There are 55 stand-alone Medicare Part D plans in West 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
OFLOXACIN 400MG TABLET (100 CT) (100 BOT) (NDC: 55111016201) 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 |
$13.70 | $175 | No Gap Coverage | 1 | Preferred Generic | $4.00 | n/a | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Value |
$22.20 | $0 | No Gap Coverage | 1 | Preferred Generic | $8.00 | $16.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Saver |
$22.40 | $295 | No Gap Coverage | 1 | Tier 1 - Preferred Generic | $5.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
Community CCRx Basic |
$25.40 | $295 | No Gap Coverage | 1 | Generic | $0.00 | n/a | None | |
Browse Plan Formulary | |||||||||
Advantage Star Plan by RxAmerica |
$27.80 | $295 | No Gap Coverage | 1 | Preferred Generic | $5.50 | $0.00 | Q:28 /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 |
|
Medco Medicare Prescription Plan - Value |
$28.50 | $295 | No Gap Coverage | 1 | Generic | 23% | 23% | None | |
Browse Plan Formulary | |||||||||
AmeriHealth Advantage Rx Option I |
$28.60 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | n/a | None | |
Browse Plan Formulary | |||||||||
First Health Part D-Premier |
$28.70 | $0 | No Gap Coverage | 1 | Preferred Generic | $7.00 | n/a | None | |
Browse Plan Formulary | |||||||||
SilverScript Value |
$28.70 | $295 | No Gap Coverage | 1 | Generic | $8.00 | $12.00 | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Bronze |
$28.80 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
HealthSpring Prescription Drug Plan -Reg 6 |
$29.90 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | 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 One |
$30.00 | $295 | No Gap Coverage | 1 | Tier 1 | $2.50 | $6.25 | None | |
Browse Plan Formulary | |||||||||
WellCare Classic |
$31.40 | $295 | No Gap Coverage | 1 | Tier 1 | $0.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
BravoRx |
$31.60 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Silver |
$32.00 | $295 | No Gap Coverage | 1 | Tier 1 Preferred Generic | $4.00 | $12.00 | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Gold |
$32.10 | $0 | No Gap Coverage | 1 | Generic | $6.00 | $12.00 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Choice |
$32.60 | $0 | No Gap Coverage | 1 | Generic | $6.00 | $6.00 | 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 |
|
MedicareRx Rewards Value |
$32.90 | $130 | No Gap Coverage | 1 | Tier 1 Preferred Generic | $10.00 | $15.00 | Q:56 /1Days | |
Browse Plan Formulary | |||||||||
BlueRx Value |
$33.10 | $295 | No Gap Coverage | 1 | Generic | $4.00 | $10.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials |
$33.40 | $195 | No Gap Coverage | 2 | Tier 2 - Non-Preferred Generic | $11.00 | $22.00 | None | |
Browse Plan Formulary | |||||||||
WellCare Signature |
$33.90 | $0 | No Gap Coverage | 1 | Tier 1 | $0.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred |
$34.80 | $0 | No Gap Coverage | 1 | Tier 1-Preferred Generic | $7.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 1 |
$35.30 | $295 | 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 |
|
AdvantraRx Premier |
$36.90 | $0 | No Gap Coverage | 1 | Preferred Generic | $5.00 | $10.00 | None | |
Browse Plan Formulary | |||||||||
Advantage Freedom Plan by RxAmerica |
$38.30 | $0 | No Gap Coverage | 1 | Preferred Generic | $5.00 | $0.00 | Q:28 /30Days | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Rx Covg - Silver Plan |
$39.00 | $150 | No Gap Coverage | 1 | Generic | $4.00 | $10.00 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two |
$39.50 | $0 | No Gap Coverage | 2 | Tier 2 | $6.00 | $15.00 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5884-064 |
