ARMODAFINIL 250 MG TABLET [Nuvigil] (30 TABLETS ) (NDC: 65862080730)
2023 Medicare Prescription Drug Plan (MAPD) Information
Click here for the Chart Legend |
See your cost using a drug discount card: Compare prices at pharmacies near you |
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. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P Q:30 /30Days | $100.22 |
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. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P Q:30 /30Days | $100.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Choice (HMO-POS)
|
$0.00 |
$195 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P Q:30 /30Days | $96.31 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Credit (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P Q:30 /30Days | $95.23 |
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 | P Q:30 /30Days | $96.69 |
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 |
Aetna Medicare Select (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$35.00 | $105.00 | P Q:30 /30Days | $95.03 |
Browse Plan Formulary all covered insulin pay $35 or less |
Align Connect (HMO C-SNP)
|
$0.00 |
$505* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$2.00 | $6.00 | P Q:30 /30Days | $54.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
AvMed Medicare Access (HMO-POS)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$30.00 | $75.00 | P Q:30 /30Days | $145.87 |
Browse Plan Formulary all covered insulin pay $35 or less |
AvMed Medicare Choice (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$25.00 | $62.50 | P Q:30 /30Days | $145.87 |
Browse Plan Formulary all covered insulin pay $35 or less |
AvMed Medicare Circle (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$0.00 | $0.00 | P Q:30 /30Days | $145.87 |
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 |
$35.00 | $105.00 | P Q:30 /30Days | $60.99 |
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 Premier (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$0.00 | $0.00 | P Q:30 /30Days | $60.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
BlueMedicare Saver (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$25.00 | $75.00 | P Q:30 /30Days | $60.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
BlueMedicare Value (PPO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$47.00 | $141.00 | P Q:30 /30Days | $60.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Bright Advantage Classic Care Plan (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $200.00 | P Q:30 /30Days | n/a |
Browse Plan Formulary all covered insulin pay $35 or less |
Bright Advantage Embrace Care Plan (HMO C-SNP)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$90.00 | $180.00 | P Q:30 /30Days | n/a |
Browse Plan Formulary all covered insulin pay $35 or less |
Bright Advantage Part B Savings Plan (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $200.00 | P 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 New Day (HMO-POS)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$5.00 | $10.00 | P Q:30 /30Days | n/a |
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 |
$0.00 | $0.00 | P Q:30 /30Days | $83.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Savings Medicare (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$10.00 | $30.00 | P Q:30 /30Days | $83.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$42.00 | $126.00 | P Q:30 /30Days | $85.72 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Miami-Dade (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$0.00 | $0.00 | P Q:30 /30Days | $181.29 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted ESSENTIALS Miami-Dade (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$0.00 | $0.00 | P Q:30 /30Days | $181.29 |
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 |
DrExtraCare (HMO-POS C-SNP)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$40.00 | $120.00 | P Q:30 /30Days | $39.54 |
Browse Plan Formulary all covered insulin pay $35 or less |
DrMax (HMO-POS)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$45.00 | $135.00 | P Q:30 /30Days | $39.54 |
Browse Plan Formulary all covered insulin pay $35 or less |
DrValue (HMO-POS)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$90.00 | $270.00 | P Q:30 /30Days | $39.54 |
Browse Plan Formulary all covered insulin pay $35 or less |
Leon MediExtra (HMO)
|
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
1 |
Generic |
$0.00 | n/a | P Q:30 /30Days | $37.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
Leon MediMore (HMO)
|
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
1 |
Generic |
$0.00 | n/a | P Q:30 /30Days | $37.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
MedicareMax (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$65.00 | $185.00 | P Q:30 /30Days | $100.57 |
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 |
MedicareMax Chronic (HMO C-SNP)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$65.00 | $185.00 | P Q:30 /30Days | $100.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
|
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | P Q:30 /30Days | $127.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care Select (HMO)
|
$0.00 |
$450 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$20.00 | $40.00 | P Q:30 /30Days | $127.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Connect Care (HMO C-SNP)
|
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$45.00 | $135.00 | P Q:30 /30Days | $127.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
PHP (HMO C-SNP)
|
$0.00 |
$505 |
Yes, but No Gap Coverage for this drug. |
1 |
Generic |
15% | n/a | P Q:30 /30Days | $41.22 |
Browse Plan Formulary all covered insulin pay $35 or less |
Preferred Choice Dade (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$40.00 | $110.00 | P Q:30 /30Days | $100.57 |
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 |
Preferred Special Care Miami-Dade (HMO C-SNP)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$45.00 | $125.00 | P Q:30 /30Days | $100.57 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Care (HMO I-SNP)
|
$0.00 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$5.00 | n/a | P Q:30 /30Days | $77.82 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Comfort (HMO I-SNP)
|
$0.00 |
$505 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$5.00 | n/a | P Q:30 /30Days | $77.82 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Extra (HMO)
|
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | P Q:30 /30Days | $77.82 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Freedom (PPO)
|
$0.00 |
$125* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$10.00 | $0.00 | P Q:30 /30Days | $77.82 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Level (HMO C-SNP)
|
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | P Q:30 /30Days | $77.82 |
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 More (HMO)
|
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | P Q:30 /30Days | $77.82 |
Browse Plan Formulary all covered insulin pay $35 or less |
SOLIS SPF 001 (HMO)
|
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
