CLONIDINE 0.3 MG/DAY PATCH [Catapres-TTS] (4 PATCHES ) (NDC: 00591351004)
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 NV-0001 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC NV-0001 (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 | $290.00 | None | $96.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC NV-0007 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC NV-0007 (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 | $290.00 | None | $96.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC NV-0008 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC NV-0008 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$295 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $96.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC NV-0005 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC NV-0005 (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 | $290.00 | None | $92.51 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Choice Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Choice Plan (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 | Q:8 /28Days | $84.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Elite Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Elite Plan (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% | Q:8 /28Days | $84.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Premier Plan (HMO-POS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (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 | Q:8 /28Days | $84.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Prime Plan (HMO-POS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Prime Plan (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 | Q:8 /28Days | $84.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Prime Plus Plan (HMO-POS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Prime Plus Plan (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 | Q:8 /28Days | $84.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Select Plan (HMO-POS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Select Plan (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 | Q:8 /28Days | $84.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Alignment Health AVA (PPO)
![Email Prescription and/or Health Benefit details for Alignment Health AVA (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 |
$40.00 | $120.00 | None | $77.27 |
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 |
Alignment Health Heart & Diabetes (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Alignment Health Heart & Diabetes (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 |
$40.00 | $120.00 | None | $77.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Alignment Health Platinum (HMO)
![Email Prescription and/or Health Benefit details for Alignment Health Platinum (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 |
$40.00 | $120.00 | None | $77.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Alignment Health Platinum + Instacart (HMO)
![Email Prescription and/or Health Benefit details for Alignment Health Platinum + Instacart (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 |
$40.00 | $120.00 | None | $77.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Alignment Health smartHMO (HMO)
![Email Prescription and/or Health Benefit details for Alignment Health smartHMO (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545* |
Yes, but No Gap Coverage for this drug. |
3* |
Preferred Brand |
$45.00 | $135.00 | None | $77.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Anthem I Carelon Chronic Care (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Anthem I Carelon Chronic Care (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$7.50 | $0.00 | Q:4 /28Days | $142.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Anthem I Carelon Home Care (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Anthem I Carelon Home Care (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$7.50 | $0.00 | Q:4 /28Days | $232.08 |
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 I Carelon Lung Care (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Anthem I Carelon Lung Care (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$7.50 | $0.00 | Q:4 /28Days | $142.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Anthem I Carelon Medicare Advantage (HMO)
![Email Prescription and/or Health Benefit details for Anthem I Carelon Medicare Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$7.50 | $0.00 | Q:4 /28Days | $142.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Anthem I Carelon Premium Savings (HMO)
![Email Prescription and/or Health Benefit details for Anthem I Carelon Premium Savings (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$10.50 | $0.00 | Q:4 /28Days | $142.10 |
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. |
4 |
Non-Preferred Drug |
$95.00 | $190.00 | Q:4 /28Days | $142.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Champion Advantage (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Champion Advantage (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$8.00 | $16.00 | Q:8 /28Days | $67.76 |
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 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:4 /28Days | $179.43 |
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 and Heart (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Humana Gold Plus - Diabetes and Heart (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$80.00 | $230.00 | Q:4 /28Days | $86.13 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H6622-028 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H6622-028 (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 |
$100.00 | $290.00 | Q:4 /28Days | $86.13 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H6622-056 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H6622-056 (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 |
$100.00 | $290.00 | Q:4 /28Days | $86.13 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H6622-082 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H6622-082 (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 |
$100.00 | $290.00 | Q:4 /28Days | $86.13 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Lung (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Lung (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$80.00 | $230.00 | Q:4 /28Days | $86.13 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-141 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-141 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$365 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:4 /28Days | $86.13 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-281 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-281 (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 | $290.00 | Q:4 /28Days | $86.13 |
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 | $68.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
SCAN Balance (HMO C-SNP)
![Email Prescription and/or Health Benefit details for SCAN Balance (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $265.00 | None | $34.22 |
Browse Plan Formulary all covered insulin pay $35 or less |
SCAN Classic (HMO)
