There are 23 stand-alone Medicare Part D plans in Arizona 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
LESCOL 40MG CAPSULE (100 BOT) (NDC: 00078023405) 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 |
||||||
First Health Part D-Secure |
$13.90 | $175 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $50.00 | n/a | Q:60 /30Days | |
Browse Plan Formulary | |||||||||
AdvantraRx Value |
$22.90 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $55.00 | $165.00 | Q:60 /30Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan One |
$23.20 | $295 | No Gap Coverage | 2 | Tier 2 | $33.00 | $82.50 | None | |
Browse Plan Formulary | |||||||||
First Health Part D-Premier |
$24.10 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $57.00 | n/a | Q:60 /30Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials |
$24.80 | $200 | No Gap Coverage | 4 | Tier 4 - Non-Preferred Brand | $68.00 | $136.00 | S Q:2 /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 |
|
Humana PDP Standard S5884-086 |
$26.40 | $295 | No Gap Coverage | 2 | Preferred Brand | 25% | 25% | Q:60 /30Days | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Saver |
$26.50 | $295 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $50.25 | $135.75 | S Q:62 /31Days | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred |
$32.60 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $84.70 | $239.10 | S Q:62 /31Days | |
Browse Plan Formulary | |||||||||
SilverScript Value |
$32.90 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | $98.00 | $269.50 | None | |
Browse Plan Formulary | |||||||||
UnitedHealth Rx Basic |
$35.90 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $98.00 | $279.00 | S Q:62 /31Days | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 2 |
$36.50 | $0 | No Gap Coverage | 3 | Non-Preferred Brand | $90.00 | $225.00 | Q:2 /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 |
|
AdvantraRx Premier |
$38.80 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $71.00 | $213.00 | Q:60 /30Days | |
Browse Plan Formulary | |||||||||
Humana PDP Enhanced S5884-026 |
$41.00 | $0 | No Gap Coverage | 2 | Preferred Brand | $40.00 | $100.00 | Q:60 /30Days | |
Browse Plan Formulary | |||||||||
Sterling Rx |
$41.00 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | $57.00 | $114.00 | S Q:68 /34Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two |
$47.70 | $0 | No Gap Coverage | 3 | Tier 3 | $38.00 | $95.00 | None | |
Browse Plan Formulary | |||||||||
SilverScript Plus |
$52.20 | $50 | Many Generics | 5 | Non-Preferred Brand | $95.00 | $261.00 | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier Plus |
$54.30 | $0 | Many Generics | 3 | Non-Preferred Generic/Non-Preferred Brand | $75.00 | $225.00 | Q:60 /30Days | |
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 - Costco Plus Plan |
$54.90 | $0 | Some Generics | 4 | Tier 4 - Non-Preferred Brand | $90.00 | $180.00 | S Q:2 /1Days | |
Browse Plan Formulary | |||||||||
SilverScript Complete |
$73.90 | $0 | Many Generics | 4 | Non-Preferred Brand | $98.00 | $270.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced |
$77.40 | $0 | Many Generics | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $95.00 | $270.00 | S Q:62 /31Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three |
$86.50 | $0 | Some Generics | 2 | Tier 2 | $35.00 | $87.50 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier |
$101.00 | $0 | Many Generics | 4 | Tier 4 - Non-Preferred Brand | $65.00 | $130.00 | S Q:2 /1Days | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5884-056 |
$102.20 | $0 | Many Generics | 2 | Preferred Brand | $40.00 | $100.00 | Q:60 /30Days | |
Browse Plan Formulary |
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