TERIPARATIDE 620 MCG/2.48 ML PEN INJECTOR [Forteo] (MLS ) (NDC: 47781065289)
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 IN-0007 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IN-0007 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Tier 5 |
33% | n/a | P Q:2.48 /28Days | $938.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IN-0012 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IN-0012 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Tier 5 |
33% | n/a | P Q:2.48 /28Days | $938.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IN-0017 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IN-0017 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Tier 5 |
33% | n/a | P Q:2.48 /28Days | $938.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IN-0020 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IN-0020 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$395 |
Yes, but No Gap Coverage for this drug. |
5 |
Tier 5 |
27% | n/a | P Q:2.48 /28Days | $938.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Premier (HMO-POS)
![Email Prescription and/or Health Benefit details for Aetna Medicare 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 |
Tier 5 |
33% | n/a | P | $1,968.67 |
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 SmartFit (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare SmartFit (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
5 |
Tier 5 |
29% | n/a | P | $1,968.35 |
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. |
5 |
Tier 5 |
33% | n/a | P | $1,968.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Anthem Medicare Advantage (HMO)
![Email Prescription and/or Health Benefit details for Anthem Medicare Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $1,961.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Anthem Medicare Advantage (HMO)
![Email Prescription and/or Health Benefit details for Anthem Medicare Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $1,964.03 |
Browse Plan Formulary all covered insulin pay $35 or less |
Anthem Medicare Advantage (HMO)
![Email Prescription and/or Health Benefit details for Anthem Medicare Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $1,961.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
Anthem Medicare Advantage (HMO)
![Email Prescription and/or Health Benefit details for Anthem Medicare Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $1,962.09 |
Browse Plan Formulary all covered insulin pay $35 or less |
|
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Anthem Medicare Advantage (PPO)
![Email Prescription and/or Health Benefit details for Anthem Medicare Advantage (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $1,962.09 |
Browse Plan Formulary all covered insulin pay $35 or less |
CommuniCare Advantage CSNP (HMO C-SNP)
![Email Prescription and/or Health Benefit details for CommuniCare Advantage CSNP (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | n/a | P Q:2.48 /28Days | $2,069.81 |
Browse Plan Formulary all covered insulin pay $35 or less |
CommuniCare Advantage CSNP (HMO C-SNP)
![Email Prescription and/or Health Benefit details for CommuniCare Advantage CSNP (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | n/a | P Q:2.48 /28Days | $2,054.02 |
Browse Plan Formulary all covered insulin pay $35 or less |
CommuniCare Advantage CSNP (HMO C-SNP)
![Email Prescription and/or Health Benefit details for CommuniCare Advantage CSNP (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | n/a | P Q:2.48 /28Days | $2,066.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
IU Health Plans Medicare Flex Network (HMO-POS)
![Email Prescription and/or Health Benefit details for IU Health Plans Medicare Flex Network (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
33% | n/a | P Q:2.48 /24Days | $1,945.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
IU Health Plans Medicare Kidney Care (HMO)
![Email Prescription and/or Health Benefit details for IU Health Plans Medicare Kidney Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
33% | n/a | P Q:2.48 /24Days | $1,945.62 |
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 |
IU Health Plans Medicare Select Plus (HMO)
![Email Prescription and/or Health Benefit details for IU Health Plans Medicare Select Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
33% | n/a | P Q:2.48 /24Days | $1,946.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
IU Health Plans Medicare Select Plus (HMO)
![Email Prescription and/or Health Benefit details for IU Health Plans Medicare Select Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
33% | n/a | P Q:2.48 /24Days | $1,943.51 |
Browse Plan Formulary all covered insulin pay $35 or less |
IU Health Plans Medicare Select Plus (HMO)
![Email Prescription and/or Health Benefit details for IU Health Plans Medicare Select Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
33% | n/a | P Q:2.48 /24Days | $1,935.29 |
Browse Plan Formulary all covered insulin pay $35 or less |
MDwise Medicare Inspire (HMO)
![Email Prescription and/or Health Benefit details for MDwise Medicare Inspire (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$12.00 | $27.00 | Q:2.48 /28Days | $1,676.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
MyTruAdvantage Choice Plus (PPO)
![Email Prescription and/or Health Benefit details for MyTruAdvantage Choice Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$5.00 | $0.00 | Q:2.48 /28Days | $1,748.47 |
Browse Plan Formulary all covered insulin pay $35 or less |
MyTruAdvantage Choice Plus (PPO)
![Email Prescription and/or Health Benefit details for MyTruAdvantage Choice Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$5.00 | $0.00 | Q:2.48 /28Days | $1,732.93 |
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 |
MyTruAdvantage Select (HMO)
![Email Prescription and/or Health Benefit details for MyTruAdvantage Select (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 |
$5.00 | $0.00 | Q:2.48 /28Days | $1,748.47 |
Browse Plan Formulary all covered insulin pay $35 or less |
MyTruAdvantage Select (HMO)
