PAROXETINE ER 12.5 MG TABLET 24H [Paxil CR] (30 TABLETS ) (NDC: 62175047032)
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 |
Advantage Care by Ultimate (HMO C-SNP)
|
$0.00 |
$0 | Yes, this drug has Gap Coverage. | 1 |
Generic |
$0.00 | $0.00 | None | $34.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
Advantage Care CHF by Ultimate (HMO C-SNP)
|
$0.00 |
$0 | Yes, this drug has Gap Coverage. | 1 |
Generic |
$0.00 | $0.00 | None | $34.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
Advantage Care COPD by Ultimate (HMO C-SNP)
|
$0.00 |
$0 | Yes, this drug has Gap Coverage. | 1 |
Generic |
$0.00 | $0.00 | None | $34.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Credit (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
50% | 50% | Q:90 /30Days | $55.03 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Explorer Premier (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:90 /30Days | $33.82 |
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 |
Aetna Medicare Premier (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:90 /30Days | $38.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Premier (PPO)
|
$0.00 |
$300 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:90 /30Days | $30.58 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Select (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$90.00 | $270.00 | Q:90 /30Days | $36.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Select Plus (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$90.00 | $270.00 | Q:90 /30Days | $36.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
BlueMedicare Classic (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$40.00 | $120.00 | Q:30 /30Days | $63.23 |
Browse Plan Formulary all covered insulin pay $35 or less |
BlueMedicare Premier (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$30.00 | $90.00 | Q:30 /30Days | $68.72 |
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 |
CareBreeze Platinum (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$85.00 | $245.00 | Q:60 /30Days | $15.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
CareComplete Platinum (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$85.00 | $245.00 | Q:60 /30Days | $15.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
CareOne Plus (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$45.00 | $125.00 | Q:60 /30Days | $22.29 |
Browse Plan Formulary all covered insulin pay $35 or less |
CareOne Plus (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$45.00 | $125.00 | Q:60 /30Days | $17.92 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $126.00 | Q:60 /30Days | $58.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Savings Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$40.00 | $120.00 | Q:60 /30Days | $58.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$40.00 | $120.00 | Q:60 /30Days | $58.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE GIVEBACK Tampa (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:60 /30Days | $17.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Tampa (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:60 /30Days | $17.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Tampa (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:60 /30Days | $17.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted ESSENTIALS Tampa (HMO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:60 /30Days | $17.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted ESSENTIALS Tampa (HMO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:60 /30Days | $17.94 |
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 |
Dialysis Plus (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, this drug has Gap Coverage. | 2 |
Generic |
$5.00 | $5.00 | None | $24.63 |
Browse Plan Formulary all covered insulin pay $35 or less |
Honest Care (HMO-POS)
|
$0.00 |
$0 | Yes, this drug has Gap Coverage. | 2 |
Generic |
$5.00 | $5.00 | None | $24.63 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:60 /30Days | $17.29 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$35.00 | $95.00 | Q:60 /30Days | $17.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1036-025 (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$55.00 | $155.00 | Q:60 /30Days | $17.92 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1036-265 (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$95.00 | $275.00 | Q:60 /30Days | $15.65 |
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 |
Humana Gold Plus H1036-265 (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$95.00 | $275.00 | Q:60 /30Days | $17.81 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Lung (HMO C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:60 /30Days | $17.29 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice Florida H5216-072 (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:60 /30Days | $16.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice Florida H5216-304 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:60 /30Days | $16.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice Florida H5216-393 (PPO)
|
$0.00 |
$350 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:60 /30Days | $17.09 |
Browse Plan Formulary all covered insulin pay $35 or less |
Premier by Ultimate (HMO)
|
$0.00 |
$0 | Yes, this drug has Gap Coverage. | 1 |
Generic |
$0.00 | $0.00 | None | $34.17 |
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 |
Simply Comfort (HMO I-SNP)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$5.00 | n/a | Q:30 /30Days | $7.57 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Extra (HMO)
|
$0.00 |
$0 | Yes, this drug has Gap Coverage. | 2 |
Generic |
$20.00 | $0.00 | Q:30 /30Days | $7.50 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Extra Platinum (HMO)
|
$0.00 |
$0 | Yes, this drug has Gap Coverage. | 2 |
Generic |
$20.00 | $0.00 | Q:30 /30Days | $7.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Freedom (PPO)
|
$0.00 |
$150* | Yes, but No Gap Coverage for this drug. | 2* |
Generic |
$10.00 | $0.00 | Q:30 /30Days | $7.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Freedom Extra (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 2* |
Generic |
$10.00 | $0.00 | Q:30 /30Days | $7.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Level (HMO C-SNP)
|
$0.00 |
$0 | Yes, this drug has Gap Coverage. | 2 |
Generic |
$0.00 | $0.00 | Q:30 /30Days | $7.50 |
