There are 32 stand-alone Medicare Part D plans in Hawaii 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
ETIDRONATE DISODIUM 400MG TABLET (60 CT) (60 BOT) (NDC: 00378328891) 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 |
||||||
AARP MedicareRx Saver![]() ![]() |
$19.90 | $295 | No Gap Coverage | 1 | Tier 1 - Preferred Generic | $5.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
First Health Part D-Premier![]() ![]() |
$23.70 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $62.00 | n/a | None | |
Browse Plan Formulary | |||||||||
HealthSpring Prescription Drug Plan-Reg 33![]() ![]() |
$24.80 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Value![]() ![]() |
$25.80 | $295 | No Gap Coverage | 1 | Generic | 23% | 23% | None | |
Browse Plan Formulary | |||||||||
BravoRx![]() ![]() |
$26.00 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | Q:450 /90Days | |
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 |
|
CIGNA Medicare Rx Plan One![]() ![]() |
$27.60 | $295 | No Gap Coverage | 2 | Tier 2 | $33.00 | $82.50 | None | |
Browse Plan Formulary | |||||||||
WellCare Signature![]() ![]() |
$27.60 | $0 | No Gap Coverage | 1 | Tier 1 | $0.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
WellCare Classic![]() ![]() |
$27.90 | $295 | No Gap Coverage | 1 | Tier 1 | $0.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
SilverScript Value![]() ![]() |
$28.10 | $295 | No Gap Coverage | 1 | Generic | $8.00 | $12.00 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5884-093![]() ![]() |
$30.70 | $295 | No Gap Coverage | 1 | Preferred Generic | 15% | 15% | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier![]() ![]() |
$33.10 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $74.00 | $222.00 | None | |
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 |
|
UA Medicare Part D Rx Covg - Silver Plan![]() ![]() |
$33.20 | $190 | No Gap Coverage | 1 | Generic | $4.00 | $10.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred![]() ![]() |
$34.60 | $0 | No Gap Coverage | 1 | Tier 1-Preferred Generic | $7.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
MedicareRx Rewards Value![]() ![]() |
$34.60 | $130 | No Gap Coverage | 1 | Tier 1 Preferred Generic | $9.50 | $14.25 | None | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Prescription Drug Cov![]() ![]() |
$35.30 | $0 | No Gap Coverage | 1 | Generic | $5.00 | $13.00 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Enhanced S5884-096![]() ![]() |
$36.30 | $0 | No Gap Coverage | 1 | Preferred Generic | $7.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 2![]() ![]() |
$36.90 | $0 | No Gap Coverage | 3 | Non-Preferred Brand | $90.00 | $225.00 | None | |
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 |
|
Aetna Medicare Rx Essentials![]() ![]() |
$38.10 | $200 | No Gap Coverage | 2 | Tier 2 - Non-Preferred Generic | $12.00 | $24.00 | None | |
Browse Plan Formulary | |||||||||
Fox Grand Plan![]() ![]() |
$40.40 | $295 | Some Generics | 2 | Tier 2 | $19.00 | $38.00 | None | |
Browse Plan Formulary | |||||||||
Sterling Rx![]() ![]() |
$41.40 | $295 | No Gap Coverage | 1 | Generic | $7.00 | $14.00 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Choice![]() ![]() |
$42.90 | $0 | No Gap Coverage | 1 | Generic | $6.00 | $6.00 | None | |
Browse Plan Formulary | |||||||||
UnitedHealth Rx Basic![]() ![]() |
$44.60 | $0 | No Gap Coverage | 1 | Tier 1 - Preferred Generic | $7.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two![]() ![]() |
$45.30 | $0 | No Gap Coverage | 3 | Tier 3 | $47.00 | $117.50 | None | |
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 |
|
AdvantraRx Premier Plus![]() ![]() |
$49.10 | $0 | Many Generics | 3 | Non-Preferred Generic/Non-Preferred Brand | $70.00 | $210.00 | None | |
Browse Plan Formulary | |||||||||
SilverScript Plus![]() ![]() |
$49.10 | $50 | Many Generics | 2 | Generic | $9.00 | $23.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx - Costco Plus Plan![]() ![]() |
$62.70 | $0 | Some Generics | 2 | Tier 2 - Non-Preferred Generic | $5.00 | $20.00 | None | |
Browse Plan Formulary | |||||||||
SilverScript Complete![]() ![]() |
$63.40 | $0 | Many Generics | 2 | Generic | $7.50 | $19.00 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Access![]() ![]() |
$70.70 | $0 | All Generics | 1 | Generic | $6.00 | $6.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced![]() ![]() |
$73.00 | $0 | Many Generics | 1 | Tier 1 - Preferred Generic | $7.00 | $0.00 | None | |
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 |
|
CIGNA Medicare Rx Plan Three![]() ![]() |
$88.70 | $0 | Some Generics | 2 | Tier 2 | $35.00 | $87.50 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5884-099![]() ![]() |
$94.70 | $0 | Many Generics | 1 | Preferred Generic | $7.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier![]() ![]() |
$111.10 | $0 | Many Generics | 2 | Tier 2 - Non-Preferred Generic | $10.00 | $20.00 | None | |
Browse Plan Formulary |
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