LAZANDA 400 MCG NASAL SPRAY/PUMP (UNIT ) (NDC: 71500014001)
2022 Medicare Prescription Drug Plan (MAPD) Information
Click here for the Chart Legend |
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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 |
Brand New Day Bridges Care Plan (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Bridges Care Plan (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary |
Brand New Day Bridges Care Plan (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Bridges Care Plan (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Some Generics |
5 |
Specialty Tier |
33% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary |
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. |
5 |
Specialty Tier |
33% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary |
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. |
5 |
Specialty Tier |
33% | n/a | P Q:30 /30Days | $1,626.39 |
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 |
$50 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
32% | n/a | P Q:30 /30Days | $1,626.39 |
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 |
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 |
$50 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
32% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary |
Brand New Day Dual Access Plan (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Dual Access Plan (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$480 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
25% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary |
Brand New Day Embrace Care Plan (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Embrace Care Plan (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary select insulin pay $0-$35 copay but not this drug |
Brand New Day Embrace Care Plan (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Embrace Care Plan (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary select insulin pay $0-$35 copay but not this drug |
Brand New Day Embrace Care Plan (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Embrace Care Plan (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Some Generics |
5 |
Specialty Tier |
33% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary select insulin pay $0-$35 copay but not this drug |
Brand New Day Embrace Care Plan (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Embrace Care Plan (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Some Generics |
5 |
Specialty Tier |
33% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary select insulin pay $0-$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 |
Brand New Day Harmony Care Plan (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Harmony Care Plan (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$100 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
30% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary |
Brand New Day Harmony Care Plan (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Harmony Care Plan (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$100 |
Some Generics |
5 |
Specialty Tier |
30% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary |
Brand New Day Part B Savings Plan (HMO)
![Email Prescription and/or Health Benefit details for Brand New Day Part B Savings Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary |
Brand New Day Part B Savings Plan (HMO)
![Email Prescription and/or Health Benefit details for Brand New Day Part B Savings Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary |
Brand New Day Select Care I Plan (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Select Care I Plan (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
25% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary |
Brand New Day Select Care I Plan (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Select Care I Plan (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Some Generics |
5 |
Specialty Tier |
25% | n/a | P Q:30 /30Days | $1,626.39 |
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 |
Central Health Focus Plan (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Central Health Focus Plan (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P Q:30 /30Days | $1,631.99 |
Browse Plan Formulary select insulin pay $0 copay but not this drug |
Central Health Focus Plan (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Central Health Focus Plan (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Many Generics, Some Brands |
5 |
Specialty Tier |
33% | n/a | P Q:30 /30Days | $1,631.99 |
Browse Plan Formulary select insulin pay $0 copay but not this drug |
Central Health Medi-Medi Plan (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Central Health Medi-Medi Plan (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$480 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
25% | n/a | P Q:30 /30Days | $1,631.99 |
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. |
5 |
Specialty Tier |
33% | n/a | P Q:30 /30Days | $1,631.99 |
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. |
5 |
Specialty Tier |
33% | n/a | P Q:30 /30Days | $1,631.99 |
Browse Plan Formulary |
Central Health Savings Plan (HMO)
![Email Prescription and/or Health Benefit details for Central Health Savings Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P Q:30 /30Days | $1,631.99 |
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 Savings Plan (HMO)
![Email Prescription and/or Health Benefit details for Central Health Savings Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P Q:30 /30Days | $1,631.99 |
Browse Plan Formulary |
Clever Care Fortune Medicare Advantage Plan (HMO)
![Email Prescription and/or Health Benefit details for Clever Care Fortune Medicare Advantage Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | 33% | P Q:30 /30Days | $1,638.06 |
Browse Plan Formulary select insulin pay $0-$35 copay but not this drug |
Clever Care Fortune Medicare Advantage Plan (HMO)
![Email Prescription and/or Health Benefit details for Clever Care Fortune Medicare Advantage Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | 33% | P Q:30 /30Days | $1,638.06 |
Browse Plan Formulary select insulin pay $0-$35 copay but not this drug |
Clever Care Fortune Medicare Advantage Plan (HMO)
![Email Prescription and/or Health Benefit details for Clever Care Fortune Medicare Advantage Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | 33% | P Q:30 /30Days | $1,638.06 |
Browse Plan Formulary select insulin pay $0-$35 copay but not this drug |
Clever Care Longevity Medicare Advantage (HMO)
![Email Prescription and/or Health Benefit details for Clever Care Longevity Medicare Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | 33% | P Q:30 /30Days | $1,638.06 |
