There are 12 stand-alone Medicare Part D plans in 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
PERCOCET 7.5/325MG TABLET (100 BOT) (NDC: 63481062870) 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 |
$26.90 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | $98.00 | $269.50 | None | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 1 |
$28.40 | $295 | No Gap Coverage | 2 | Preferred Brand | $42.00 | $84.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials |
$32.30 | $200 | No Gap Coverage | 4 | Tier 4 - Non-Preferred Brand | $67.00 | $134.00 | S | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred |
$38.20 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $80.30 | $225.90 | None | |
Browse Plan Formulary | |||||||||
Sterling Rx |
$40.10 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | $57.00 | $114.00 | 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 |
|
Health Net Value Orange Option 2 |
$40.90 | $0 | No Gap Coverage | 2 | Preferred Brand | $39.00 | $78.00 | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx - Costco Plus Plan |
$53.20 | $0 | Some Generics | 4 | Tier 4 - Non-Preferred Brand | $90.00 | $180.00 | S | |
Browse Plan Formulary | |||||||||
SilverScript Plus |
$59.00 | $50 | Many Generics | 5 | Non-Preferred Brand | $95.00 | $261.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced |
$72.60 | $0 | Many Generics | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $95.00 | $270.00 | None | |
Browse Plan Formulary | |||||||||
SilverScript Complete |
$75.10 | $0 | Many Generics | 4 | Non-Preferred Brand | $98.00 | $270.00 | None | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Premier |
$82.80 | $0 | Many Generics | 3 | Tier 3 Non-Preferred Brand or Generic | $75.00 | $187.50 | Q:360 /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 Premier |
$107.10 | $0 | Many Generics | 4 | Tier 4 - Non-Preferred Brand | $65.00 | $130.00 | S | |
Browse Plan Formulary |
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