There are 50 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
PANRETIN 0.1% GEL 60GM TUBE (60 GM TUBE) (NDC: 62856060122) 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 |
$18.50 | $175 | No Gap Coverage | 2 | Preferred Brand | $20.00 | n/a | Q:60 /30Days | |
Browse Plan Formulary | |||||||||
AdvantraRx Value |
$27.20 | $0 | No Gap Coverage | 2 | Preferred Brand | $24.00 | $48.00 | Q:60 /30Days | |
Browse Plan Formulary | |||||||||
HealthSpring Prescription Drug Plan-Reg 31 |
$30.70 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Value |
$31.90 | $295 | No Gap Coverage | 2 | Preferred Brand | 23% | 23% | None | |
Browse Plan Formulary | |||||||||
SilverScript Value |
$32.20 | $295 | No Gap Coverage | 4 | Specialty | 25% | n/a | 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 |
|
First Health Part D-Premier |
$32.60 | $0 | No Gap Coverage | 2 | Preferred Brand | $25.00 | n/a | Q:60 /30Days | |
Browse Plan Formulary | |||||||||
Prescriba Rx Bronze |
$32.80 | $295 | No Gap Coverage | 3 | Tier 3 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials |
$33.20 | $195 | No Gap Coverage | 5 | Tier 5 - Specialty | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
BravoRx |
$36.50 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
SierraRx |
$36.80 | $0 | No Gap Coverage | 3 | Specialty | 33% | 33% | P | |
Browse Plan Formulary | |||||||||
Advantage Star Plan by RxAmerica |
$37.70 | $295 | No Gap Coverage | 2 | Preferred Brand | 25% | 30% | 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 |
$37.70 | $130 | No Gap Coverage | 5 | Tier 5. | 29% | n/a | None | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Silver |
$38.30 | $295 | No Gap Coverage | 4 | Tier 4 NonPreferred Brand | $75.00 | $225.00 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan One |
$38.50 | $295 | No Gap Coverage | 4 | Tier 4 | 25% | 25% | P | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5884-089 |
$38.90 | $295 | No Gap Coverage | 3 | Other - Non-Preferred (Gen/Brand) | 43% | 43% | None | |
Browse Plan Formulary | |||||||||
Community CCRx Basic |
$39.40 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | 55% | n/a | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Gold |
$39.50 | $0 | No Gap Coverage | 3 | Specialty | 33% | n/a | 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 Saver |
$40.00 | $295 | No Gap Coverage | 4 | Tier 4 - Specialty (Generic, Brand) | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
Humana PDP Enhanced S5884-029 |
$40.00 | $0 | No Gap Coverage | 4 | Specialty | 33% | n/a | None | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 1 |
$40.20 | $295 | No Gap Coverage | 5 | Specialty | 25% | n/a | Q:2 /1Days | |
Browse Plan Formulary | |||||||||
WellCare Classic |
$41.60 | $295 | No Gap Coverage | 2 | Tier 2 | $30.00 | $90.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred |
$42.90 | $0 | No Gap Coverage | 4 | Tier 4 - Specialty (Generic, Brand) | 33% | 30% | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier |
$43.20 | $0 | No Gap Coverage | 2 | Preferred Brand | $31.00 | $62.00 | 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 |
|
Advantage Freedom Plan by RxAmerica |
$44.00 | $0 | No Gap Coverage | 2 | Preferred Brand | 35% | 40% | None | |
Browse Plan Formulary | |||||||||
Sterling Rx |
$44.00 | $295 | No Gap Coverage | 4 | Specialty | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two |
$44.10 | $0 | No Gap Coverage | 5 | Tier 5 | 33% | 33% | P | |
Browse Plan Formulary | |||||||||
Educators Rx Basic |
$47.10 | $295 | No Gap Coverage | 2 | Preferred Brand | $30.00 | $90.00 | None | |
Browse Plan Formulary | |||||||||
WellCare Signature |
$47.20 | $0 | No Gap Coverage | 2 | Tier 2 | $39.00 | $117.00 | None | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Rx Covg - Silver Plan |
$47.70 | $110 | No Gap Coverage | 2 | Preferred Brand | $40.00 | $100.00 | 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 |
$47.90 | $0 | No Gap Coverage | 2 | Preferred Brand | $33.00 | $66.00 | None | |
Browse Plan Formulary | |||||||||
UnitedHealth Rx Basic |
$48.70 | $0 | No Gap Coverage | 4 | Tier 4 - Specialty (Generic, Brand) | 33% | 30% | None | |
Browse Plan Formulary | |||||||||
Health Net Value Orange Option 2 |
$48.90 | $0 | No Gap Coverage | 5 | Specialty | 33% | n/a | Q:2 /1Days | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Choice |
$49.80 | $0 | No Gap Coverage | 2 | Preferred Brand | $38.00 | $95.00 | None | |
Browse Plan Formulary | |||||||||
Educators Rx Advantage |
$60.70 | $50 | No Gap Coverage | 2 | Preferred Brand | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier Plus |
$61.30 | $0 | Many Generics | 2 | Preferred Brand | $30.00 | $60.00 | 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 |
|
EnvisionRxPlus Gold |
$61.80 | $0 | No Gap Coverage | 4 | Tier 4 NonPreferred Brand | $75.00 | $225.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx - Costco Plus Plan |
$64.70 | $0 | Some Generics | 5 | Tier 5 - Specialty | 33% | 33% | None | |
Browse Plan Formulary | |||||||||
Community CCRx Choice |
$64.70 | $0 | No Gap Coverage | 4 | Specialty | 33% | n/a | None | |
Browse Plan Formulary | |||||||||
SilverScript Plus |
$65.70 | $50 | Many Generics | 6 | Specialty | 31% | n/a | None | |
Browse Plan Formulary | |||||||||
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 | 4 | Tier 4 - Specialty (Generic, Brand) | 33% | 30% | 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 |
$73.20 | $0 | Some Generics | 4 | Tier 4 | 33% | 33% | P | |
Browse Plan Formulary | |||||||||
Prescriba Rx Platinum |
$74.00 | $0 | All Generics | 3 | Specialty | 33% | n/a | None | |
Browse Plan Formulary | |||||||||
SierraRx Basic |
$78.00 | $295 | No Gap Coverage | 3 | Tier 3 | 25% | 25% | P | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Access |
$79.60 | $0 | All Generics | 2 | Preferred Brand | $35.00 | $87.50 | 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 | 5 | Specialty | 33% | n/a | 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 |
|
Community CCRx Gold |
$85.20 | $0 | All Generics | 4 | Specialty | 33% | n/a | None | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5884-059 |
$98.30 | $0 | Many Generics | 4 | Specialty | 33% | n/a | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier |
$113.70 | $0 | Many Generics | 5 | Tier 5 - Specialty | 33% | 33% | None | |
Browse Plan Formulary |
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