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2024 Medicare Part D Plan’s Negotiated Retail Drug Price
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2024 Medicare Advantage Prescription Drug Price Information
Community Care's Partnership Program (HMO D-SNP) (H2034-001-0)
Benefits & Contact Info         
Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less.

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Community Care's Partnership Program (HMO D-SNP) Formulary
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ALENDRONATE SODIUM 70 MG TABLET [Fosamax]  
Plan’s average negotiated retail drug price in
in Outagamie, WI: CMS MA Region 14, includes: WI 		$42.88* 30-Day Supply
$128.64^ 90-Day Supply (calculated)
Formulary (Drug List) drug tier:Tier 1
Does this plan offer any Gap coverage?No Gap Coverage
Does this drug have Gap coverage?No, this drug IS NOT covered in the gap, but all drugs receive the donut hole discount.
Drug Usage Management Restrictions:None
Formulary (Drug List) Tier Cost-Sharing Details
Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less.
  30-Day Supply
Cost-Sharing		 90-Day Supply
Cost-Sharing^
Preferred Pharmacy Standard Pharmacy Mail- Order** Preferred Pharmacy Standard Pharmacy Mail- Order**
Initial $545 Deductible Cost Sharing:
 100% 100% n/a n/a n/a n/a
Initial Coverage Phase Cost-Sharing:
 $0.00 $0.00 n/a n/a n/a n/a
Coverage Gap Phase Cost-Sharing Incl. Donut Hole Discount (Generics 75%):
 25% 25% n/a n/a n/a n/a
Coverage Gap Phase Cost-Sharing Incl. Donut Hole Discount (Brand 75%):
 25% 25% n/a n/a n/a n/a
Catastrophic Coverage Phase Cost-Sharing (all Formulary Drugs):
 $0$0n/a n/an/an/a
Your Estimated Cost for Purchases During Each Coverage Phase
  30-Day Supply
Cost-Sharing		 90-Day Supply
Cost-Sharing^
Preferred Pharmacy Standard Pharmacy Mail- Order** Preferred Pharmacy Standard Pharmacy Mail- Order**
Your Estimated Cost in Deductible Phase:
 $42.88 $42.88 n/a n/a n/a n/a
Your Estimated Cost Initial Coverage Phase:
 $0.00 $0.00 $0.00 n/a n/a n/a
Your Estimated Cost in Gap if Drug is Generic (75% discount):
 $10.72$10.72n/a n/an/an/a
Your Estimated Cost in Gap if Drug is Brand-Name (75% discount):
 $10.72$10.72n/a n/an/an/a
Your Estimated Cost in Catastrophic Coverage (all Formulary Drugs):
 $0$0n/a n/an/an/a
Tier Cost-Sharing Details and Your Costs with Explanations
  30-Day Supply
Cost-Sharing		 90-Day Supply
Cost-Sharing^
Preferred Pharmacy Standard Pharmacy Mail- Order** Preferred Pharmacy Standard Pharmacy Mail- Order**
--- If you purchase during the Initial Deductible Phase ---
Initial $545 Deductible Cost Sharing:
 100% 100% n/a n/a n/a n/a
Your Estimated Cost in Deductible Phase:
 $42.88 $42.88 n/a n/a n/a n/a
Explanation for 30-Day Preferred Pharmacy purchase:
 In the initial deductible phase, you will pay 100% of the drug cost up to your deductible limit of $545. Any excess would fall into the initial coverage phase.
--- If you purchase during the Initial Coverage Phase ---
Initial Coverage Phase Cost-Sharing:
 $0.00 $0.00 n/a n/a n/a n/a
Your Estimated Cost Initial Coverage Phase:
 $0.00 $0.00 $0.00 n/a n/a n/a
Explanation for 30-Day Preferred Pharmacy purchase:
 The cost-sharing for purchases made during the initial coverage phase (ICP) would be a flat fee of $0.00.
--- If you purchase during the Coverage Gap Phase (Donut Hole) ---
Your Estimated Cost in Gap if Drug is Generic (75% discount):
 $10.72$10.72n/a n/an/an/a
Explanation for 30-Day Preferred Pharmacy purchase:
 Your cost is the negotiated retail price of $42.88 x 25%.
Your Estimated Cost in Gap if Drug is Brand-Name (75% discount):
