (PPO)
|
$160.00 |
$0 |
No |
2 |
Generic |
$10.00 | $0.00 | None | $255.60 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
PriorityMedicare (HMO-POS)
|
$170.00 |
$0 |
No |
2 |
Generic |
$8.00 | $0.00 | None | $331.20 |
Browse Plan Formulary |
PriorityMedicare (HMO-POS)
|
$170.00 |
$0 |
No |
2 |
Generic |
$8.00 | $0.00 | None | $328.80 |
Browse Plan Formulary |
PriorityMedicare (HMO-POS)
|
$170.00 |
$0 |
No |
2 |
Generic |
$8.00 | $0.00 | None | $336.00 |
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 (HMO-POS)
|
$170.00 |
$0 |
No |
2 |
Generic |
$8.00 | $0.00 | None | $336.00 |
Browse Plan Formulary |
PriorityMedicare (HMO-POS)
|
$170.00 |
$0 |
No |
2 |
Generic |
$8.00 | $0.00 | None | $328.80 |
Browse Plan Formulary |
HAP Senior Plus Option 2 (HMO-POS)
|
$190.00 |
$0 |
No |
2 |
Generic |
$10.00 | $0.00 | None | $255.60 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
PriorityMedicare Select (PPO)
|
$199.00 |
$0 |
No |
2 |
Generic |
$7.00 | $0.00 | None | $328.80 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$199.00 |
$0 |
No |
2 |
Generic |
$7.00 | $0.00 | None | $331.20 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$199.00 |
$0 |
No |
2 |
Generic |
$7.00 | $0.00 | None | $328.80 |
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 |
PriorityMedicare Select (PPO)
|
$199.00 |
$0 |
No |
2 |
Generic |
$7.00 | $0.00 | None | $336.00 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$199.00 |
$0 |
No |
2 |
Generic |
$7.00 | $0.00 | None | $336.00 |
Browse Plan Formulary |
HAP Senior Plus Option 4 (PPO)
|
$200.00 |
$0 |
No |
2 |
Generic |
$10.00 | $0.00 | None | $255.60 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$249.00 |
$0 |
No |
2 |
Generic |
$7.00 | $0.00 | None | $255.60 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$249.00 |
$0 |
No |
2 |
Generic |
$7.00 | $0.00 | None | $284.40 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$249.00 |
$0 |
No |
2 |
Generic |
$7.00 | $0.00 | None | $243.60 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
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)
|
$249.00 |
$0 |
No |
2 |
Generic |
$7.00 | $0.00 | None | $292.80 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$249.00 |
$0 |
No |
2 |
Generic |
$7.00 | $0.00 | None | $280.80 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
Medicare Plus Blue PPO Assure (PPO)
|
$257.00 |
$0 |
No |
2 |
Generic |
$7.00 | $0.00 | None | $228.00 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$257.00 |
$0 |
No |
2 |
Generic |
$7.00 | $0.00 | None | $216.00 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$257.00 |
$0 |
No |
2 |
Generic |
$7.00 | $0.00 | None | $208.80 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$257.00 |
$0 |
No |
2 |
Generic |
$7.00 | $0.00 | None | $223.20 |
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)
|
$257.00 |
$0 |
No |
2 |
Generic |
$7.00 | $0.00 | None | $208.80 |
Browse Plan Formulary |