SEVELAMER 2.4 GM POWDER PACKET POWDER PACK [Renvela] (NDC: 65862093190)
2024 Medicare Prescription Drug Plan (MAPD) Information
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Plan Name |
Monthly Prem. |
De- duct- ible | Does Plan Offer Additional Gap Coverage | Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Plan’s Avg. Retail Drug Price 30-Day |
Tier Nbr. |
Tier Desc. |
30-Day Prfrd. Pharm |
90-Day Mail Order |
AARP Medicare Advantage from UHC FL-0026 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.69 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC FL-0031 (Regional PPO)
|
$0.00 |
$395 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.53 |
Browse Plan Formulary all covered insulin pay $35 or less |
BlueMedicare Classic (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$93.00 | $279.00 | Q:90 /30Days | $685.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
BlueMedicare Premier (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$50.00 | $150.00 | Q:90 /30Days | $685.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
BlueMedicare Value (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:90 /30Days | $685.30 |
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 |
CareBreeze Platinum (HMO C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$85.00 | $245.00 | Q:180 /30Days | $155.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
CareComplete Platinum (HMO C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$85.00 | $245.00 | Q:180 /30Days | $155.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
CareFree (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:180 /30Days | $155.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
CareFree Platinum (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$85.00 | $245.00 | Q:180 /30Days | $155.73 |
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 |
$25.00 | $65.00 | Q:180 /30Days | $155.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$35.00 | $105.00 | Q:150 /30Days | $601.87 |
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 |
Cigna Preferred Savings Medicare (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:150 /30Days | $601.87 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:150 /30Days | $596.38 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Miami-Dade (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$0.00 | $0.00 | Q:180 /30Days | $90.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted ESSENTIALS Miami-Dade (HMO)
|
$0.00 |
$150* | Yes, but No Gap Coverage for this drug. | 2* |
Generic |
$5.00 | $12.50 | Q:180 /30Days | $90.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
DrExtraCare (HMO C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$40.00 | $120.00 | Q:90 /30Days | $538.56 |
Browse Plan Formulary all covered insulin pay $35 or less |
DrMax (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$45.00 | $135.00 | Q:90 /30Days | $538.56 |
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 |
DrSelect (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$45.00 | $135.00 | Q:90 /30Days | $538.56 |
Browse Plan Formulary all covered insulin pay $35 or less |
DrValue (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$90.00 | $270.00 | Q:90 /30Days | $538.56 |
Browse Plan Formulary all covered insulin pay $35 or less |
HealthSun HealthAdvantage Plan (HMO)
|
$0.00 |
$0 | Yes, this drug has Gap Coverage. | 2 |
Generic |
$0.00 | $0.00 | Q:180 /30Days | $1,234.31 |
Browse Plan Formulary all covered insulin pay $35 or less |
HealthSun HealthAdvantage Plus (HMO)
|
$0.00 |
$0 | Yes, this drug has Gap Coverage. | 2 |
Generic |
$0.00 | $0.00 | Q:180 /30Days | $1,234.31 |
Browse Plan Formulary all covered insulin pay $35 or less |
HealthSun VitalCare (HMO C-SNP)
|
$0.00 |
$0 | Yes, this drug has Gap Coverage. | 2 |
Generic |
$0.00 | $0.00 | Q:180 /30Days | $1,234.31 |
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 |
$85.00 | $245.00 | Q:180 /30Days | $155.29 |
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 |
Humana Gold Plus H1036-054C (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$5.00 | $5.00 | Q:180 /30Days | $155.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1036-305 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$80.00 | $230.00 | Q:180 /30Days | $155.29 |
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 |
$85.00 | $245.00 | Q:180 /30Days | $155.29 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice Florida H5216-068 (PPO)
|
$0.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:180 /30Days | $155.29 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice Florida H5216-311 (PPO)
|
$0.00 |
$350 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:180 /30Days | $154.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice Florida H7284-008 (PPO)
|
$0.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:180 /30Days | $155.29 |
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 |
Leon MediExtra (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Non-Preferred Brand |
$40.00 | n/a | None | $503.42 |
