RISPERDAL CONSTA 37.5MG SYR (37.5 MG VIAL DSPK) (NDC: 50458030711)
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 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage (HMO-POS)](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 | None | $941.67 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Choice (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Choice (PPO)](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 | None | $947.82 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Choice Plan 2 (Regional PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Choice Plan 2 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$195 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
30% | n/a | None | $937.62 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Premier (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Premier (HMO-POS)](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 | None | $939.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Advantage Care by Ultimate (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Advantage Care by Ultimate (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Specialty Tier |
33% | n/a | None | $862.69 |
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 Care by Ultimate (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Advantage Care by Ultimate (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Specialty Tier |
33% | n/a | None | $861.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Advantage Care CHF by Ultimate (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Advantage Care CHF by Ultimate (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Specialty Tier |
33% | n/a | None | $862.07 |
Browse Plan Formulary all covered insulin pay $35 or less |
Advantage Care COPD by Ultimate (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Advantage Care COPD by Ultimate (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Specialty Tier |
33% | n/a | None | $864.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Credit (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Credit (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 | Q:2 /28Days | $947.54 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Premier (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$300 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
28% | n/a | Q:2 /28Days | $949.19 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Premier Plus (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$150 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
30% | n/a | Q:2 /28Days | $947.59 |
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 Select (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Select (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 | Q:2 /28Days | $947.54 |
Browse Plan Formulary all covered insulin pay $35 or less |
BlueMedicare Classic (HMO)
![Email Prescription and/or Health Benefit details for BlueMedicare Classic (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 Drug |
$93.00 | $279.00 | Q:2 /28Days | $924.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
BlueMedicare Premier (HMO)
![Email Prescription and/or Health Benefit details for BlueMedicare Premier (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 Drug |
$90.00 | $270.00 | Q:2 /28Days | $911.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
BlueMedicare Value (PPO)
![Email Prescription and/or Health Benefit details for BlueMedicare Value (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$150 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:2 /28Days | $895.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
CareBreeze Platinum (HMO-POS C-SNP)
![Email Prescription and/or Health Benefit details for CareBreeze Platinum (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. |
5 |
Specialty Tier |
33% | n/a | Q:2 /28Days | $941.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
CareComplete Platinum (HMO-POS C-SNP)
![Email Prescription and/or Health Benefit details for CareComplete Platinum (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. |
5 |
Specialty Tier |
33% | n/a | Q:2 /28Days | $941.24 |
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 |
CareOne Plus (HMO)
![Email Prescription and/or Health Benefit details for CareOne Plus (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 | Q:2 /28Days | $948.51 |
Browse Plan Formulary all covered insulin pay $35 or less |
CareOne Plus (HMO)
![Email Prescription and/or Health Benefit details for CareOne Plus (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 | Q:2 /28Days | $941.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
![Email Prescription and/or Health Benefit details for Cigna Preferred Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | n/a | Q:2 /28Days | $933.19 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Savings Medicare (HMO)
![Email Prescription and/or Health Benefit details for Cigna Preferred Savings Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | n/a | Q:2 /28Days | $933.19 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | n/a | Q:2 /28Days | $933.19 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE GIVEBACK Tampa (PPO)
![Email Prescription and/or Health Benefit details for Devoted CHOICE GIVEBACK Tampa (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$150 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
30% | n/a | Q:2 /28Days | $842.36 |
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 |
Devoted CORE Tampa (HMO)
![Email Prescription and/or Health Benefit details for Devoted CORE Tampa (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 | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Tampa (HMO)
![Email Prescription and/or Health Benefit details for Devoted CORE Tampa (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 | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted ESSENTIALS Tampa (HMO)
![Email Prescription and/or Health Benefit details for Devoted ESSENTIALS Tampa (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 | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted ESSENTIALS Tampa (HMO)
![Email Prescription and/or Health Benefit details for Devoted ESSENTIALS Tampa (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 | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Freedom VIP Care (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Freedom VIP Care (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Specialty Tier |
33% | n/a | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Freedom VIP Savings (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Freedom VIP Savings (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Specialty Tier |
33% | n/a | Q:2 /28Days | $842.36 |
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 |
Freedom VIP Savings COPD (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Freedom VIP Savings COPD (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Specialty Tier |
33% | n/a | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Humana Gold Plus - Diabetes and Heart (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 | Q:2 /28Days | $948.51 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Humana Gold Plus - Diabetes and Heart (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 | Q:2 /28Days | $948.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1036-025 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1036-025 (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 | Q:2 /28Days | $948.51 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1036-265 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1036-265 (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 | Q:2 /28Days | $941.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1036-265 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1036-265 (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 | Q:2 /28Days | $948.51 |