1 |
Preferred Generic |
$0.00 | $0.00 | P Q:30 /30Days | $54.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
Solis SPF 003 (HMO)
|
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
1 |
Preferred Generic |
$0.00 | $0.00 | P Q:30 /30Days | $54.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$0.00 | $0.00 | P Q:30 /30Days | $7.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$0.00 | $0.00 | P Q:30 /30Days | $7.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Specialty Giveback (HMO C-SNP)
|
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | P Q:30 /30Days | $7.94 |
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 Access Open (PPO D-SNP)
|
$18.60 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
$0.00 | $0.00 | P Q:30 /30Days | $73.79 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$20.10 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
15% | 15% | P Q:30 /30Days | $85.72 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$20.10 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
$0.00 | $0.00 | P Q:30 /30Days | $85.72 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Assure Plus (HMO D-SNP)
|
$24.40 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
35% | 35% | P Q:30 /30Days | $182.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Reserve (HMO D-SNP)
|
$28.50 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
15% | 15% | P Q:30 /30Days | $74.58 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare Nursing Home Plan (HMO-POS I-SNP)
|
$30.80 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | P Q:30 /30Days | $98.39 |
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 |
Wellcare Dual Liberty (HMO D-SNP)
|
$30.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
$0.00 | $0.00 | P Q:30 /30Days | $74.58 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Assure (HMO D-SNP)
|
$32.00 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
37% | 37% | P Q:30 /30Days | $182.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted PRIME (HMO)
|
$32.00 |
$505* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$0.00 | $0.00 | P Q:30 /30Days | $180.38 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted PRIME (HMO)
|
$32.00 |
$505* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$0.00 | $0.00 | P Q:30 /30Days | $181.29 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted PRIME (HMO)
|
$32.00 |
$505* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$0.00 | $0.00 | P Q:30 /30Days | $181.29 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted PRIME (HMO)
|
$32.00 |
$505* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$0.00 | $0.00 | P Q:30 /30Days | $181.29 |
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)
|
$32.00 |
$505* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$0.00 | $0.00 | P Q:30 /30Days | $181.29 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$32.60 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
$0.00 | $0.00 | P Q:30 /30Days | $74.58 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Miami-Dade (HMO D-SNP)
|
$32.90 |
$505 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
25% | 25% | P Q:30 /30Days | $181.29 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Complete Care Select (HMO D-SNP)
|
$35.20 |
$505 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$47.00 | $141.00 | P Q:30 /30Days | $127.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Align Thrive (HMO I-SNP)
|
$35.90 |
$505* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$2.00 | $6.00 | P Q:30 /30Days | $54.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
AmeriHealth Caritas VIP Care (HMO D-SNP)
|
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Generic |
$6.75 | $20.25 | P | $90.31 |
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 |
BlueMedicare Complete (HMO D-SNP)
|
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
25% | 25% | P Q:30 /30Days | $60.99 |
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. |
4 |
Non-Preferred Drug |
25% | 25% | P 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. |
4 |
Non-Preferred Drug |
25% | 25% | P Q:30 /30Days | n/a |
Browse Plan Formulary all covered insulin pay $35 or less |
DrPlus (HMO-POS D-SNP)
|
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
25% | 25% | P Q:30 /30Days | $39.54 |
Browse Plan Formulary all covered insulin pay $35 or less |
Florida Complete Care (HMO I-SNP)
|
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | 25% | P Q:30 /30Days | $209.62 |
Browse Plan Formulary all covered insulin pay $35 or less |
Florida Complete Care- In The Community (HMO I-SNP)
|
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | 25% | P Q:30 /30Days | $209.62 |
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 |
Leon MediDual (HMO D-SNP)
|
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Generic |
24% | n/a | P Q:30 /30Days | $37.96 |
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 | P Q:30 /30Days | $33.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
MedicareMax Plus (HMO D-SNP)
|
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
15% | 15% | P Q:30 /30Days | $100.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Complete Care (HMO D-SNP)
|
$35.90 |
$505 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$47.00 | $141.00 | P Q:30 /30Days | $127.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Preferred Medicare Assist (HMO D-SNP)
|
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
15% | 15% | P Q:30 /30Days | $100.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Complete (HMO D-SNP)
|
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$20.00 | $60.00 | P Q:30 /30Days | $97.70 |
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 |
SOLIS SPF 002 (HMO D-SNP)
|
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Preferred Generic |
25% | 25% | P Q:30 /30Days | $54.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
Solis SPF 004 (HMO D-SNP)
|
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Preferred Generic |
25% | 25% | P Q:30 /30Days | $54.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
SOLIS SPF 011 (HMO C-SNP)
|
$35.90 |
$0 |
Yes, this drug has Gap Coverage. |
1 |
Preferred Generic |
0% | 0% | P Q:30 /30Days | $54.61 |
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 |
4 |
Tier 4 |
15% | 15% | P Q:30 /30Days | $100.18 |
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 |
4 |
Tier 4 |
15% | 15% | P Q:30 /30Days | $100.20 |
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 |
4 |
Tier 4 |
$0.00 | $0.00 | P Q:30 /30Days | $100.31 |
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 |
UnitedHealthcare Dual Complete RP (Regional PPO D-SNP)
|
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
15% | 15% | P Q:30 /30Days | $100.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
UnitedHealthcare Nursing Home Plan (PPO I-SNP)
|
$35.90 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | P Q:30 /30Days | $100.22 |
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 | P Q:30 /30Days | $60.53 |
Browse Plan Formulary all covered insulin pay $35 or less |