TRESIBA 100 UNIT/ML VIAL (10 mls ) (NDC: 00169266211)
2023 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 |
AARP Medicare Advantage Choice Plan 2 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Choice Plan 2 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $131.00 | None | $366.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Choice Plan 2 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Choice Plan 2 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $131.00 | None | $366.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Freedom Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Freedom Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $95.00 | None | $366.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Freedom Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Freedom Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $95.00 | None | $366.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Harmony (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Harmony (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $95.00 | None | $366.93 |
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 |
AARP Medicare Advantage Harmony (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Harmony (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $95.00 | None | $366.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Rebate (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Rebate (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $131.00 | None | $366.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Rebate (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Rebate (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $131.00 | None | $366.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage SecureHorizons Focus (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage SecureHorizons Focus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $95.00 | None | $366.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage SecureHorizons Focus (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage SecureHorizons Focus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $95.00 | None | $366.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Plus Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Plus Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $111.00 | None | $366.01 |
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 Plus Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Plus Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $111.00 | None | $366.01 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Prime Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Prime Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $141.00 | None | $366.02 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Prime Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Prime Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $141.00 | None | $366.02 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Select Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Select Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $141.00 | None | $366.01 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Select Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Select Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $141.00 | None | $366.01 |
Browse Plan Formulary all covered insulin pay $35 or less |
Align Connect (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Align Connect (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$35 max* | $135.00 | None | $428.31 |
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 |
Align Connect (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Align Connect (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$35 max* | $135.00 | None | $428.31 |
Browse Plan Formulary all covered insulin pay $35 or less |
Align Thrive (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Align Thrive (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$35 max* | $135.00 | None | $428.31 |
Browse Plan Formulary all covered insulin pay $35 or less |
Align Thrive (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Align Thrive (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$35 max* | $135.00 | None | $428.31 |
Browse Plan Formulary all covered insulin pay $35 or less |
Alignment Health AVA (HMO-POS)
![Email Prescription and/or Health Benefit details for Alignment Health AVA (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $120.00 | Q:60 /30Days | $349.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
Alignment Health AVA (HMO-POS)
![Email Prescription and/or Health Benefit details for Alignment Health AVA (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $120.00 | Q:60 /30Days | $349.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
Alignment Health AVA (PPO)
![Email Prescription and/or Health Benefit details for Alignment Health AVA (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $120.00 | Q:60 /30Days | $350.39 |
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 |
Alignment Health AVA (PPO)
![Email Prescription and/or Health Benefit details for Alignment Health AVA (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $120.00 | Q:60 /30Days | $350.39 |
Browse Plan Formulary all covered insulin pay $35 or less |
Alignment Health CalPlus + Veterans (HMO)
![Email Prescription and/or Health Benefit details for Alignment Health CalPlus + Veterans (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$35 max* | 25% | Q:60 /30Days | $348.87 |
Browse Plan Formulary all covered insulin pay $35 or less |
Alignment Health CalPlus + Veterans (HMO)
![Email Prescription and/or Health Benefit details for Alignment Health CalPlus + Veterans (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$35 max* | 25% | Q:60 /30Days | $348.87 |
Browse Plan Formulary all covered insulin pay $35 or less |
Alignment Health ESRD Balance (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Alignment Health ESRD 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. |
3 |
Preferred Brand |
$35 max* | $120.00 | Q:60 /30Days | $349.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Alignment Health ESRD Balance (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Alignment Health ESRD 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. |
3 |
Preferred Brand |
$35 max* | $120.00 | Q:60 /30Days | $349.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Alignment Health Harmony (HMO)
![Email Prescription and/or Health Benefit details for Alignment Health Harmony (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $120.00 | Q:60 /30Days | $349.03 |
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 |
Alignment Health Harmony (HMO)