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 |
Simply Level Platinum (HMO C-SNP)
|
$0.00 |
$0 | Yes, this drug has Gap Coverage. | 2 |
Generic |
$0.00 | $0.00 | Q:30 /30Days | $7.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply More (HMO)
|
$0.00 |
$0 | Yes, this drug has Gap Coverage. | 2 |
Generic |
$0.00 | $0.00 | Q:30 /30Days | $7.50 |
Browse Plan Formulary all covered insulin pay $35 or less |
Super Plus (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, this drug has Gap Coverage. | 2 |
Generic |
$5.00 | $5.00 | None | $24.63 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | Q:60 /30Days | $46.39 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | Q:60 /30Days | $46.39 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$100 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | Q:60 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted DUAL PLUS Florida (HMO D-SNP)
|
$16.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
25% | 25% | Q:60 /30Days | $17.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Tampa (HMO D-SNP)
|
$19.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
25% | 25% | Q:60 /30Days | $17.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted PREMIUM Florida (HMO)
|
$21.90 |
$545 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
25% | 25% | Q:60 /30Days | $17.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted PREMIUM Florida (HMO)
|
$21.90 |
$545 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
25% | 25% | Q:60 /30Days | $18.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted PREMIUM Florida (HMO)
|
$21.90 |
$545 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
25% | 25% | Q:60 /30Days | $17.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted PREMIUM Florida (HMO)
|
$21.90 |
$545 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
25% | 25% | Q:60 /30Days | $17.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted PREMIUM Florida (HMO)
|
$21.90 |
$545 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
25% | 25% | Q:60 /30Days | $17.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice Florida H5216-392 (PPO)
|
$22.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $275.00 | Q:60 /30Days | $17.09 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | Q:60 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Super Complete (HMO-POS C-SNP)
|
$25.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 2 |
Tier 2 |
25% | 25% | None | $24.63 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$26.60 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:60 /30Days | $58.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$27.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:60 /30Days | $59.95 |
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 |
CareNeeds Plus (HMO D-SNP)
|
$28.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:60 /30Days | $17.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Advantage Plus by Ultimate (Full) (HMO D-SNP)
|
$29.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Generic |
25% | 25% | None | $34.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Fully Integrated H1036-280 (HMO D-SNP)
|
$29.60 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:60 /30Days | $16.56 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Complete (HMO D-SNP)
|
$29.90 |
$545 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$20.00 | $60.00 | Q:30 /30Days | $7.03 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice R5826-074 (Regional PPO)
|
$31.00 |
$395 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:60 /30Days | $16.89 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H1036-102 (HMO D-SNP)
|
$31.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:60 /30Days | $17.29 |
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 |
CareNeeds Platinum (HMO D-SNP)
|
$32.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:60 /30Days | $17.13 |
Browse Plan Formulary all covered insulin pay $35 or less |
Advantage Plus by Ultimate (Partial) (HMO D-SNP)
|
$32.60 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Generic |
25% | 25% | None | $34.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H1036-314 (HMO D-SNP)
|
$32.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:60 /30Days | $16.60 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual (HMO D-SNP)
|
$34.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | Q:60 /30Days | $44.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Dialysis Complete (HMO-POS C-SNP)
|
$36.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 2 |
Tier 2 |
25% | 25% | None | $24.63 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Complete Platinum (HMO D-SNP)
|
$37.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$20.00 | $60.00 | Q:30 /30Days | $7.03 |
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 Dual Liberty (HMO D-SNP)
|
$37.60 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | Q:60 /30Days | $44.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Assure (HMO D-SNP)
|
$37.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
25% | 25% | Q:90 /30Days | $54.75 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Assure Plus (HMO D-SNP)
|
$37.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
25% | 25% | Q:90 /30Days | $55.03 |
Browse Plan Formulary all covered insulin pay $35 or less |
BlueMedicare Complete (HMO D-SNP)
|
$37.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | Q:30 /30Days | $65.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice Florida SNP-DE H5216-394 (PPO D-SNP)
|
$37.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:60 /30Days | $17.09 |
Browse Plan Formulary all covered insulin pay $35 or less |
Longevity Health Plan (HMO I-SNP)
|
$37.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | n/a | Q:60 /30Days | $60.30 |
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 Dual Reserve (HMO D-SNP)
|
$37.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | Q:60 /30Days | $44.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Premium Enhanced Open (PPO)
|
$93.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | Q:60 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice R5826-005 (Regional PPO)
|
$173.00 |
$100 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $275.00 | Q:60 /30Days | $16.89 |
Browse Plan Formulary all covered insulin pay $35 or less |