LINZESS 290 MCG CAPSULE (30 EA ) (NDC: 00456120230)
2023 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 Medicare Advantage Choice (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$45.00 | $125.00 | Q:30 /30Days | $562.58 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Choice Plan 2 (Regional PPO)
|
$0.00 |
$195 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days | $561.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Advantage Care by Ultimate (HMO C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Preferred Brand |
$20.00 | $40.00 | Q:30 /30Days | $501.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Advantage Care COPD by Ultimate (HMO C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Preferred Brand |
$20.00 | $40.00 | Q:30 /30Days | $501.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Premier (PPO)
|
$0.00 |
$300 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:30 /30Days | $556.26 |
Browse Plan Formulary all covered insulin pay $35 or less |
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)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:30 /30Days | $556.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Select (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$90.00 | $270.00 | Q:30 /30Days | $556.05 |
Browse Plan Formulary all covered insulin pay $35 or less |
BlueMedicare Classic (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$40.00 | $120.00 | Q:30 /30Days | $563.01 |
Browse Plan Formulary all covered insulin pay $35 or less |
BlueMedicare Premier (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$35.00 | $105.00 | Q:30 /30Days | $565.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
BlueMedicare Value (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | Q:30 /30Days | $565.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
Bright Advantage Health Dollars Plan (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$0.00 | $0.00 | Q:30 /30Days | n/a |
Browse Plan Formulary all covered insulin pay $35 or less |
|
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 |
Bright Advantage Part B Savings Plan (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $94.00 | Q:30 /30Days | n/a |
Browse Plan Formulary all covered insulin pay $35 or less |
Bright Advantage Part B Savings Plan (PPO)
|
$0.00 |
$110 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $94.00 | Q:30 /30Days | n/a |
Browse Plan Formulary all covered insulin pay $35 or less |
CareBreeze (HMO C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$35.00 | $95.00 | Q:30 /30Days | $556.32 |
Browse Plan Formulary all covered insulin pay $35 or less |
CareBreeze Platinum (HMO C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$40.00 | $110.00 | Q:30 /30Days | $556.32 |
Browse Plan Formulary all covered insulin pay $35 or less |
CareComplete (HMO C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$35.00 | $95.00 | Q:30 /30Days | $556.32 |
Browse Plan Formulary all covered insulin pay $35 or less |
CareComplete Platinum (HMO C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$40.00 | $110.00 | Q:30 /30Days | $556.32 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
CareFree (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$35.00 | $95.00 | Q:30 /30Days | $556.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
CareFree (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$35.00 | $95.00 | Q:30 /30Days | $556.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
CareFree Platinum (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$45.00 | $125.00 | Q:30 /30Days | $556.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
CareOne Platinum (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$30.00 | $80.00 | Q:30 /30Days | $556.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
CareOne Plus (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$25.00 | $65.00 | Q:30 /30Days | $556.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$25.00 | $75.00 | Q:30 /30Days | $559.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
Cigna Preferred Savings Medicare (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $126.00 | Q:30 /30Days | $559.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$40.00 | $120.00 | Q:30 /30Days | $559.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE North Florida (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:30 /30Days | $493.32 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE North Florida (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$85.00 | $255.00 | Q:30 /30Days | $493.32 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted ESSENTIALS North Florida (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$85.00 | $255.00 | Q:30 /30Days | $493.32 |
Browse Plan Formulary all covered insulin pay $35 or less |
Freedom Platinum Plan Rx (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Non-Preferred Drug |
$70.00 | $140.00 | Q:30 /30Days | $493.32 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 Platinum Rewards Plan Rx (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Non-Preferred Drug |
$85.00 | $170.00 | Q:30 /30Days | $493.32 |
Browse Plan Formulary all covered insulin pay $35 or less |
Freedom VIP Care (HMO C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Non-Preferred Drug |
$55.00 | $110.00 | Q:30 /30Days | $493.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Freedom VIP Savings (HMO C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Non-Preferred Drug |
$65.00 | $130.00 | Q:30 /30Days | $493.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Freedom VIP Savings COPD (HMO C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Non-Preferred Drug |
$60.00 | $120.00 | Q:30 /30Days | $493.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Community (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$30.00 | $80.00 | Q:30 /30Days | $556.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$45.00 | $125.00 | Q:30 /30Days | $556.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 H1036-146 (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$30.00 | $80.00 | Q:30 /30Days | $556.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1036-269 (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$35.00 | $95.00 | Q:30 /30Days | $556.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice Florida H5216-074 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days | $556.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice Florida H5216-304 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days | $556.34 |
Browse Plan Formulary all covered insulin pay $35 or less |
Optimum Diamond Savings (HMO C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Non-Preferred Drug |
$80.00 | $160.00 | Q:30 /30Days | $493.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Optimum Diamond Savings COPD (HMO C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Non-Preferred Drug |
$80.00 | $160.00 | Q:30 /30Days | $493.34 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 Gold Rewards Plan (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Non-Preferred Drug |
$85.00 | $170.00 | Q:30 /30Days | $493.32 |
Browse Plan Formulary all covered insulin pay $35 or less |
Premier by Ultimate (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Preferred Brand |
$30.00 | $60.00 | Q:30 /30Days | $501.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Freedom (PPO)
|
$0.00 |
$125* | Yes, but No Gap Coverage for this drug. | 3* |
Preferred Brand |