![Email Prescription and/or Health Benefit details for Alignment Health Harmony (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $120.00 | Q:60 /30Days | $349.03 |
Browse Plan Formulary all covered insulin pay $35 or less |
Alignment Health Heart & Diabetes (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Alignment Health Heart & Diabetes (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $75.00 | Q:60 /30Days | $349.12 |
Browse Plan Formulary all covered insulin pay $35 or less |
Alignment Health Heart & Diabetes (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Alignment Health Heart & Diabetes (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $75.00 | Q:60 /30Days | $349.12 |
Browse Plan Formulary all covered insulin pay $35 or less |
Alignment Health My Choice (HMO)
![Email Prescription and/or Health Benefit details for Alignment Health My Choice (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $75.00 | Q:60 /30Days | $349.23 |
Browse Plan Formulary all covered insulin pay $35 or less |
Alignment Health My Choice (HMO)
![Email Prescription and/or Health Benefit details for Alignment Health My Choice (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $75.00 | Q:60 /30Days | $349.23 |
Browse Plan Formulary all covered insulin pay $35 or less |
Alignment Health My Choice CalPlus (HMO)
![Email Prescription and/or Health Benefit details for Alignment Health My Choice CalPlus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $120.00 | Q:60 /30Days | $348.41 |
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 |
Alignment Health My Choice CalPlus (HMO)
![Email Prescription and/or Health Benefit details for Alignment Health My Choice CalPlus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $120.00 | Q:60 /30Days | $348.41 |
Browse Plan Formulary all covered insulin pay $35 or less |
Alignment Health Platinum (HMO)
![Email Prescription and/or Health Benefit details for Alignment Health Platinum (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $75.00 | Q:60 /30Days | $349.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Alignment Health Platinum (HMO)
![Email Prescription and/or Health Benefit details for Alignment Health Platinum (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $75.00 | Q:60 /30Days | $349.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Alignment Health smartHMO (HMO)
![Email Prescription and/or Health Benefit details for Alignment Health smartHMO (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $75.00 | Q:60 /30Days | $349.90 |
Browse Plan Formulary all covered insulin pay $35 or less |
Alignment Health smartHMO (HMO)
![Email Prescription and/or Health Benefit details for Alignment Health smartHMO (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $75.00 | Q:60 /30Days | $349.90 |
Browse Plan Formulary all covered insulin pay $35 or less |
Alignment Health the ONE + Rite Aid (HMO)
![Email Prescription and/or Health Benefit details for Alignment Health the ONE + Rite Aid (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $120.00 | Q:60 /30Days | $349.13 |
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 |
Alignment Health the ONE + Rite Aid (HMO)
![Email Prescription and/or Health Benefit details for Alignment Health the ONE + Rite Aid (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $120.00 | Q:60 /30Days | $349.13 |
Browse Plan Formulary all covered insulin pay $35 or less |
Anthem MediBlue Dual Advantage (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Anthem MediBlue Dual Advantage (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$380 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$35 max* | $141.00 | Q:30 /30Days | $378.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Anthem MediBlue Dual Advantage (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Anthem MediBlue Dual Advantage (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$380 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$35 max* | $141.00 | Q:30 /30Days | $378.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Anthem MediBlue Full Dual Advantage (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Anthem MediBlue Full Dual Advantage (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$35 max* | $141.00 | Q:30 /30Days | $378.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Anthem MediBlue Full Dual Advantage (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Anthem MediBlue Full Dual Advantage (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$35 max* | $141.00 | Q:30 /30Days | $378.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Anthem MediBlue Plus (HMO)
![Email Prescription and/or Health Benefit details for Anthem MediBlue Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $126.00 | Q:30 /30Days | $378.61 |
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 |
Anthem MediBlue Plus (HMO)
![Email Prescription and/or Health Benefit details for Anthem MediBlue Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $126.00 | Q:30 /30Days | $378.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
Anthem MediBlue Select (HMO)
![Email Prescription and/or Health Benefit details for Anthem MediBlue Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $84.00 | Q:30 /30Days | $378.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
Anthem MediBlue Select (HMO)
![Email Prescription and/or Health Benefit details for Anthem MediBlue Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $84.00 | Q:30 /30Days | $378.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Shield 65 Plus (HMO)
![Email Prescription and/or Health Benefit details for Blue Shield 65 Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $95.00 | Q:30 /30Days | $352.98 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Shield 65 Plus (HMO)
![Email Prescription and/or Health Benefit details for Blue Shield 65 Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $95.00 | Q:30 /30Days | $352.98 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Shield 65 Plus Plan 2 (HMO)
![Email Prescription and/or Health Benefit details for Blue Shield 65 Plus Plan 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $100.00 | Q:30 /30Days | $352.75 |
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 |
Blue Shield 65 Plus Plan 2 (HMO)
![Email Prescription and/or Health Benefit details for Blue Shield 65 Plus Plan 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $100.00 | Q:30 /30Days | $352.75 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Shield Balance (HMO)
![Email Prescription and/or Health Benefit details for Blue Shield Balance (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $87.50 | Q:30 /30Days | $353.16 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Shield Balance (HMO)
![Email Prescription and/or Health Benefit details for Blue Shield Balance (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $87.50 | Q:30 /30Days | $353.16 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Shield Inspire (HMO)
