PARICALCITOL 4 MCG CAPSULE [Zemplar] (CAPSULES ) (NDC: 49483068903)
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 |
Aetna Medicare SmartFit (PPO)
|
$0.00 |
$250 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
50% | 50% | None | $407.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $300.00 | None | $367.49 |
Browse Plan Formulary all covered insulin pay $35 or less |
BCN Advantage HMO-POS Prime Value (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$11.00 | $0.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
BCN Advantage HMO-POS Prime Value (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$11.00 | $0.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
BCN Advantage HMO-POS Prime Value (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$11.00 | $0.00 | None | $551.59 |
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 |
BCN Advantage HMO-POS Prime Value (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$11.00 | $0.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
BCN Advantage HMO-POS Prime Value (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$11.00 | $0.00 | None | $515.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
HAP Medicare Connect (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$9.00 | $0.00 | None | $363.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
HAP Medicare Explore (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$11.00 | $0.00 | None | $363.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
HAP MSUHC Medicare (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$9.00 | $0.00 | None | $363.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana USAA Honor with Rx (PPO)
|
$0.00 |
$350 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:12 /30Days | $162.00 |
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 |
HumanaChoice - Diabetes and Heart (PPO C-SNP)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:12 /30Days | $162.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-306 (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:12 /30Days | $162.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-384 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:12 /30Days | $193.46 |
Browse Plan Formulary all covered insulin pay $35 or less |
McLaren Medicare Inspire (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$12.00 | $27.00 | None | $428.57 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medicare Plus Blue + Meijer (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medicare Plus Blue + Meijer (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | None | $551.59 |
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 |
Medicare Plus Blue + Meijer (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medicare Plus Blue + Meijer (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medicare Plus Blue + Meijer (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | None | $515.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medicare Plus Blue PPO Essential (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$11.00 | $0.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medicare Plus Blue PPO Essential (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$11.00 | $0.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medicare Plus Blue PPO Essential (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$11.00 | $0.00 | None | $551.59 |
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 |
Medicare Plus Blue PPO Essential (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$11.00 | $0.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medicare Plus Blue PPO Essential (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$11.00 | $0.00 | None | $515.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medicare Plus Blue PPO Part B Credit (PPO)
|
$0.00 |
$350 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $90.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medicare Plus Blue PPO Part B Credit (PPO)
|
$0.00 |
$350 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $90.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medicare Plus Blue PPO Part B Credit (PPO)
|
$0.00 |
$350 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $90.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medicare Plus Blue PPO Part B Credit (PPO)
|
$0.00 |
$350 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $90.00 | None | $551.59 |
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 |
Medicare Plus Blue PPO Part B Credit (PPO)
|
$0.00 |
$350 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $90.00 | None | $515.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
|
$0.00 |
$125 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P | $331.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care Select (HMO)
|
$0.00 |
$375 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$0.00 | $0.00 | P | $331.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
PHP Medicare Advantage (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $388.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Edge (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | None | $380.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Edge (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | None | $380.65 |
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 |
PriorityMedicare Edge (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | None | $398.87 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | None | $380.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | None | $380.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | None | $380.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | None | $380.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | None | $398.87 |
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 |
PriorityMedicare Vital (PPO)
|
$0.00 |
$350 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | None | $380.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Vital (PPO)
|
$0.00 |
$350 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | None | $380.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Vital (PPO)
|
$0.00 |
$350 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | None | $398.87 |
Browse Plan Formulary all covered insulin pay $35 or less |
Sparrow Advantage (HMO-POS)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$90.00 | $237.50 | None | $388.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback (HMO)
|
$0.00 |
$315 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | P | $240.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO-POS)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$5.00 | $0.00 | P | $130.37 |
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 |
$275 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
50% | 50% | P | $240.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Low Premium (HMO-POS)
|
$9.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$5.00 | $0.00 | P | $130.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Premier (PPO)
|
$14.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $300.00 | None | $367.49 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$17.50 |
$400 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | P | $240.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-380 (PPO)
|
$19.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:12 /30Days | $162.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Ideal (PPO)
|
$19.00 |
$125 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $380.65 |
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 |
PriorityMedicare Ideal (PPO)
|
$19.00 |
$125 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $380.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Ideal (PPO)
|
$19.00 |
$125 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $380.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Ideal (PPO)
|
$19.00 |
$125 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $380.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Ideal (PPO)
|
$19.00 |
$125 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $398.87 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$20.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P | $152.87 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Complete Care Select (HMO D-SNP)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P | $331.20 |
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 |
McLaren Medicare Inspire Plus (HMO)
|
$25.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$12.00 | $27.00 | None | $428.57 |
Browse Plan Formulary all covered insulin pay $35 or less |
Sparrow Advantage Plus (HMO-POS)
|
$25.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$90.00 | $237.50 | None | $388.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Complete Care (HMO D-SNP)
|
$27.90 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $331.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-382 (PPO)
|
$28.20 |
$260 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:12 /30Days | $193.46 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Value (HMO-POS)
|
$31.00 |
$75 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $380.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Value (HMO-POS)