Browse Plan Formulary all covered insulin pay $35 or less |
Leon MediMore (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Non-Preferred Brand |
$97.00 | n/a | None | $503.42 |
Browse Plan Formulary all covered insulin pay $35 or less |
Memory Care (HMO C-SNP)
|
$0.00 |
$400* | No additional gap coverage, only the Donut Hole Discount | 2* |
Generic |
$10.00 | $30.00 | None | $620.28 |
Browse Plan Formulary all covered insulin pay $35 or less |
Premier Care (HMO I-SNP)
|
$0.00 |
$400* | No additional gap coverage, only the Donut Hole Discount | 2* |
Generic |
$10.00 | $30.00 | None | $620.28 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Comfort (HMO I-SNP)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$5.00 | n/a | Q:180 /30Days | $807.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Extra (HMO)
|
$0.00 |
$0 | Yes, this drug has Gap Coverage. | 2 |
Generic |
$0.00 | $0.00 | Q:180 /30Days | $823.41 |
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 Extra Platinum (HMO)
|
$0.00 |
$0 | Yes, this drug has Gap Coverage. | 2 |
Generic |
$0.00 | $0.00 | Q:180 /30Days | $823.41 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Freedom (PPO)
|
$0.00 |
$125* | Yes, but No Gap Coverage for this drug. | 2* |
Generic |
$10.00 | $0.00 | Q:180 /30Days | $822.62 |
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:180 /30Days | $823.41 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Level Platinum (HMO C-SNP)
|
$0.00 |
$0 | Yes, this drug has Gap Coverage. | 2 |
Generic |
$0.00 | $0.00 | Q:180 /30Days | $823.41 |
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:180 /30Days | $823.41 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply More Platinum (HMO)
|
$0.00 |
$0 | Yes, this drug has Gap Coverage. | 2 |
Generic |
$0.00 | $0.00 | Q:180 /30Days | $823.41 |
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 |
Solis Healthy Living Plan (HMO)
|
$0.00 |
$0 | Yes, this drug has Gap Coverage. | 2 |
Generic |
$0.00 | $0.00 | None | $780.97 |
Browse Plan Formulary all covered insulin pay $35 or less |
Solis Wellness Plan (HMO C-SNP)
|
$0.00 |
$0 | Yes, this drug has Gap Coverage. | 2 |
Generic |
$0.00 | $0.00 | None | $780.97 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC MedicareMax Complete Care FL-0030 (HMO C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$65.00 | $185.00 | None | $164.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC MedicareMax Medicare Advantage FL-0028 (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$65.00 | $185.00 | None | $164.79 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Preferred Complete Care FL-0003 (HMO C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$45.00 | $125.00 | None | $164.79 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Preferred Medicare Advantage FL-0001 (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$40.00 | $110.00 | None | $164.79 |
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 (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
50% | 50% | Q:180 /30Days | $196.49 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Miami-Dade (HMO D-SNP)
|
$11.60 |
$545 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
25% | 25% | Q:180 /30Days | $90.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Leon MediDual (HMO D-SNP)
|
$14.90 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Non-Preferred Brand |
28% | n/a | None | $503.42 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Complete (HMO D-SNP)
|
$16.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$20.00 | $60.00 | Q:180 /30Days | $1,030.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
HealthSun MediSun Extra (HMO D-SNP)
|
$19.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
25% | 25% | Q:180 /30Days | $1,234.31 |
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. | 2* |
Generic |
$0.00 | $0.00 | Q:180 /30Days | $98.43 |
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 |
Devoted PREMIUM Florida (HMO)
|
$21.90 |
$545* | Yes, but No Gap Coverage for this drug. | 2* |
Generic |
$0.00 | $0.00 | Q:180 /30Days | $101.70 |
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. | 2* |
Generic |
$0.00 | $0.00 | Q:180 /30Days | $91.49 |
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. | 2* |
Generic |
$0.00 | $0.00 | Q:180 /30Days | $97.08 |
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. | 2* |
Generic |
$0.00 | $0.00 | Q:180 /30Days | $90.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
HealthSun MediMax (HMO)
|
$23.90 |
$545 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
25% | 25% | Q:180 /30Days | $1,234.31 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice Florida H7284-007 (PPO)
|
$25.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $275.00 | Q:180 /30Days | $154.94 |
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 |
UHC Nursing Home Plan EX-F006 (HMO-POS I-SNP)
|
$25.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
25% | 25% | None | $164.62 |
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:180 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Reserve (HMO D-SNP)
|
