There are 12 stand-alone Medicare Part D plans in Wisconsin 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
PRANDIMET TABLET (100 BOT) (NDC: 00169009201) 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 |
||||||
AARP MedicareRx Saver |
$28.70 | $295 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $76.50 | $214.50 | S Q:155 /31Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials |
$34.60 | $200 | No Gap Coverage | 4 | Tier 4 - Non-Preferred Brand | $71.00 | $142.00 | None | |
Browse Plan Formulary | |||||||||
WellCare Classic |
$37.80 | $295 | No Gap Coverage | 2 | Tier 2 | $35.00 | $105.00 | None | |
Browse Plan Formulary | |||||||||
Sterling Rx |
$39.10 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | $57.00 | $114.00 | Q:170 /34Days | |
Browse Plan Formulary | |||||||||
WellCare Signature |
$39.10 | $0 | No Gap Coverage | 2 | Tier 2 | $39.00 | $117.00 | 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 |
$39.40 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $97.75 | $278.25 | S Q:155 /31Days | |
Browse Plan Formulary | |||||||||
DeanCare Rx Value |
$39.90 | $0 | No Gap Coverage | 3 | Tier 3 | $78.00 | $156.00 | None | |
Browse Plan Formulary | |||||||||
UnitedHealth Rx Basic |
$41.90 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $98.00 | $279.00 | S Q:155 /31Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Plus |
$61.60 | $0 | Some Generics | 4 | Tier 4 - Non-Preferred Brand | $77.00 | $154.00 | 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:155 /31Days | |
Browse Plan Formulary | |||||||||
DeanCare Rx Enhanced |
$93.70 | $0 | Many Generics, Few Brands |
3 | Tier 3 | $70.00 | $140.00 | 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 |
$102.70 | $0 | Many Generics | 4 | Tier 4 - Non-Preferred Brand | $65.00 | $130.00 | None | |
Browse Plan Formulary |
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