|
$31.00 |
$75 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $380.65 |
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 |
PriorityMedicare Value (HMO-POS)
|
$31.00 |
$75 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $380.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Value (HMO-POS)
|
$31.00 |
$75 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $380.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Value (HMO-POS)
|
$31.00 |
$75 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $398.87 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO-POS D-SNP)
|
$32.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $152.87 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$32.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $152.87 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-385 (PPO D-SNP)
|
$35.90 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:12 /30Days | $162.00 |
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 |
HumanaChoice SNP-DE H5216-388 (PPO D-SNP)
|
$35.90 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:12 /30Days | $193.46 |
Browse Plan Formulary all covered insulin pay $35 or less |
McLaren Medicare Inspire Duals (HMO D-SNP)
|
$35.90 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | None | $428.57 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare D-SNP (HMO D-SNP)
|
$35.90 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | None | $434.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete MI-S001 (PPO D-SNP)
|
$35.90 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | P | $99.01 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete MI-S002 (HMO-POS D-SNP)
|
$35.90 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | P | $99.01 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete MI-V001 (HMO-POS D-SNP)
|
$35.90 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | P | $99.01 |
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 Choice H8145-006 (PFFS)
|
$40.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:12 /30Days | $193.46 |
Browse Plan Formulary all covered insulin pay $35 or less |
McLaren Medicare Inspire Flex (HMO-POS)
|
$49.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$12.00 | $27.00 | None | $372.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
McLaren Medicare Inspire Flex (HMO-POS)
|
$49.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$12.00 | $27.00 | None | $480.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medicare Plus Blue PPO Vitality (PPO)
|
$68.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$11.00 | $0.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medicare Plus Blue PPO Vitality (PPO)
|
$68.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$11.00 | $0.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medicare Plus Blue PPO Vitality (PPO)
|
$68.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$11.00 | $0.00 | None | $551.59 |
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 |
Medicare Plus Blue PPO Vitality (PPO)
|
$68.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$11.00 | $0.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medicare Plus Blue PPO Vitality (PPO)
|
$68.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$11.00 | $0.00 | None | $515.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Merit (PPO)
|
$73.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $380.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Merit (PPO)
|
$73.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $380.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Merit (PPO)
|
$73.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $398.87 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Merit (PPO)
|
$73.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $380.65 |
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 |
PriorityMedicare Merit (PPO)
|
$73.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
50% | 50% | None | $380.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare (HMO-POS)
|
$79.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | None | $380.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare (HMO-POS)
|
$79.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | None | $380.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare (HMO-POS)
|
$79.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | None | $380.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare (HMO-POS)
|
$79.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | None | $380.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare (HMO-POS)
|
$79.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | None | $398.87 |
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 |
HumanaChoice H5216-011 (PPO)
|
$84.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:12 /30Days | $162.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice R3887-002 (Regional PPO)
|
$105.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
25% | 25% | Q:12 /30Days | $162.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$110.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$7.00 | $0.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$110.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$7.00 | $0.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$110.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$7.00 | $0.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$110.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$7.00 | $0.00 | None | $551.59 |
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 |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$110.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$7.00 | $0.00 | None | $515.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
HAP Senior Plus (HMO-POS)
|
$110.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$9.00 | $0.00 | None | $363.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medicare Plus Blue PPO Signature (PPO)
|
$117.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$10.00 | $0.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medicare Plus Blue PPO Signature (PPO)
|
$117.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$10.00 | $0.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medicare Plus Blue PPO Signature (PPO)
|
$117.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$10.00 | $0.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medicare Plus Blue PPO Signature (PPO)
|
$117.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$10.00 | $0.00 | None | $551.59 |
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 |
Medicare Plus Blue PPO Signature (PPO)
|
$117.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$10.00 | $0.00 | None | $515.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Select (PPO)
|
$147.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | None | $380.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Select (PPO)
|
$147.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | None | $380.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Select (PPO)
|
$147.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | None | $380.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Select (PPO)
|
$147.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | None | $380.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
PriorityMedicare Select (PPO)
|
$147.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
45% | 45% | None | $398.87 |
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 |
HAP Senior Plus (PPO)
|
$165.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$11.00 | $0.00 | None | $363.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$240.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$7.00 | $0.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$240.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$7.00 | $0.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$240.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$7.00 | $0.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$240.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$7.00 | $0.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$240.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$7.00 | $0.00 | None | $515.21 |
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 |
Medicare Plus Blue PPO Assure (PPO)
|
$246.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$7.00 | $0.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medicare Plus Blue PPO Assure (PPO)
|
$246.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$7.00 | $0.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medicare Plus Blue PPO Assure (PPO)
|
$246.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$7.00 | $0.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medicare Plus Blue PPO Assure (PPO)
|
$246.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$7.00 | $0.00 | None | $551.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medicare Plus Blue PPO Assure (PPO)
|
$246.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$7.00 | $0.00 | None | $515.21 |
Browse Plan Formulary all covered insulin pay $35 or less |