![Email Prescription and/or Health Benefit details for MyTruAdvantage Select (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 |
$5.00 | $0.00 | Q:2.48 /28Days | $1,732.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
MyTruAdvantage Select Plus (HMO)
![Email Prescription and/or Health Benefit details for MyTruAdvantage Select Plus (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 |
$5.00 | $0.00 | Q:2.48 /28Days | $1,737.77 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Complete No Premium (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Complete 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 |
Tier 5 |
33% | n/a | P Q:2.48 /28Days | $1,861.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Complete No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Complete No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
33% | n/a | P Q:2.48 /28Days | $1,861.30 |
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 |
$175 |
Yes, but No Gap Coverage for this drug. |
5 |
Tier 5 |
30% | n/a | P Q:2.48 /28Days | $1,882.67 |
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)
![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 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
33% | n/a | P Q:2.48 /28Days | $1,882.67 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing ESRD Select IN (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing ESRD Select IN (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 |
Tier 5 |
33% | n/a | P Q:2.48 /28Days | $2,078.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Open Choice Diabetes & Heart IN (PPO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Open Choice Diabetes & Heart IN (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Tier 5 |
33% | n/a | P Q:2.48 /28Days | $2,078.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Open Choice IN (PPO)
![Email Prescription and/or Health Benefit details for Zing Open Choice IN (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Tier 5 |
33% | n/a | P Q:2.48 /28Days | $2,078.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Care IN (HMO)
![Email Prescription and/or Health Benefit details for Zing Select Care IN (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Tier 5 |
33% | n/a | P Q:2.48 /28Days | $2,078.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Diabetes & Heart IN (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart IN (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 |
Tier 5 |
33% | n/a | P Q:2.48 /28Days | $2,078.45 |
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)
![Email Prescription and/or Health Benefit details for Wellcare Low Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
33% | n/a | P Q:2.48 /28Days | $1,882.67 |
Browse Plan Formulary all covered insulin pay $35 or less |
Anthem Extra Help (HMO)
![Email Prescription and/or Health Benefit details for Anthem Extra Help (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.70 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | n/a | P Q:3 /28Days | $1,962.09 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Assist (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.80 |
$505 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | n/a | P Q:2.48 /28Days | $1,882.67 |
Browse Plan Formulary all covered insulin pay $35 or less |
CommuniCare Advantage Sapphire (HMO)
![Email Prescription and/or Health Benefit details for CommuniCare Advantage Sapphire (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | n/a | P Q:2.48 /28Days | $2,069.81 |
Browse Plan Formulary all covered insulin pay $35 or less |
CommuniCare Advantage Sapphire (HMO)
![Email Prescription and/or Health Benefit details for CommuniCare Advantage Sapphire (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | n/a | P Q:2.48 /28Days | $2,054.02 |
Browse Plan Formulary all covered insulin pay $35 or less |
CommuniCare Advantage Sapphire (HMO)
![Email Prescription and/or Health Benefit details for CommuniCare Advantage Sapphire (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | n/a | P Q:2.48 /28Days | $2,082.82 |
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 |
UHC Care Advantage IN-E001 (PPO I-SNP)
![Email Prescription and/or Health Benefit details for UHC Care Advantage IN-E001 (PPO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.80 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
33% | n/a | P Q:2.48 /28Days | $938.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan IN-F001 (PPO I-SNP)
![Email Prescription and/or Health Benefit details for UHC Nursing Home Plan IN-F001 (PPO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | 25% | P Q:2.48 /28Days | $938.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
MDwise Medicare Inspire Plus (HMO)
![Email Prescription and/or Health Benefit details for MDwise Medicare Inspire Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$12.00 | $27.00 | Q:2.48 /28Days | $1,676.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IN-0002 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IN-0002 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Tier 5 |
33% | n/a | P Q:2.48 /28Days | $938.59 |
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) |
$28.00 |
$400 |
Yes, but No Gap Coverage for this drug. |
5 |
Tier 5 |
27% | n/a | P | $1,968.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Anthem Medicare Advantage 2 (PPO)
![Email Prescription and/or Health Benefit details for Anthem Medicare Advantage 2 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $1,962.09 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Anthem Dual Advantage (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Anthem Dual Advantage (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
15% | 15% | P Q:3 /28Days | $1,962.14 |
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) |
$35.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
$0.00 | $0.00 | P Q:2.48 /28Days | $1,882.67 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete IN-S001 (PPO D-SNP)
![Email Prescription and/or Health Benefit details for UHC Dual Complete IN-S001 (PPO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