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 Florida H5216-072 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice Florida H5216-072 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$150 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
30% | n/a | Q:2 /28Days | $947.51 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice Florida H5216-304 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice Florida H5216-304 (PPO)](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 | Q:2 /28Days | $947.51 |
Browse Plan Formulary all covered insulin pay $35 or less |
Optimum Diamond Rewards (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Optimum Diamond Rewards (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Specialty Tier |
33% | n/a | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Optimum Diamond Rewards COPD (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Optimum Diamond Rewards COPD (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Specialty Tier |
33% | n/a | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Optimum Gold Plus Plan (HMO)
![Email Prescription and/or Health Benefit details for Optimum Gold Plus Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Specialty Tier |
33% | n/a | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Optimum Gold Rewards Plan (HMO)
![Email Prescription and/or Health Benefit details for Optimum Gold Rewards Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Specialty Tier |
33% | n/a | Q:2 /28Days | $842.36 |
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 |
Optimum Platinum Plan (HMO)
![Email Prescription and/or Health Benefit details for Optimum Platinum Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Specialty Tier |
33% | n/a | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Premier by Ultimate (HMO)
![Email Prescription and/or Health Benefit details for Premier by Ultimate (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Specialty Tier |
33% | n/a | None | $861.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Premier Plus by Ultimate (HMO)
![Email Prescription and/or Health Benefit details for Premier Plus by Ultimate (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Specialty Tier |
33% | n/a | None | $861.72 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Care (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Simply Care (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 |
5 |
Specialty Tier |
25% | n/a | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Comfort (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Simply Comfort (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$505 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
25% | n/a | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Extra (HMO)
![Email Prescription and/or Health Benefit details for Simply Extra (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 | Q:2 /28Days | $842.36 |
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 |
Simply Freedom (PPO)
![Email Prescription and/or Health Benefit details for Simply Freedom (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$150 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
30% | n/a | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Freedom Extra (PPO)
![Email Prescription and/or Health Benefit details for Simply Freedom Extra (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$150 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
30% | n/a | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Level (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Simply Level (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 | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply More (HMO)
![Email Prescription and/or Health Benefit details for Simply More (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 | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare Medicare Advantage Walgreens (HMO-POS C-SNP)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Medicare Advantage Walgreens (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. |
5 |
Specialty Tier |
33% | n/a | None | $876.14 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare Medicare Advantage Walgreens (HMO-POS C-SNP)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Medicare Advantage Walgreens (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. |
5 |
Specialty Tier |
33% | n/a | None | $948.15 |
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)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Medicare Advantage Walgreens (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. |
5 |
Specialty Tier |
33% | n/a | None | $902.41 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare Medicare Advantage Walgreens (HMO-POS C-SNP)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Medicare Advantage Walgreens (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. |
5 |
Specialty Tier |
33% | n/a | None | $946.27 |
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. |
5 |
Specialty Tier |
33% | n/a | Q:2 /28Days | $963.02 |
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. |
5 |
Specialty Tier |
33% | n/a | Q:2 /28Days | $963.02 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$100 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
31% | n/a | Q:2 /28Days | $963.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Specialty Giveback (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Wellcare Specialty Giveback (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 | Q:2 /28Days | $963.02 |
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 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 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | Q:2 /28Days | $963.02 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice R5826-074 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-074 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$395 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
26% | n/a | Q:2 /28Days | $948.66 |
Browse Plan Formulary all covered insulin pay $35 or less |
CareNeeds Plus (HMO D-SNP)
![Email Prescription and/or Health Benefit details for CareNeeds Plus (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
25% | n/a | Q:2 /28Days | $947.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Cigna TotalCare Plus (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
$0.00 | $0.00 | Q:2 /28Days | $933.19 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Primary Medicare (HMO)
![Email Prescription and/or Health Benefit details for Cigna Primary Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.60 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
25% | n/a | Q:2 /28Days | $933.19 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
![Email Prescription and/or Health Benefit details for Wellcare Dual Access Open (PPO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.60 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
$0.00 | $0.00 | Q:2 /28Days | $964.42 |
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 |
Cigna TotalCare (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Cigna TotalCare (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
15% | 15% | Q:2 /28Days | $934.05 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H1036-102 (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Humana Gold Plus SNP-DE H1036-102 (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
25% | n/a | Q:2 /28Days | $948.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Assure (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Aetna Medicare Assure (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
