There are 22 stand-alone Medicare Part D plans in Virginia meeting your criteria.
Caution: The 2009 Medicare Part D plan information below is for research purposes.
Click here to see 2024 Medicare Part D plans
AMBIEN CR 12.5MG TABLET (100'S BOT) (NDC: 00024552131) 2009 Medicare Prescription Drug Plan (PDP) Information Click here for the Chart Legend | |||||||||
Plan Name | Monthly Prem. |
De- duct- ible |
Does Plan Offer Gap Coverage |
Drug Tier Information | Cost-Sharing | Drug Usage Mgmt |
|||
---|---|---|---|---|---|---|---|---|---|
Tier Nbr. |
Tier Desc. |
30-Day Prfrd. Pharm |
90-Day Order |
||||||
SilverScript Value |
$26.90 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | $98.00 | $269.50 | S Q:30 /60Days | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Saver |
$27.10 | $295 | No Gap Coverage | 2 | Tier 2 - Generic and Preferred Brand | $22.00 | $51.00 | Q:31 /31Days | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 1 |
$28.40 | $295 | No Gap Coverage | 2 | Preferred Brand | $42.00 | $84.00 | S Q:1 /1Days | |
Browse Plan Formulary | |||||||||
BravoRx |
$29.00 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials |
$32.30 | $200 | No Gap Coverage | 3 | Tier 3 - Preferred Brand | $27.00 | $54.00 | S Q:1 /1Days | |
Browse Plan Formulary | |||||||||
Plan Name | Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Order |
Drug Usage Mgmt |
|
Blue MedicareRx Value |
$35.30 | $130 | No Gap Coverage | 3 | Tier 3 Non-Preferred Brand or Generic | $85.00 | $212.50 | P Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Choice |
$36.20 | $0 | No Gap Coverage | 2 | Preferred Brand | $35.00 | $87.50 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred |
$38.20 | $0 | No Gap Coverage | 2 | Tier 2 - Generic and Preferred Brand | $38.00 | $99.00 | Q:31 /31Days | |
Browse Plan Formulary | |||||||||
UnitedHealth Rx Basic |
$39.30 | $0 | No Gap Coverage | 2 | Tier 2 - Generic and Preferred Brand | $35.00 | $90.00 | Q:31 /31Days | |
Browse Plan Formulary | |||||||||
Sterling Rx |
$40.10 | $295 | No Gap Coverage | 2 | Preferred Brand | $25.00 | $50.00 | S Q:34 /34Days | |
Browse Plan Formulary | |||||||||
Health Net Value Orange Option 2 |
$40.90 | $0 | No Gap Coverage | 2 | Preferred Brand | $39.00 | $78.00 | S Q:1 /1Days | |
Browse Plan Formulary | |||||||||
Plan Name | Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Order |
Drug Usage Mgmt |
|
Blue MedicareRx Plus |
$44.40 | $0 | No Gap Coverage | 3 | Tier 3 Non-Preferred Brand or Generic | $75.00 | $187.50 | P Q:30 /30Days | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Prescription Drug Cov |
$46.30 | $0 | No Gap Coverage | 2 | Preferred Brand | $31.00 | $62.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx - Costco Plus Plan |
$53.20 | $0 | Some Generics | 3 | Tier 3 - Preferred Brand | $35.00 | $80.00 | S Q:1 /1Days | |
Browse Plan Formulary | |||||||||
SilverScript Plus |
$59.00 | $50 | Many Generics | 5 | Non-Preferred Brand | $95.00 | $261.00 | Q:30 /60Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three |
$61.70 | $0 | Some Generics | 3 | Tier 3 | $60.00 | $150.00 | S Q:30 /30Days | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Gold |
$67.00 | $0 | No Gap Coverage | 3 | Tier 3 Preferred Brand | $40.00 | $120.00 | S | |
Browse Plan Formulary | |||||||||
Plan Name | Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Order |
Drug Usage Mgmt |
|
Medco Medicare Prescription Plan - Access |
$67.40 | $0 | All Generics | 2 | Preferred Brand | $35.00 | $87.50 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced |
$72.60 | $0 | Many Generics | 2 | Tier 2 - Generic and Preferred Brand | $39.00 | $102.00 | Q:31 /31Days | |
Browse Plan Formulary | |||||||||
SilverScript Complete |
$75.10 | $0 | Many Generics | 4 | Non-Preferred Brand | $98.00 | $270.00 | Q:30 /60Days | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Premier |
$82.80 | $0 | Many Generics | 3 | Tier 3 Non-Preferred Brand or Generic | $75.00 | $187.50 | P Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier |
$107.10 | $0 | Many Generics | 3 | Tier 3 - Preferred Brand | $30.00 | $60.00 | S Q:1 /1Days | |
Browse Plan Formulary |
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