Browse Plan Formulary select insulin pay $0-$35 copay but not this drug |
Clever Care Longevity Medicare Advantage (HMO)
![Email Prescription and/or Health Benefit details for Clever Care Longevity Medicare Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | 33% | P Q:30 /30Days | $1,638.06 |
Browse Plan Formulary select insulin pay $0-$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 |
Clever Care Longevity Medicare Advantage (HMO)
![Email Prescription and/or Health Benefit details for Clever Care Longevity Medicare Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | 33% | P Q:30 /30Days | $1,638.06 |
Browse Plan Formulary select insulin pay $0-$35 copay but not this drug |
Clever Care Value Medicare Advantage Plan (HMO)
![Email Prescription and/or Health Benefit details for Clever Care Value Medicare Advantage Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | 33% | P Q:30 /30Days | $1,638.06 |
Browse Plan Formulary select insulin pay $0-$35 copay but not this drug |
Clever Care Value Medicare Advantage Plan (HMO)
![Email Prescription and/or Health Benefit details for Clever Care Value Medicare Advantage Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | 33% | P Q:30 /30Days | $1,638.06 |
Browse Plan Formulary select insulin pay $0-$35 copay but not this drug |
Clever Care Value Medicare Advantage Plan (HMO)
![Email Prescription and/or Health Benefit details for Clever Care Value Medicare Advantage Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | 33% | P Q:30 /30Days | $1,638.06 |
Browse Plan Formulary select insulin pay $0-$35 copay but not this drug |
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)
![Email Prescription and/or Health Benefit details for Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Brand |
$100.00 | $200.00 | P | $1,651.15 |
Browse Plan Formulary |
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)
![Email Prescription and/or Health Benefit details for Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Brand |
$100.00 | $200.00 | P | $1,651.15 |
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 |
PHP (HMO C-SNP)
![Email Prescription and/or Health Benefit details for PHP (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$480 |
Yes, but No Gap Coverage for this drug. |
4 |
Specialty Tier |
25% | n/a | P Q:30 /30Days | $1,636.87 |
Browse Plan Formulary |
PHP (HMO C-SNP)
![Email Prescription and/or Health Benefit details for PHP (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$480 |
Few Generics |
4 |
Specialty Tier |
25% | n/a | P Q:30 /30Days | $1,636.87 |
Browse Plan Formulary |
SCAN Balance (HMO C-SNP)
![Email Prescription and/or Health Benefit details for SCAN Balance (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $1,623.48 |
Browse Plan Formulary select insulin pay $0 copay but not this drug |
SCAN Balance (HMO C-SNP)
![Email Prescription and/or Health Benefit details for SCAN Balance (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Many Generics, Some Brands |
5 |
Specialty Tier |
33% | n/a | P | $1,623.48 |
Browse Plan Formulary select insulin pay $0 copay but not this drug |
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. |
5 |
Specialty Tier |
33% | n/a | P | $1,623.48 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
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. |
5 |
Specialty Tier |
33% | n/a | P | $1,623.48 |
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 |
SCAN Connections (HMO D-SNP)
![Email Prescription and/or Health Benefit details for SCAN Connections (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$480 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
25% | n/a | P | $1,623.48 |
Browse Plan Formulary |
SCAN Connections at Home (HMO D-SNP)
![Email Prescription and/or Health Benefit details for SCAN Connections at Home (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$480 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
25% | n/a | P | $1,623.48 |
Browse Plan Formulary |
SCAN Embrace (HMO I-SNP)
![Email Prescription and/or Health Benefit details for SCAN Embrace (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $1,623.48 |
Browse Plan Formulary select insulin pay $0 copay but not this drug |
SCAN Embrace (HMO I-SNP)
![Email Prescription and/or Health Benefit details for SCAN Embrace (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Many Generics, Some Brands |
5 |
Specialty Tier |
33% | n/a | P | $1,623.48 |
Browse Plan Formulary select insulin pay $0 copay but not this drug |
SCAN Healthy at Home (HMO I-SNP)
![Email Prescription and/or Health Benefit details for SCAN Healthy at Home (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $1,623.48 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
SCAN Healthy at Home (HMO I-SNP)
![Email Prescription and/or Health Benefit details for SCAN Healthy at Home (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Some Generics |
5 |
Specialty Tier |
33% | n/a | P | $1,623.48 |
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 |
SCAN Prime (HMO)
![Email Prescription and/or Health Benefit details for SCAN Prime (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $1,623.48 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
SCAN Venture (HMO)
![Email Prescription and/or Health Benefit details for SCAN Venture (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $1,623.48 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
SCAN Venture (HMO)
![Email Prescription and/or Health Benefit details for SCAN Venture (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $1,623.48 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
SCAN Prime (HMO)
![Email Prescription and/or Health Benefit details for SCAN Prime (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $1,623.48 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
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) |
$27.30 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Tier 4 |
$100.00 | $200.00 | P | $1,651.15 |
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) |
$27.30 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Tier 4 |
$100.00 | $200.00 | P | $1,651.15 |
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 Sr Adv Medicare Medi-Cal (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Kaiser Permanente Sr Adv Medicare Medi-Cal (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.40 |
$480 |
No |
4 |
Tier 4 |
15% | 15% | P | $1,651.15 |
Browse Plan Formulary |
Kaiser Permanente Sr Adv Medicare Medi-Cal (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Kaiser Permanente Sr Adv Medicare Medi-Cal (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.40 |
$480 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
15% | 15% | P | $1,651.15 |
Browse Plan Formulary |
Brand New Day Classic Choice Plan (HMO)
