There are 33 stand-alone Medicare Part D plans in New Hampshire 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
PREVACID 30MG SOLUTAB (NDC: 00300154411) 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-Premier![]() ![]() |
$25.40 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $59.00 | n/a | S Q:30 /30Days | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Saver![]() ![]() |
$27.10 | $295 | No Gap Coverage | 2 | Tier 2 - Generic and Preferred Brand | $22.00 | $51.00 | None | |
Browse Plan Formulary | |||||||||
SilverScript Value![]() ![]() |
$27.10 | $295 | No Gap Coverage | 2 | Preferred Brand | $36.50 | $82.25 | Q:90 /365Days | |
Browse Plan Formulary | |||||||||
Advantage Freedom Plan by RxAmerica![]() ![]() |
$29.90 | $0 | No Gap Coverage | 2 | Preferred Brand | 35% | 40% | S | |
Browse Plan Formulary | |||||||||
Community CCRx Basic![]() ![]() |
$30.00 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | 45% | n/a | Q:30 /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 |
|
CIGNA Medicare Rx Plan One![]() ![]() |
$30.50 | $295 | No Gap Coverage | 2 | Tier 2 | $33.00 | $82.50 | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials![]() ![]() |
$31.20 | $205 | No Gap Coverage | 3 | Tier 3 - Preferred Brand | $27.00 | $54.00 | Q:1 /1Days | |
Browse Plan Formulary | |||||||||
MedicareRx Rewards Standard![]() ![]() |
$31.40 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Advantage Star Plan by RxAmerica![]() ![]() |
$32.00 | $295 | No Gap Coverage | 2 | Preferred Brand | 25% | 30% | S | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Value![]() ![]() |
$35.00 | $130 | No Gap Coverage | 2 | Tier 2 Preferred Brand | $44.00 | $110.00 | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred![]() ![]() |
$35.50 | $0 | No Gap Coverage | 2 | Tier 2 - Generic and Preferred Brand | $38.00 | $99.00 | 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![]() ![]() |
$37.20 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $64.00 | $192.00 | S Q:30 /30Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two![]() ![]() |
$37.20 | $0 | No Gap Coverage | 3 | Tier 3 | $38.00 | $95.00 | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Sterling Rx![]() ![]() |
$37.50 | $295 | No Gap Coverage | 2 | Preferred Brand | $25.00 | $50.00 | S | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5884-092![]() ![]() |
$39.20 | $295 | No Gap Coverage | 2 | Preferred Brand | 25% | 25% | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
UnitedHealth Rx Basic![]() ![]() |
$40.80 | $0 | No Gap Coverage | 2 | Tier 2 - Generic and Preferred Brand | $35.00 | $90.00 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Choice![]() ![]() |
$41.70 | $0 | No Gap Coverage | 2 | Preferred Brand | $35.00 | $87.50 | Q:180 /90Days | |
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 Choice![]() ![]() |
$42.50 | $0 | No Gap Coverage | 3 | Non-Preferred Brand | $60.00 | n/a | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Humana PDP Enhanced S5884-095![]() ![]() |
$42.50 | $0 | No Gap Coverage | 2 | Preferred Brand | $40.00 | $100.00 | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
SilverScript Plus![]() ![]() |
$45.30 | $50 | Many Generics | 4 | Preferred Brand | $35.00 | $82.00 | Q:90 /365Days | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Value Plus![]() ![]() |
$45.50 | $0 | No Gap Coverage | 2 | Tier 2 Preferred Brand | $35.00 | $87.50 | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Prescription Drug Cov![]() ![]() |
$45.80 | $0 | No Gap Coverage | 2 | Preferred Brand | $32.00 | $64.00 | Q:180 /90Days | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier Plus![]() ![]() |
$53.40 | $0 | Many Generics | 3 | Non-Preferred Generic/Non-Preferred Brand | $74.00 | $222.00 | S Q:30 /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![]() ![]() |
$56.50 | $0 | No Gap Coverage | 3 | Tier 3 Preferred Brand | $40.00 | $120.00 | None | |
Browse Plan Formulary | |||||||||
Community CCRx Gold![]() ![]() |
$59.20 | $0 | All Generics | 3 | Non-Preferred Brand | $60.00 | n/a | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Plus![]() ![]() |
$61.20 | $0 | Some Generics | 3 | Tier 3 - Preferred Brand | $36.00 | $72.00 | Q:1 /1Days | |
Browse Plan Formulary | |||||||||
SilverScript Complete![]() ![]() |
$62.00 | $0 | Many Generics | 3 | Preferred Brand | $39.00 | $92.00 | Q:90 /365Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three![]() ![]() |
$67.60 | $0 | Some Generics | 2 | Tier 2 | $35.00 | $87.50 | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Access![]() ![]() |
$78.90 | $0 | All Generics | 2 | Preferred Brand | $35.00 | $87.50 | Q:180 /90Days | |
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 Enhanced![]() ![]() |
$81.70 | $0 | Many Generics | 2 | Tier 2 - Generic and Preferred Brand | $39.00 | $102.00 | None | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Premier![]() ![]() |
$81.80 | $0 | Many Generics | 2 | Tier 2 Preferred Brand | $35.00 | $87.50 | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5884-098![]() ![]() |
$100.20 | $0 | Many Generics | 2 | Preferred Brand | $40.00 | $100.00 | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier![]() ![]() |
$101.70 | $0 | Many Generics | 3 | Tier 3 - Preferred Brand | $30.00 | $60.00 | Q:1 /1Days | |
Browse Plan Formulary |
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