![Email Prescription and/or Health Benefit details for Blue Shield Inspire (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $87.50 | Q:30 /30Days | $352.98 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Shield Inspire (HMO)
![Email Prescription and/or Health Benefit details for Blue Shield Inspire (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $87.50 | Q:30 /30Days | $352.98 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-021 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5619-021 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $70.00 | None | $367.42 |
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 H5619-021 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5619-021 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $70.00 | None | $367.42 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-146 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5619-146 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $94.00 | None | $367.42 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-146 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5619-146 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $94.00 | None | $367.42 |
Browse Plan Formulary all covered insulin pay $35 or less |
Imperial Dynamic Plan (HMO)
![Email Prescription and/or Health Benefit details for Imperial Dynamic Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $75.00 | None | $332.56 |
Browse Plan Formulary all covered insulin pay $35 or less |
Imperial Dynamic Plan (HMO)
![Email Prescription and/or Health Benefit details for Imperial Dynamic Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $75.00 | None | $332.56 |
Browse Plan Formulary all covered insulin pay $35 or less |
Imperial Senior Value (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Imperial Senior Value (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $90.00 | None | $332.56 |
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 |
Imperial Senior Value (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Imperial Senior Value (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $90.00 | None | $332.56 |
Browse Plan Formulary all covered insulin pay $35 or less |
Imperial Strong (HMO)
![Email Prescription and/or Health Benefit details for Imperial Strong (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
$35 max* | 25% | None | $332.56 |
Browse Plan Formulary all covered insulin pay $35 or less |
Imperial Strong (HMO)
![Email Prescription and/or Health Benefit details for Imperial Strong (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
$35 max* | 25% | None | $332.56 |
Browse Plan Formulary all covered insulin pay $35 or less |
Imperial Traditional (HMO)
![Email Prescription and/or Health Benefit details for Imperial Traditional (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $90.00 | None | $332.56 |
Browse Plan Formulary all covered insulin pay $35 or less |
Imperial Traditional (HMO)
![Email Prescription and/or Health Benefit details for Imperial Traditional (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $90.00 | None | $332.56 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$35 max* | $94.00 | None | $324.58 |
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 |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$35 max* | $94.00 | None | $324.58 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care Select (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$450 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$35 max* | $94.00 | None | $324.58 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care Select (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$450 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$35 max* | $94.00 | None | $324.58 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare Chronic Complete (HMO-POS C-SNP)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Chronic Complete (HMO-POS C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $95.00 | None | $366.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare Chronic Complete (HMO-POS C-SNP)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Chronic Complete (HMO-POS C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $95.00 | None | $366.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $74.00 | None | $371.38 |
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 Giveback (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $74.00 | None | $371.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $74.00 | None | $371.38 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $74.00 | None | $371.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Focus (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Focus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
6 |
Select Diabetic Drugs |
$35 max* | $0.00 | None | $371.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Focus (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Focus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
6 |
Select Diabetic Drugs |
$35 max* | $0.00 | None | $371.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $74.00 | None | $371.34 |
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 |
Wellcare No Premium (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $74.00 | None | $371.34 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Best (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Best (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $50.00 | None | $371.34 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Best (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Best (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $50.00 | None | $371.34 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Specialty No Premium (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Wellcare Specialty No Premium (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
6 |
Select Diabetic Drugs |
$35 max* | $0.00 | None | $371.38 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Specialty No Premium (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Wellcare Specialty No Premium (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
6 |
Select Diabetic Drugs |
$35 max* | $0.00 | None | $371.38 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Align 001 (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Wellcare Dual Align 001 (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
$35 max* | $0.00 | None | $372.11 |
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 Dual Align 001 (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Wellcare Dual Align 001 (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