 $10.72$10.72n/a n/an/an/a
Explanation for 30-Day Preferred Pharmacy purchase:
 Your costs is the negotiated retail price of $42.88 x 25%.
--- If you purchase during the Catastrophic Coverage Phase ---
Catastrophic Coverage Phase Cost-Sharing (all Formulary Drugs):
 $0$0n/a n/an/an/a
Your Estimated Cost in Catastrophic Coverage (all Formulary Drugs):
 $0$0n/a n/an/an/a
Explanation for 30-Day Preferred Pharmacy purchase:
 Beginning with plan year 2024, the Inflation Reduction Act (IRA) of 2022 eliminates beneficiary cost-sharing once your TrOOP reaches $8,000 -- the established maximum cap on out-of-pocket spending for Part D formulary drugs (RxMOOP).
Community Care's Partnership Program (HMO D-SNP)
Average Negotiated Retail Drug Price History
 30-Day Supply90 Day Supply
March, 2024: $42.88n/a
January, 2024: $43.02n/a
September, 2023: $43.12n/a
June, 2023: $45.24n/a
March, 2023: $41.52n/a
January, 2023: $40.04n/a
September, 2022: $40.88n/a
June, 2022: $40.92n/a
March, 2022: $40.52n/a
January, 2022: $55.08n/a
September, 2021: $4.28n/a
June, 2021: $4.68n/a
March, 2021: $52.44n/a
January, 2021: $47.00n/a
September, 2020: n/an/a
June, 2020: n/an/a
March, 2020: n/an/a
January, 2020: n/an/a
September, 2019: 
June, 2019: 
March, 2019: 
January, 2019: 
September, 2018: 
June, 2018: 
March, 2018: 
January, 2018: 
September, 2017: 
June, 2017: 
March, 2017: 
January, 2017: 
September, 2016: 
June, 2016: 
April, 2016: 
January, 2016: 
September, 2015: 
June, 2015: 
April, 2015: 
January, 2015: 
September, 2014: 
June, 2014: 
March, 2014: 
January, 2014: 
October, 2013: 
January, 2013: --
April, 2012: --
September, 2010: --
Notes:
*The Medicare drug plan’s average negotiated retail drug price is based on several variables: the medication, the quantity of your prescription, the specific Medicare Part D plan, and the pharmacies in the plan’s service area. In this case, the average of the ALENDRONATE SODIUM 70 MG TABLET [Fosamax] prices that the Community Care's Partnership Program (HMO D-SNP) has negotiated with each of the retail pharmacies in the plan’s service area (in Outagamie, WI: CMS MA Region 14, includes: WI). In other words, when you use the Community Care's Partnership Program (HMO D-SNP) to purchase ALENDRONATE SODIUM 70 MG TABLET [Fosamax], you may pay slightly more or slightly less than the figures shown in the table above depending on the pharmacy where you fill your prescription and the quantity of your prescription. The example average retail prices used above are based on a quantity of 4 for the 30-day supply.

**The mail-order cost-sharing is the plan’s "preferred" mail-order cost-sharing.

^If the cost-sharing for your 90-day supply is a percentage (co-insurance), your estimated cost shown in the table above is calculated based on the 30-day average retail price multiplied by three (3). Please keep in mind that some plans offer discounts for purchasing a 90-day mail-order supply. For example, if you purchase a 90-day mail-order supply of your medication, you may only pay for a 60-day supply, based on your plan coverage. However, such a plan-specific discount is NOT shown in the table above because this data is not provided to us in a usable format. You can telephone the Medicare prescription drug plan directly for more details.
Return to the Community Care's Partnership Program (HMO D-SNP) 2024 Formulary Browser by choosing a letter below:
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Chart Legend:

What does all this mean? Below are a few notes to help you understand the above 2024 Medicare Part D Community Care's Partnership Program (HMO D-SNP) Plan Formulary.