![Email Prescription and/or Health Benefit details for Brand New Day Classic Choice Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.20 |
$480 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
25% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary |
Brand New Day Classic Choice Plan (HMO)
![Email Prescription and/or Health Benefit details for Brand New Day Classic Choice Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.20 |
$480 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
25% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary |
Brand New Day Dual Access Plan (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Dual Access Plan (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.90 |
$480 |
Some Generics |
5 |
Specialty Tier |
25% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary |
Brand New Day Bridges Choice Plan (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Bridges Choice Plan (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$480 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
25% | n/a | P Q:30 /30Days | $1,626.39 |
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 |
Brand New Day Bridges Choice Plan (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Bridges Choice Plan (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$480 |
Some Generics |
5 |
Specialty Tier |
25% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary |
Brand New Day Embrace Choice Plan (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Embrace Choice Plan (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$480 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
25% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary |
Brand New Day Embrace Choice Plan (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Embrace Choice Plan (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$480 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
25% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary |
Brand New Day Embrace Choice Plan (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Embrace Choice Plan (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$480 |
Some Generics |
5 |
Specialty Tier |
25% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary |
Brand New Day Embrace Choice Plan (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Embrace Choice Plan (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$480 |
Some Generics |
5 |
Specialty Tier |
25% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary |
Brand New Day Harmony Choice Plan (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Harmony Choice Plan (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$480 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
25% | n/a | P Q:30 /30Days | $1,626.39 |
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 |
Brand New Day Harmony Choice Plan (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Harmony Choice Plan (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$480 |
Some Generics |
5 |
Specialty Tier |
25% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary |
Brand New Day Select Choice I Plan (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Select Choice I Plan (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$480 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
25% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary |
Brand New Day Select Choice I Plan (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Brand New Day Select Choice I Plan (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$480 |
Some Generics |
5 |
Specialty Tier |
25% | n/a | P Q:30 /30Days | $1,626.39 |
Browse Plan Formulary |
Central Health Medi-Medi Plan (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Central Health Medi-Medi Plan (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$480 |
Many Generics, Some Brands |
5 |
Specialty Tier |
25% | n/a | P Q:30 /30Days | $1,631.99 |
Browse Plan Formulary |
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) |
$33.20 |
$480 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
25% | n/a | P Q:30 /30Days | $1,631.99 |
Browse Plan Formulary |
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) |
$33.20 |
$480 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
25% | n/a | P Q:30 /30Days | $1,631.99 |
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 |
Clever Care Balance Medicare Advantage (HMO)
![Email Prescription and/or Health Benefit details for Clever Care Balance Medicare Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$480 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
25% | 25% | P Q:30 /30Days | $1,638.06 |
Browse Plan Formulary select insulin pay $0-$35 copay but not this drug |
Clever Care Balance Medicare Advantage (HMO)
![Email Prescription and/or Health Benefit details for Clever Care Balance Medicare Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$480 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
25% | 25% | P Q:30 /30Days | $1,638.06 |
Browse Plan Formulary select insulin pay $0-$35 copay but not this drug |
Clever Care Balance Medicare Advantage (HMO)
![Email Prescription and/or Health Benefit details for Clever Care Balance Medicare Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$480 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
25% | 25% | P Q:30 /30Days | $1,638.06 |
Browse Plan Formulary select insulin pay $0-$35 copay but not this drug |
SCAN Connections (HMO D-SNP)
![Email Prescription and/or Health Benefit details for SCAN Connections (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$480 |
Some Generics |
5 |
Specialty Tier |
25% | n/a | P | $1,623.48 |
Browse Plan Formulary |
SCAN Connections at Home (HMO D-SNP)
![Email Prescription and/or Health Benefit details for SCAN Connections at Home (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$480 |
Some Generics |
5 |
Specialty Tier |
25% | n/a | P | $1,623.48 |
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) |
$33.20 |
$480 |
No |
5 |
Specialty Tier |
25% | n/a | P | $1,623.48 |
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 |
SCAN Plus (HMO)
![Email Prescription and/or Health Benefit details for SCAN Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$480 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
25% | n/a | P | $1,623.48 |
Browse Plan Formulary |
VillageHealth (HMO-POS C-SNP)
![Email Prescription and/or Health Benefit details for VillageHealth (HMO-POS C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$480 |
No |
5 |
Specialty Tier |
25% | n/a | P | $1,623.48 |
Browse Plan Formulary |
VillageHealth (HMO-POS C-SNP)
![Email Prescription and/or Health Benefit details for VillageHealth (HMO-POS C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$480 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
25% | n/a | P | $1,623.48 |
Browse Plan Formulary |