$35 max* | $0.00 | None | $372.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare Chronic Complete Focus (HMO C-SNP)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Chronic Complete Focus (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.30 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
$35 max* | 25% | None | $366.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare Chronic Complete Focus (HMO C-SNP)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Chronic Complete Focus (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.30 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
$35 max* | 25% | None | $366.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Low Premium (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Low Premium (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $74.00 | None | $371.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Low Premium (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Low Premium (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $74.00 | None | $371.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
Anthem MediBlue Extra (HMO)
![Email Prescription and/or Health Benefit details for Anthem MediBlue Extra (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.00 |
$505 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $141.00 | Q:30 /30Days | $378.49 |
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 |
Anthem MediBlue Extra (HMO)
![Email Prescription and/or Health Benefit details for Anthem MediBlue Extra (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.00 |
$505 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $141.00 | Q:30 /30Days | $378.49 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Align 129 (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Wellcare Dual Align 129 (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.10 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
$35 max* | $0.00 | None | $372.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Align 129 (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Wellcare Dual Align 129 (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.10 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
$35 max* | $0.00 | None | $372.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-149 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5619-149 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $80.00 | None | $367.42 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-149 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5619-149 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $80.00 | None | $367.42 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage SecureHorizons Premier (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage SecureHorizons Premier (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.90 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $131.00 | None | $366.93 |
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 |
AARP Medicare Advantage SecureHorizons Premier (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage SecureHorizons Premier (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.90 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $131.00 | None | $366.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
Align Premier (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Align Premier (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
$35 max* | 25% | None | $428.31 |
Browse Plan Formulary all covered insulin pay $35 or less |
Align Premier (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Align Premier (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
$35 max* | 25% | None | $428.31 |
Browse Plan Formulary all covered insulin pay $35 or less |
L.A. Care Medicare Plus (HMO D-SNP)
![Email Prescription and/or Health Benefit details for L.A. Care Medicare Plus (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.90 |
$505 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $141.00 | None | $418.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
L.A. Care Medicare Plus (HMO D-SNP)
![Email Prescription and/or Health Benefit details for L.A. Care Medicare Plus (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.90 |
$505 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $141.00 | None | $418.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Complete Care (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Molina Medicare Complete Care (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$35 max* | $120.00 | None | $324.58 |
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 |
Molina Medicare Complete Care (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Molina Medicare Complete Care (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$35 max* | $120.00 | None | $324.58 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Complete Care Plus (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Molina Medicare Complete Care Plus (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$35 max* | $120.00 | None | $324.58 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Complete Care Plus (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Molina Medicare Complete Care Plus (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$35 max* | $120.00 | None | $324.58 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Shield Enhanced (HMO)
![Email Prescription and/or Health Benefit details for Blue Shield Enhanced (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $87.50 | Q:30 /30Days | $352.98 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Shield Enhanced (HMO)
![Email Prescription and/or Health Benefit details for Blue Shield Enhanced (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $87.50 | Q:30 /30Days | $352.98 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Choice Plan 1 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Choice Plan 1 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $131.00 | None | $366.93 |
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 |
AARP Medicare Advantage Choice Plan 1 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Choice Plan 1 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $131.00 | None | $366.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Choice Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Choice Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$87.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $141.00 | None | $365.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Choice Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Choice Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$87.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$35 max* | $141.00 | None | $365.99 |
Browse Plan Formulary all covered insulin pay $35 or less |