RANOLAZINE ER 1,000 MG TABLET 12H [Ranexa] (60 TABLETS ) (NDC: 27241012602)
2024 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 from UHC IL-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0002 (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 |
$47.00 | $131.00 | Q:60 /30Days | $46.06 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-001P (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-001P (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 |
$47.00 | $131.00 | Q:60 /30Days | $46.03 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$195 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:60 /30Days | $42.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | None | $33.66 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Choice (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Choice (PPO)](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 |
50% | 50% | None | $51.91 |
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 Duly Prime (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Duly Prime (PPO)](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 |
$100.00 | $300.00 | None | $57.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Prime (HMO-POS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Prime (HMO-POS)](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 |
$100.00 | $300.00 | None | $51.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Value (PPO)](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 |
$100.00 | $300.00 | None | $51.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (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 |
$47.00 | $94.00 | Q:60 /30Days | $89.87 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic 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 |
$47.00 | $94.00 | Q:60 /30Days | $89.87 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:60 /30Days | $91.25 |
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 Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:60 /30Days | $90.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:60 /30Days | $90.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Secure (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Secure (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 |
$47.00 | $94.00 | Q:60 /30Days | $90.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:60 /30Days | $89.83 |
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 |
3 |
Preferred Brand |
$45.00 | $135.00 | Q:60 /30Days | $66.83 |
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 |
3 |
Preferred Brand |
$45.00 | $135.00 | Q:60 /30Days | $66.83 |
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 Premier Medicare (HMO-POS)
![Email Prescription and/or Health Benefit details for Cigna Premier Medicare (HMO-POS)](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 |
$45.00 | $135.00 | Q:60 /30Days | $66.64 |
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 |
3 |
Preferred Brand |
$45.00 | $135.00 | Q:60 /30Days | $66.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Savings Medicare (PPO)](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 |
$45.00 | $135.00 | Q:60 /30Days | $66.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Community Advantage Plan (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Community Advantage Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$0.00 | $0.00 | None | $66.05 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$0.00 | $0.00 | None | $65.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$0.00 | $0.00 | None | $65.64 |
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 CHOICE Illinois (PPO)
![Email Prescription and/or Health Benefit details for Devoted CHOICE Illinois (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$5.00 | $12.50 | None | $146.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Illinois (HMO)
![Email Prescription and/or Health Benefit details for Devoted CORE Illinois (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$0.00 | $0.00 | None | $146.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Illinois (HMO)
![Email Prescription and/or Health Benefit details for Devoted GIVEBACK Illinois (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$10.00 | $25.00 | None | $146.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Community Select (HMO)
![Email Prescription and/or Health Benefit details for Humana Community 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 |
$47.00 | $131.00 | Q:120 /30Days | $28.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:120 /30Days | $25.82 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-251 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-251 (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 |
$47.00 | $131.00 | Q:120 /30Days | $26.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | None | $102.53 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | None | $100.26 |
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 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | None | $112.34 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Complete - Giveback (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Complete - Giveback (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$500 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | None | $259.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $219.76 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO-POS)
![Email Prescription and/or Health Benefit details for Wellcare No Premium (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | 45% | None | $272.52 |
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 Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | None | $219.16 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | None | $219.16 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Exclusive (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Exclusive (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 |
49% | 49% | None | $282.73 |
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 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | None | $231.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Value (HMO-POS)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Value (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | None | $272.52 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Choice IL (HMO)
![Email Prescription and/or Health Benefit details for Zing Choice IL (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 |
$47.00 | $94.00 | None | $246.64 |
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 |
Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Essential Wellness Diabetes & Heart IL (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 |
$47.00 | $94.00 | None | $232.09 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Care IL (HMO)
![Email Prescription and/or Health Benefit details for Zing Select Care IL (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$47.00 | $94.00 | None | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Diabetes & Heart IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$47.00 | $94.00 | None | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist Compass (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Assist Compass (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | 45% | None | $118.07 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan IL-F002 (HMO-POS I-SNP)
![Email Prescription and/or Health Benefit details for UHC Nursing Home Plan IL-F002 (HMO-POS I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | Q:60 /30Days | $46.02 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Value Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$400 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
40% | 40% | None | $51.91 |
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 |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
25% | 25% | Q:60 /30Days | $46.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0001 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0001 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:60 /30Days | $46.06 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-283 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-283 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:120 /30Days | $26.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan IL-F001 (PPO I-SNP)
![Email Prescription and/or Health Benefit details for UHC Nursing Home Plan IL-F001 (PPO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.60 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
25% | 25% | Q:60 /30Days | $46.04 |
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) |
$32.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | n/a | None | $41.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Provider Partners Illinois Advantage Plan (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Provider Partners Illinois Advantage Plan (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | 25% | None | $241.87 |
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 |
Zing Select Diabetes & Heart Complete IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart Complete IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
25% | 25% | None | $232.09 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0004 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days | $46.06 |
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) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None | $51.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:120 /30Days | $29.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1468-014 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-014 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:120 /30Days | $28.49 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Premier Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Premier Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$76.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$47.00 | $94.00 | Q:60 /30Days | $89.87 |
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 Cross Medicare Advantage Choice Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Choice Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$77.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$47.00 | $94.00 | Q:60 /30Days | $89.87 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice R5361-002 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5361-002 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$97.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
24% | 24% | Q:120 /30Days | $28.79 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:120 /30Days | $27.19 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Choice Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Choice Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$135.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$47.00 | $94.00 | Q:60 /30Days | $89.87 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-357 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-357 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:120 /30Days | $26.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Enhanced Select (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Enhanced Select (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$169.00 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
40% | 40% | None | $68.24 |
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 |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:60 /30Days | $90.86 |
Browse Plan Formulary all covered insulin pay $35 or less |