$47.00 | $141.00 | Q:30 /30Days | $493.32 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare Medicare Advantage Walgreens (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days | $561.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare Medicare Advantage Walgreens (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days | $563.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare Medicare Advantage Walgreens (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days | $562.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 Medicare Advantage Walgreens (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days | $562.23 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare The Villages Medicare Advantage (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$45.00 | $125.00 | Q:30 /30Days | $562.58 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare The Villages Medicare Focus (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$40.00 | $110.00 | Q:30 /30Days | $562.58 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$80.00 | $160.00 | Q:30 /30Days | $561.31 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$65.00 | $130.00 | Q:30 /30Days | $561.31 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$90.00 | $180.00 | Q:30 /30Days | $561.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 R5826-074 (Regional PPO)
|
$4.00 |
$395 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days | $556.88 |
Browse Plan Formulary all covered insulin pay $35 or less |
CareNeeds Plus (HMO D-SNP)
|
$14.70 |
$505 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days | $556.31 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Primary Medicare (HMO)
|
$17.20 |
$505 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
20% | 20% | Q:30 /30Days | $559.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$18.60 |
$505 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | Q:30 /30Days | $565.28 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$19.60 |
$505 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:30 /30Days | $558.81 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$20.70 |
$505 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:30 /30Days | $559.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 Assure Plus (HMO D-SNP)
|
$22.40 |
$505 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
37% | 37% | Q:30 /30Days | $556.05 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H1036-213 (HMO D-SNP)
|
$27.00 |
$505 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days | $556.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Fully Integrated H1036-280 (HMO D-SNP)
|
$28.80 |
$505 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days | $556.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Freedom Platinum Plus Plan Rx (HMO)
|
$30.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Non-Preferred Drug |
$60.00 | $120.00 | Q:30 /30Days | $493.32 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL North Florida (HMO D-SNP)
|
$31.20 |
$505 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
25% | 25% | Q:30 /30Days | $493.32 |
Browse Plan Formulary all covered insulin pay $35 or less |
Advantage Plus by Ultimate (Full) (HMO D-SNP)
|
$35.90 |
$505 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
25% | 25% | Q:30 /30Days | $502.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
Advantage Plus by Ultimate (Partial) (HMO D-SNP)
|
$35.90 |
$505 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
25% | 25% | Q:30 /30Days | $502.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
BlueMedicare Complete (HMO D-SNP)
|
$35.90 |
$505 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | Q:30 /30Days | $562.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Bright Advantage Embrace Assist Plan (HMO C-SNP)
|
$35.90 |
$505 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
25% | 25% | Q:30 /30Days | n/a |
Browse Plan Formulary all covered insulin pay $35 or less |
Bright Advantage Embrace Choice Plan (HMO C-SNP)
|
$35.90 |
$505 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
25% | 25% | Q:30 /30Days | n/a |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted PREMIUM (HMO)
|
$35.90 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:30 /30Days | $493.32 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted PREMIUM (HMO)
|
$35.90 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:30 /30Days | $493.32 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
Devoted PREMIUM (HMO)
|
$35.90 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:30 /30Days | $493.32 |
Browse Plan Formulary all covered insulin pay $35 or less |
Freedom Medi-Medi Full (HMO D-SNP)
|
$35.90 |
$505 | No additional gap coverage, only the Donut Hole Discount | 3 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:30 /30Days | $493.39 |
Browse Plan Formulary all covered insulin pay $35 or less |
Freedom Medi-Medi Partial (HMO D-SNP)
|
$35.90 |
$505 | No additional gap coverage, only the Donut Hole Discount | 3 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:30 /30Days | $493.39 |
Browse Plan Formulary all covered insulin pay $35 or less |
Longevity Health Plan (HMO I-SNP)
|
$35.90 |
$505 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | n/a | Q:30 /30Days | $489.66 |
Browse Plan Formulary all covered insulin pay $35 or less |
Optimum Emerald Full (HMO D-SNP)
|
$35.90 |
$505 | No additional gap coverage, only the Donut Hole Discount | 3 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:30 /30Days | $493.39 |
Browse Plan Formulary all covered insulin pay $35 or less |
Optimum Emerald Partial (HMO D-SNP)
|
$35.90 |
$505 | No additional gap coverage, only the Donut Hole Discount | 3 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:30 /30Days | $493.39 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 Assisted Living Plan (PPO I-SNP)
|
$35.90 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days | $561.47 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare Dual Complete Choice (PPO D-SNP)
|
$35.90 |
$505 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:30 /30Days | $561.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare Dual Complete Choice (PPO D-SNP)
|
$35.90 |
$505 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:30 /30Days | $561.31 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare Dual Complete LP (HMO-POS D-SNP)
|
$35.90 |
$505 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:30 /30Days | $561.32 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare Dual Complete ONE (HMO-POS D-SNP)
|
$35.90 |
$505 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:30 /30Days | $560.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare Dual Complete RP (Regional PPO D-SNP)
|
$35.90 |
$505 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:30 /30Days | $561.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 I-SNP)
|
$35.90 |
$505 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:30 /30Days | $561.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$35.90 |
$505 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | Q:30 /30Days | $565.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$35.90 |
$505 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | Q:30 /30Days | $565.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Select (HMO D-SNP)
|
$35.90 |
$505 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | Q:30 /30Days | $565.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
BlueMedicare Choice (Regional PPO)
|
$49.90 |
$250 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$40.00 | $120.00 | Q:30 /30Days | $562.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice Florida H7284-001 (PPO)
|
$84.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days | $555.66 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 Premium Enhanced Open (PPO)
|
$99.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$90.00 | $180.00 | Q:30 /30Days | $561.92 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice R5826-005 (Regional PPO)
|
$111.00 |
$100 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $125.00 | Q:30 /30Days | $556.88 |
Browse Plan Formulary all covered insulin pay $35 or less |