ROPINIROLE HCL 3 MG TABLET (100.000 EA ) (NDC: 43547027210)
2024 Medicare Prescription Drug Plan (MAPD) Information
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Plan Name |
Monthly Prem. |
De- duct- ible |
Does Plan Offer Additional Gap Coverage |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Plan’s Avg. Retail Drug Price 30-Day |
Tier Nbr. |
Tier Desc. |
30-Day Prfrd. Pharm |
90-Day Mail Order |
AARP Medicare Advantage from UHC OR-0002 (PPO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$10.00 | $0.00 | None | $20.92 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC OR-0004 (HMO-POS)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$12.00 | $0.00 | None | $21.50 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC OR-0004 (HMO-POS)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$12.00 | $0.00 | None | $20.92 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Elite Plan (HMO-POS)
|
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$5.00 | $0.00 | None | $9.47 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare SmartFit Elite Plan (HMO-POS)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $7.00 |
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 Value Plan (HMO-POS)
|
$0.00 |
$150* |
Yes, this drug has Gap Coverage. |
2* |
Generic |
$0.00 | $0.00 | None | $7.02 |
Browse Plan Formulary all covered insulin pay $35 or less |
ATRIO Choice Rx (PPO)
|
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$0.00 | $0.00 | None | $16.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $14.22 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
|
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $14.22 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Oregon (PPO)
|
$0.00 |
$225* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$0.00 | $0.00 | None | $3.42 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Oregon (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$0.00 | $0.00 | None | $3.42 |
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 - Diabetes (HMO C-SNP)
|
$0.00 |
$250* |
Yes, this drug has Gap Coverage. |
2* |
Generic |
$0.00 | $0.00 | None | $8.07 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1036-153 (HMO)
|
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $8.12 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-247 (PPO)
|
$0.00 |
$125* |
Yes, this drug has Gap Coverage. |
2* |
Generic |
$8.00 | $0.00 | None | $8.62 |
Browse Plan Formulary all covered insulin pay $35 or less |
Kaiser Permanente Senior Advantage Value (HMO-POS)
|
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$10.00 | $20.00 | None | $18.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
Moda Health Elements PPORX (PPO)
|
$0.00 |
$225* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$0.00 | $0.00 | None | $38.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
PacificSource Medicare Explorer Rx 11 (PPO)
|
$0.00 |
$150* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$4.00 | $8.00 | None | $3.70 |
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 |
PacificSource Medicare MyCare Choice Rx 34 (HMO-POS)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$0.00 | $0.00 | None | $3.69 |
Browse Plan Formulary all covered insulin pay $35 or less |
PacificSource Medicare MyCare Rx 40 (HMO)
|
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$9.00 | $18.00 | None | $3.67 |
Browse Plan Formulary all covered insulin pay $35 or less |
Providence Medicare Prime + Rx (HMO)
|
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$10.00 | $10.00 | None | $10.47 |
Browse Plan Formulary all covered insulin pay $35 or less |
Regence BlueAdvantage HMO (HMO)
|
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $0.00 | None | $11.08 |
Browse Plan Formulary all covered insulin pay $35 or less |
Regence BlueAdvantage HMO (HMO)
|
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $0.00 | None | $14.90 |
Browse Plan Formulary all covered insulin pay $35 or less |
Regence BlueAdvantage HMO (HMO)
|
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $0.00 | None | $24.28 |
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 |
Regence MedAdvantage + Rx Primary (PPO)
|
$0.00 |
$200* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$13.00 | $0.00 | None | $24.28 |
Browse Plan Formulary all covered insulin pay $35 or less |
Regence MedAdvantage + Rx Primary (PPO)
|
$0.00 |
$200* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$13.00 | $0.00 | None | $11.08 |
Browse Plan Formulary all covered insulin pay $35 or less |
Regence MedAdvantage + Rx Primary (PPO)
|
$0.00 |
$200* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$13.00 | $0.00 | None | $13.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$15.00 | $0.00 | None | $14.82 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$425* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$8.00 | $0.00 | None | $14.92 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$250* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$8.00 | $0.00 | None | $15.30 |
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 Open (PPO)
|
$0.00 |
$300* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$8.00 | $0.00 | None | $15.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE PLUS Oregon (PPO)
|
$12.00 |
$150* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$0.00 | $0.00 | None | $3.42 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$16.60 |
$380 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$20.00 | $0.00 | None | $43.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Choice Plan (PPO)
|
$20.00 |
$150* |
Yes, this drug has Gap Coverage. |
2* |
Generic |
$0.00 | $0.00 | None | $7.02 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus Plan (HMO-POS)
|
$20.70 |
$400 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
40% | 40% | None | $7.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care OR-001A (PPO C-SNP)
|
$21.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