$39.50 | $295 | No Gap Coverage | 1 | Preferred Generic | 15% | 15% | None | |
Browse Plan Formulary | |||||||||
Sterling Rx |
$42.10 | $295 | No Gap Coverage | 1 | Generic | $7.00 | $14.00 | 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 Prescription Drug Cov |
$42.40 | $0 | No Gap Coverage | 1 | Generic | $5.00 | $13.00 | None | |
Browse Plan Formulary | |||||||||
Community CCRx Choice |
$42.60 | $0 | No Gap Coverage | 1 | Generic | $5.00 | n/a | None | |
Browse Plan Formulary | |||||||||
SecureRx - Option 4 |
$43.00 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
UnitedHealth Rx Basic |
$43.10 | $0 | No Gap Coverage | 1 | Tier 1 - Preferred Generic | $7.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
UPMC for Life Prescription Drug Plan |
$44.10 | $0 | No Gap Coverage | 1 | Generic | $5.00 | $12.50 | None | |
Browse Plan Formulary | |||||||||
SecureRx - Option 3 |
$44.60 | $0 | No Gap Coverage | 1 | Generic Drugs | $9.00 | $25.00 | 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 |
|
Humana PDP Enhanced S5884-005 |
$44.90 | $0 | No Gap Coverage | 1 | Preferred Generic | $7.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
Health Net Value Orange Option 2 |
$46.60 | $0 | No Gap Coverage | 3 | Non-Preferred Brand | $75.00 | $188.00 | None | |
Browse Plan Formulary | |||||||||
BlueRx Plus |
$49.10 | $0 | No Gap Coverage | 1 | Generic | $5.00 | $12.50 | None | |
Browse Plan Formulary | |||||||||
SilverScript Plus |
$51.50 | $50 | Many Generics | 2 | Generic | $9.00 | $23.00 | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier Plus |
$52.80 | $0 | Many Generics | 1 | Preferred Generic | $4.00 | $8.00 | None | |
Browse Plan Formulary | |||||||||
AmeriHealth Rx Option I |
$54.30 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | 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 |
|
AmeriHealth Rx Option II |
$58.90 | $0 | No Gap Coverage | 1 | Generic | $7.00 | $14.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Plus |
$63.90 | $0 | Some Generics | 2 | Tier 2 - Non-Preferred Generic | $10.00 | $20.00 | None | |
Browse Plan Formulary | |||||||||
SierraRx Basic |
$64.90 | $295 | No Gap Coverage | 1 | Tier 1 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Platinum |
$65.00 | $0 | All Generics | 1 | Generic | $6.00 | $12.00 | None | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Gold |
$66.60 | $0 | No Gap Coverage | 1 | Tier 1 Preferred Generics | $0.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Access |
$68.30 | $0 | All Generics | 1 | Generic | $6.00 | $6.00 | 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 |
|
SilverScript Complete |
$69.10 | $0 | Many Generics | 2 | Generic | $7.50 | $19.00 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three |
$72.60 | $0 | Some Generics | 1 | Tier 1 | $6.00 | $15.00 | None | |
Browse Plan Formulary | |||||||||
Community CCRx Gold |
$75.10 | $0 | All Generics | 1 | Generic | $5.00 | n/a | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced |
$76.40 | $0 | Many Generics | 1 | Tier 1 - Preferred Generic | $7.00 | $0.00 | None | |
Browse Plan Formulary | |||||||||
SecureRx - Option 1 |
$86.90 | $0 | Many Generics | 1 | Generic Drugs | $7.00 | $17.00 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5884-034 |
$95.40 | $0 | Many Generics | 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 |
|
Aetna Medicare Rx Premier |
$99.90 | $0 | Many Generics | 2 | Tier 2 - Non-Preferred Generic | $10.00 | $20.00 | None | |
Browse Plan Formulary | |||||||||
BlueRx Complete |
$108.00 | $0 | Many Generics | 1 | Generic | $5.00 | $12.50 | None | |
Browse Plan Formulary |
|