25% | n/a | Q:2 /28Days | $948.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Fully Integrated H1036-280 (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Humana Fully Integrated H1036-280 (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.80 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
25% | n/a | Q:2 /28Days | $947.72 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Tampa (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Devoted DUAL Tampa (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.20 |
$505 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
25% | n/a | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Assure Plus (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Aetna Medicare Assure Plus (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.40 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
25% | n/a | Q:2 /28Days | $947.54 |
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 PRIME (HMO)
![Email Prescription and/or Health Benefit details for Devoted PRIME (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$505 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
25% | n/a | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted PRIME (HMO)
![Email Prescription and/or Health Benefit details for Devoted PRIME (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$505 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
25% | n/a | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted PRIME (HMO)
![Email Prescription and/or Health Benefit details for Devoted PRIME (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$505 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
25% | n/a | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted PRIME (HMO)
![Email Prescription and/or Health Benefit details for Devoted PRIME (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$505 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
25% | n/a | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted PRIME (HMO)
![Email Prescription and/or Health Benefit details for Devoted PRIME (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$505 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
25% | n/a | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Reserve (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Wellcare Dual Reserve (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.60 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
15% | 15% | Q:2 /28Days | $964.54 |
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 (Full) (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Advantage Plus by Ultimate (Full) (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Specialty Tier |
25% | n/a | None | $864.50 |
Browse Plan Formulary all covered insulin pay $35 or less |
Advantage Plus by Ultimate (Partial) (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Advantage Plus by Ultimate (Partial) (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Specialty Tier |
25% | n/a | None | $864.50 |
Browse Plan Formulary all covered insulin pay $35 or less |
BlueMedicare Complete (HMO D-SNP)
![Email Prescription and/or Health Benefit details for BlueMedicare Complete (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
25% | 25% | Q:2 /28Days | $913.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Freedom Medi-Medi Full (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Freedom Medi-Medi Full (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Specialty Tier |
25% | n/a | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Freedom Medi-Medi Partial (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Freedom Medi-Medi Partial (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Specialty Tier |
25% | n/a | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Longevity Health Plan (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Longevity Health Plan (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | n/a | Q:2 /28Days | $867.44 |
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 |
Optimum Emerald Full (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Optimum Emerald Full (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Specialty Tier |
25% | n/a | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Optimum Emerald Partial (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Optimum Emerald Partial (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Specialty Tier |
25% | n/a | Q:2 /28Days | $842.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Complete (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Simply Complete (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
25% | n/a | Q:2 /28Days | $881.23 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare Assisted Living Plan (PPO I-SNP)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Assisted Living Plan (PPO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.90 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | n/a | None | $935.43 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare Dual Complete Choice (PPO D-SNP)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Dual Complete Choice (PPO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
15% | 15% | None | $937.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare Dual Complete Choice (PPO D-SNP)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Dual Complete Choice (PPO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
15% | 15% | None | $937.90 |
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 Dual Complete LP (HMO-POS D-SNP)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Dual Complete LP (HMO-POS D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
15% | 15% | None | $940.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare Dual Complete ONE (HMO-POS D-SNP)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Dual Complete ONE (HMO-POS D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
$0.00 | $0.00 | None | $942.88 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare Dual Complete RP (Regional PPO D-SNP)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Dual Complete RP (Regional PPO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
15% | 15% | None | $937.62 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare Nursing Home Plan (PPO I-SNP)
![Email Prescription and/or Health Benefit details for UnitedHealthcare Nursing Home Plan (PPO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | 25% | None | $939.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Wellcare Dual Access (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
$0.00 | $0.00 | Q:2 /28Days | $964.39 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Wellcare Dual Liberty (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
$0.00 | $0.00 | Q:2 /28Days | $964.39 |
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 |
BlueMedicare Choice (Regional PPO)
![Email Prescription and/or Health Benefit details for BlueMedicare Choice (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.90 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$93.00 | $279.00 | Q:2 /28Days | $944.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Premium Enhanced Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Premium Enhanced Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$99.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | Q:2 /28Days | $963.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice R5826-005 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-005 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$111.00 |
$100 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
31% | n/a | Q:2 /28Days | $948.66 |
Browse Plan Formulary all covered insulin pay $35 or less |