25% | 25% | None | $20.93 |
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 |
Wellcare Low Premium Open (PPO)
|
$24.00 |
$350* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$15.00 | $0.00 | None | $14.82 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan OR-F002 (PPO I-SNP)
|
$28.30 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
25% | 25% | None | $20.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Providence Medicare Bridge + Rx (HMO-POS)
|
$29.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$10.00 | $10.00 | None | $10.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan OR-F001 (PPO I-SNP)
|
$30.40 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
25% | 25% | None | $20.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Care Advantage RI-E002 (PPO I-SNP)
|
$33.00 |
$200* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$12.00 | $0.00 | None | $21.26 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-294 (PPO)
|
$36.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$20.00 | $0.00 | None | $8.27 |
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 from UHC OR-0001 (PPO)
|
$39.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$10.00 | $0.00 | None | $20.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
Moda Health + Fred Meyer PPORX (PPO)
|
$39.00 |
$200* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$0.00 | $0.00 | None | $38.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
AgeRight Advantage Health Plan (HMO I-SNP)
|
$40.60 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | 25% | None | $38.69 |
Browse Plan Formulary all covered insulin pay $35 or less |
ATRIO Select Rx (PPO)
|
$40.60 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$0.00 | $0.00 | None | $16.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
CareOregon Advantage Plus (HMO-POS D-SNP)
|
$40.60 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Generic |
25% | 25% | None | $9.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
PacificSource Dual Care (HMO D-SNP)
|
$40.60 |
$545 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$20.00 | $60.00 | None | $9.74 |
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 |
Providence Medicare Dual Plus (HMO D-SNP)
|
$40.60 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
15% | 15% | None | $10.66 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Care Advantage OR-E001 (PPO I-SNP)
|
$40.60 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $0.00 | None | $20.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Regence BlueAdvantage HMO Plus (HMO)
|
$41.00 |
$100* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$8.00 | $16.00 | None | $14.66 |
Browse Plan Formulary all covered insulin pay $35 or less |
Regence BlueAdvantage HMO Plus (HMO)
|
$41.00 |
$100* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$8.00 | $16.00 | None | $14.90 |
Browse Plan Formulary all covered insulin pay $35 or less |
Regence MedAdvantage + Rx Classic (PPO)
|
$44.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$13.00 | $26.00 | None | $11.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Regence MedAdvantage + Rx Classic (PPO)
|
$44.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$13.00 | $26.00 | None | $13.99 |
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 |
Regence MedAdvantage + Rx Classic (PPO)
|
$44.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$13.00 | $26.00 | None | $24.28 |
Browse Plan Formulary all covered insulin pay $35 or less |
Kaiser Permanente Senior Advantage Standard (HMO-POS)
|
$46.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$10.00 | $20.00 | None | $18.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
Providence Medicare Extra Part B Only + Rx (HMO)
|
$49.40 |
$0 |
to be determined |
2 |
Tier 2 |
$12.00 | $28.80 | None | $9.77 |
Browse Plan Formulary all covered insulin pay $35 or less |
AgeRight Advantage Plus Health Plan (HMO I-SNP)
|
$55.00 |
$300* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$0.00 | $0.00 | None | $38.69 |
Browse Plan Formulary all covered insulin pay $35 or less |
AgeRight Advantage Premier Health Plan (HMO C-SNP)
|
$55.00 |
$300* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$0.00 | $0.00 | None | $38.69 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC OR-0003 (HMO-POS)
|
$58.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$10.00 | $0.00 | None | $20.93 |
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 |
Providence Medicare Choice + Rx (HMO-POS)
|
$71.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$10.00 | $10.00 | None | $10.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
Moda Health Metro PPORX (PPO)
|
$86.00 |
$150* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$0.00 | $0.00 | None | $38.92 |
Browse Plan Formulary all covered insulin pay $35 or less |
ATRIO Prime Rx (PPO)
|
$125.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$0.00 | $0.00 | None | $16.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Kaiser Permanente Senior Advantage Enhanced (HMO-POS)
|
$131.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$10.00 | $20.00 | None | $18.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Premium Ultra Open (PPO)
|
$139.00 |
$150* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$10.00 | $0.00 | None | $15.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Providence Medicare Extra + Rx (HMO)
|
$155.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$10.00 | $10.00 | None | $10.49 |
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 |
Regence MedAdvantage + Rx Enhanced (PPO)
|
$166.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$8.00 | $16.00 | None | $11.08 |
Browse Plan Formulary all covered insulin pay $35 or less |
Regence MedAdvantage + Rx Enhanced (PPO)
|
$166.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$8.00 | $16.00 | None | $16.56 |
Browse Plan Formulary all covered insulin pay $35 or less |