$27.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | Q:180 /30Days | $128.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$27.60 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:150 /30Days | $596.38 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$27.60 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:150 /30Days | $596.38 |
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:180 /30Days | $153.15 |
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 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:180 /30Days | $153.22 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$31.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | Q:180 /30Days | $128.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
DrPlus (HMO D-SNP)
|
$31.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
25% | 25% | Q:90 /30Days | $538.56 |
Browse Plan Formulary all covered insulin pay $35 or less |
DrFlex (HMO D-SNP)
|
$31.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
25% | 25% | Q:90 /30Days | $538.56 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan FL-F001 (PPO I-SNP)
|
$32.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
25% | 25% | None | $164.53 |
Browse Plan Formulary all covered insulin pay $35 or less |
CareNeeds Platinum (HMO D-SNP)
|
$32.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:180 /30Days | $155.29 |
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 |
Wellcare All Dual (HMO D-SNP)
|
$33.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | Q:180 /30Days | $128.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
CareNeeds Plus (HMO D-SNP)
|
$34.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:180 /30Days | $155.29 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simply Complete Platinum (HMO D-SNP)
|
$37.60 |
$545 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$20.00 | $60.00 | Q:180 /30Days | $1,030.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
AmeriHealth Caritas VIP Care (HMO D-SNP)
|
$37.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | None | $343.09 |
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 | 4 |
Non-Preferred Drug |
25% | 25% | Q:90 /30Days | $685.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Florida Complete Care (HMO I-SNP)
|
$37.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | Q:180 /30Days | $124.43 |
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 |
Florida Complete Care- D-SNP (HMO D-SNP)
|
$37.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | Q:180 /30Days | $124.43 |
Browse Plan Formulary all covered insulin pay $35 or less |
Florida Complete Care- In The Community (HMO I-SNP)
|
$37.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | Q:180 /30Days | $124.43 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H1036-077A (HMO D-SNP)
|
$37.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:180 /30Days | $155.29 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H1036-304 (HMO D-SNP)
|
$37.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:180 /30Days | $155.29 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP)
|
$37.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:180 /30Days | $154.94 |
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:90 /30Days | $603.98 |
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 |
Senior Care (HMO I-SNP)
|
$37.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$15.00 | $45.00 | None | $620.28 |
Browse Plan Formulary all covered insulin pay $35 or less |
Solis Guardian Plan (HMO D-SNP)
|
$37.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
25% | 25% | None | $780.97 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Care Advantage FL-E001 (PPO I-SNP)
|
$37.70 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.53 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete FL-D003 (PPO D-SNP)
|
$37.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | None | $164.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete FL-D003 (PPO D-SNP)
|
$37.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | None | $164.52 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete FL-D005 (Regional PPO D-SNP)
|
$37.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | None | $164.53 |
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 FL-Y001 (HMO-POS D-SNP)
|
$37.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | None | $164.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC MedicareMax Medicare Advantage FL-D004 (HMO D-SNP)
|
$37.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | None | $164.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Preferred Dual Complete FL-D001 (HMO D-SNP)
|
$37.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | None | $164.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
BlueMedicare Choice (Regional PPO)
|
$67.40 |
$250 | Yes, but No Gap Coverage for this drug. | 4 |
Non-Preferred Drug |
$93.00 | $279.00 | Q:90 /30Days | $683.23 |
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:180 /30Days | $153.22 |
Browse Plan Formulary all covered insulin pay $35 or less |