$0.00 | $0.00 | P Q:2.48 /28Days | $938.59 |
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) |
$37.60 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
$0.00 | $0.00 | P Q:2.48 /28Days | $1,882.67 |
Browse Plan Formulary all covered insulin pay $35 or less |
Anthem Full Dual Advantage (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Anthem Full Dual Advantage (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.40 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
$0.00 | $0.00 | P Q:3 /28Days | $1,962.14 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Assure Premier (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Aetna Medicare Assure Premier (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$42.30 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
$0.00 | $0.00 | P | $1,968.67 |
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 |
American Health Advantage of Indiana (HMO I-SNP)
![Email Prescription and/or Health Benefit details for American Health Advantage of Indiana (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$42.30 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | 25% | P | $2,071.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Anthem Full Dual Advantage Aligned (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Anthem Full Dual Advantage Aligned (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$42.30 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
$0.00 | $0.00 | P Q:3 /28Days | $1,962.14 |
Browse Plan Formulary all covered insulin pay $35 or less |
CommuniCare Advantage ISNP (HMO I-SNP)
![Email Prescription and/or Health Benefit details for CommuniCare Advantage ISNP (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$42.30 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | n/a | P | $2,063.60 |
Browse Plan Formulary all covered insulin pay $35 or less |
CommuniCare Advantage ISNP (HMO I-SNP)
![Email Prescription and/or Health Benefit details for CommuniCare Advantage ISNP (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$42.30 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | n/a | P | $2,054.02 |
Browse Plan Formulary all covered insulin pay $35 or less |
CommuniCare Advantage ISNP (HMO I-SNP)
![Email Prescription and/or Health Benefit details for CommuniCare Advantage ISNP (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$42.30 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | n/a | P | $2,063.66 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete IN-D001 (PPO D-SNP)
![Email Prescription and/or Health Benefit details for UHC Dual Complete IN-D001 (PPO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$42.30 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
15% | 15% | P Q:2.48 /28Days | $938.59 |
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 |
UHC Dual Complete IN-S002 (PPO D-SNP)
![Email Prescription and/or Health Benefit details for UHC Dual Complete IN-S002 (PPO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$42.30 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
$0.00 | $0.00 | P Q:2.48 /28Days | $938.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Choice Diabetes & Heart Complete IN (PPO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Choice Diabetes & Heart Complete IN (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$42.30 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | n/a | P Q:2.48 /28Days | $2,078.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Diabetes & Heart Complete IN (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart Complete IN (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$42.30 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
25% | n/a | P Q:2.48 /28Days | $2,078.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
MDwise Medicare Inspire Flex (HMO-POS)
![Email Prescription and/or Health Benefit details for MDwise Medicare Inspire Flex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$12.00 | $27.00 | Q:2.48 /28Days | $1,676.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
CommuniCare Advantage Emerald (HMO)
![Email Prescription and/or Health Benefit details for CommuniCare Advantage Emerald (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$51.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Tier 5 |
33% | n/a | P Q:2.48 /28Days | $2,069.81 |
Browse Plan Formulary all covered insulin pay $35 or less |
CommuniCare Advantage Emerald (HMO)
![Email Prescription and/or Health Benefit details for CommuniCare Advantage Emerald (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$51.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Tier 5 |
33% | n/a | P Q:2.48 /28Days | $2,054.02 |
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 |
CommuniCare Advantage Emerald (HMO)
![Email Prescription and/or Health Benefit details for CommuniCare Advantage Emerald (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$51.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Tier 5 |
33% | n/a | P Q:2.48 /28Days | $2,082.82 |
Browse Plan Formulary all covered insulin pay $35 or less |
Anthem Medicare Advantage 3 (PPO)
![Email Prescription and/or Health Benefit details for Anthem Medicare Advantage 3 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$58.00 |
$60 |
Yes, but No Gap Coverage for this drug. |
5 |
Tier 5 |
32% | n/a | P Q:3 /28Days | $1,962.09 |
Browse Plan Formulary all covered insulin pay $35 or less |
Anthem Medicare Advantage (Regional PPO)
![Email Prescription and/or Health Benefit details for Anthem Medicare Advantage (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$73.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $1,962.06 |
Browse Plan Formulary all covered insulin pay $35 or less |
IU Health Plans Medicare Choice (HMO-POS)
![Email Prescription and/or Health Benefit details for IU Health Plans Medicare Choice (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$98.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Tier 5 |
33% | n/a | P Q:2.48 /24Days | $1,943.05 |
Browse Plan Formulary all covered insulin pay $35 or less |