There are 18 stand-alone Medicare Part D plans in Utah 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
MYSOLINE 250MG TABLET (NDC: 66490069111) 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 |
$32.20 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | $98.00 | $269.50 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials |
$33.20 | $195 | No Gap Coverage | 4 | Tier 4 - Non-Preferred Brand | $67.00 | $134.00 | None | |
Browse Plan Formulary | |||||||||
SierraRx |
$36.80 | $0 | No Gap Coverage | 2 | Brand | $45.00 | $135.00 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan One |
$38.50 | $295 | No Gap Coverage | 2 | Tier 2 | $33.00 | $82.50 | None | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 1 |
$40.20 | $295 | No Gap Coverage | 2 | Preferred Brand | $44.00 | $88.00 | 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 |
|
AARP MedicareRx Preferred |
$42.90 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $76.85 | $215.55 | None | |
Browse Plan Formulary | |||||||||
Sterling Rx |
$44.00 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | $57.00 | $114.00 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two |
$44.10 | $0 | No Gap Coverage | 3 | Tier 3 | $38.00 | $95.00 | None | |
Browse Plan Formulary | |||||||||
Health Net Value Orange Option 2 |
$48.90 | $0 | No Gap Coverage | 2 | Preferred Brand | $39.00 | $78.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx - Costco Plus Plan |
$64.70 | $0 | Some Generics | 4 | Tier 4 - Non-Preferred Brand | $90.00 | $180.00 | None | |
Browse Plan Formulary | |||||||||
SilverScript Plus |
$65.70 | $50 | Many Generics | 5 | Non-Preferred Brand | $95.00 | $261.00 | 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 |
|
Regence Medicare Script |
$66.50 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | $40.00 | $120.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced |
$72.90 | $0 | Many Generics | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $95.00 | $270.00 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three |
$73.20 | $0 | Some Generics | 2 | Tier 2 | $35.00 | $87.50 | None | |
Browse Plan Formulary | |||||||||
SierraRx Basic |
$78.00 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
Regence Medicare Script Enhanced |
$83.50 | $0 | Many Generics | 3 | Non-Preferred Brand | $50.00 | $150.00 | None | |
Browse Plan Formulary | |||||||||
SilverScript Complete |
$84.60 | $0 | Many Generics | 4 | Non-Preferred Brand | $98.00 | $270.00 | 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 Premier |
$113.70 | $0 | Many Generics | 4 | Tier 4 - Non-Preferred Brand | $65.00 | $130.00 | None | |
Browse Plan Formulary |
|