![Email Prescription and/or Health Benefit details for SCAN Classic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $265.00 | None | $34.22 |
Browse Plan Formulary all covered insulin pay $35 or less |
SCAN Compass (HMO)
![Email Prescription and/or Health Benefit details for SCAN Compass (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 |
$95.00 | $265.00 | None | $34.22 |
Browse Plan Formulary all covered insulin pay $35 or less |
SCAN Heart First (HMO C-SNP)
![Email Prescription and/or Health Benefit details for SCAN Heart First (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $265.00 | None | $34.22 |
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 |
SCAN MyChoice (HMO)
![Email Prescription and/or Health Benefit details for SCAN MyChoice (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 |
$70.00 | $190.00 | None | $34.22 |
Browse Plan Formulary all covered insulin pay $35 or less |
SCAN Venture (HMO)
![Email Prescription and/or Health Benefit details for SCAN Venture (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 |
$95.00 | $265.00 | None | $34.22 |
Browse Plan Formulary all covered insulin pay $35 or less |
Select Health Medicare + Kroger (HMO)
![Email Prescription and/or Health Benefit details for Select Health Medicare + Kroger (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 |
$40.00 | $120.00 | None | $61.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Select Health Medicare Choice (PPO)
![Email Prescription and/or Health Benefit details for Select Health Medicare Choice (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 | $141.00 | None | $61.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Select Health Medicare Essential (HMO)
![Email Prescription and/or Health Benefit details for Select Health Medicare Essential (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 | $141.00 | None | $61.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Senior Care Plus Complete Plan (HMO)
![Email Prescription and/or Health Benefit details for Senior Care Plus Complete Plan (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 |
$100.00 | $200.00 | None | $70.76 |
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 NV-0004 (HMO-POS C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care NV-0004 (HMO-POS C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $96.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Medicare Advantage NV-001P (HMO-POS)
![Email Prescription and/or Health Benefit details for UHC Medicare Advantage NV-001P (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 | $290.00 | None | $96.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $35.83 |
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 |
$150* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$5.00 | $0.00 | None | $34.34 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Specialty No Premium (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Wellcare Specialty No Premium (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $35.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Alignment Health the ONE (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Alignment Health the ONE (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$7.60 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
3 |
Tier 3 |
$0.00 | $0.00 | None | $77.27 |
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 |
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) |
$15.90 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
$0.00 | $0.00 | Q:4 /28Days | $106.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Anthem I Carelon Full Dual Advantage (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Anthem I Carelon Full Dual Advantage (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.10 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Tier 2 |
$0.00 | $0.00 | Q:4 /28Days | $106.10 |
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) |
$22.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
$0.00 | $0.00 | None | $55.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus Plan (HMO-POS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Value Plus Plan (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.00 |
$400 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
40% | 40% | Q:8 /28Days | $84.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Complete Care (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Molina Medicare Complete Care (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
$0.00 | $0.00 | None | $68.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Select Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Select Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:8 /28Days | $84.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-037 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-037 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$225 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:4 /28Days | $86.13 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H6622-079 (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Humana Gold Plus SNP-DE H6622-079 (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.10 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
$0.00 | $0.00 | Q:4 /28Days | $87.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Prime Plan (HMO D-SNP)
![Email Prescription and/or Health Benefit details for Aetna Medicare Dual Prime Plan (HMO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.70 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
$0.00 | $0.00 | Q:8 /28Days | $69.87 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC NV-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC NV-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $96.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Champion Connect (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Champion Connect (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
25% | 25% | Q:8 /28Days | $67.76 |
Browse Plan Formulary all covered insulin pay $35 or less |
Champion Select (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Champion Select (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
25% | 25% | Q:8 /28Days | $67.76 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice SNP-DE H5216-302 (PPO D-SNP)
![Email Prescription and/or Health Benefit details for HumanaChoice SNP-DE H5216-302 (PPO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
$0.00 | $0.00 | Q:4 /28Days | $86.01 |
Browse Plan Formulary all covered insulin pay $35 or less |
SCAN Strive (HMO C-SNP)
![Email Prescription and/or Health Benefit details for SCAN Strive (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $34.22 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete NV-S001 (HMO-POS D-SNP)
![Email Prescription and/or Health Benefit details for UHC Dual Complete NV-S001 (HMO-POS D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
$0.00 | $0.00 | None | $96.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete NV-S002 (PPO D-SNP)
![Email Prescription and/or Health Benefit details for UHC Dual Complete NV-S002 (PPO D-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
$0.00 | $0.00 | None | $96.36 |
Browse Plan Formulary all covered insulin pay $35 or less |