There are 46 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
PRISTIQ 50MG TABLET SR 24HR (NDC: 00008121130) 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![]() ![]() |
$12.80 | $175 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $48.00 | n/a | S Q:30 /30Days | |
Browse Plan Formulary | |||||||||
AdvantraRx Value![]() ![]() |
$13.50 | $0 | No Gap Coverage | 3 | Non-Preferred Generic/Non-Preferred Brand | $50.00 | $150.00 | S Q:30 /30Days | |
Browse Plan Formulary | |||||||||
WellCare Classic![]() ![]() |
$21.20 | $250 | No Gap Coverage | 3 | Tier 3 | $75.00 | $225.00 | P | |
Browse Plan Formulary | |||||||||
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 | |||||||||
HealthSpring Prescription Drug Plan -Reg 1![]() ![]() |
$26.10 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | 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 |
|
AARP MedicareRx Saver![]() ![]() |
$27.10 | $295 | No Gap Coverage | 2 | Tier 2 - Generic and Preferred Brand | $22.00 | $51.00 | Q:31 /31Days | |
Browse Plan Formulary | |||||||||
SilverScript Value![]() ![]() |
$27.10 | $295 | No Gap Coverage | 2 | Preferred Brand | $36.50 | $82.25 | None | |
Browse Plan Formulary | |||||||||
WellCare Signature![]() ![]() |
$28.80 | $0 | No Gap Coverage | 3 | Tier 3 | $79.00 | $237.00 | P | |
Browse Plan Formulary | |||||||||
Prescriba Rx Bronze![]() ![]() |
$29.10 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | S Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Advantage Freedom Plan by RxAmerica![]() ![]() |
$29.90 | $0 | No Gap Coverage | 2 | Preferred Brand | 35% | 40% | None | |
Browse Plan Formulary | |||||||||
Community CCRx Basic![]() ![]() |
$30.00 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | 45% | n/a | 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 |
|
Medco Medicare Prescription Plan - Value![]() ![]() |
$30.40 | $295 | No Gap Coverage | 2 | Preferred Brand | 23% | 23% | Q:90 /90Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan One![]() ![]() |
$30.50 | $295 | No Gap Coverage | 3 | Tier 3 | $81.00 | $202.50 | P Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials![]() ![]() |
$31.20 | $205 | No Gap Coverage | 4 | Tier 4 - Non-Preferred Brand | $67.00 | $134.00 | S Q:1 /1Days | |
Browse Plan Formulary | |||||||||
MedicareRx Rewards Standard![]() ![]() |
$31.40 | $295 | No Gap Coverage | 3 | Tier 3 | 25% | 25% | P Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Advantage Star Plan by RxAmerica![]() ![]() |
$32.00 | $295 | No Gap Coverage | 2 | Preferred Brand | 25% | 30% | None | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Silver![]() ![]() |
$34.20 | $295 | No Gap Coverage | 4 | Tier 4 NonPreferred Brand | $75.00 | $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 |
|
Health Net Orange Option 1![]() ![]() |
$34.40 | $295 | No Gap Coverage | 3 | Non-Preferred Brand | $90.00 | $225.00 | P Q:1 /1Days | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Value![]() ![]() |
$35.00 | $130 | No Gap Coverage | 3 | Tier 3 Non-Preferred Brand or Generic | $85.00 | $212.50 | P 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 | Q:31 /31Days | |
Browse Plan Formulary | |||||||||
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 | 4 | Tier 4 | $80.00 | $200.00 | P Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Sterling Rx![]() ![]() |
$37.50 | $295 | No Gap Coverage | 2 | Preferred Brand | $25.00 | $50.00 | 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 |
|
Prescriba Rx Gold![]() ![]() |
$38.60 | $0 | No Gap Coverage | 2 | Brand | $44.00 | $88.00 | S Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5884-092![]() ![]() |
$39.20 | $295 | No Gap Coverage | 3 | Other - Non-Preferred (Gen/Brand) | 45% | 45% | P Q:30 /30Days | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Rx Covg - Silver Plan![]() ![]() |
$40.20 | $160 | No Gap Coverage | 2 | Preferred Brand | $40.00 | $100.00 | Q:90 /90Days | |
Browse Plan Formulary | |||||||||
UnitedHealth Rx Basic![]() ![]() |
$40.80 | $0 | No Gap Coverage | 2 | Tier 2 - Generic and Preferred Brand | $35.00 | $90.00 | Q:31 /31Days | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Choice![]() ![]() |
$41.70 | $0 | No Gap Coverage | 2 | Preferred Brand | $35.00 | $87.50 | Q:90 /90Days | |
Browse Plan Formulary | |||||||||
Community CCRx Choice![]() ![]() |
$42.50 | $0 | No Gap Coverage | 3 | Non-Preferred Brand | $60.00 | n/a | 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 |
|
Humana PDP Enhanced S5884-095![]() ![]() |
$42.50 | $0 | No Gap Coverage | 3 | Non-Preferred Brand | $70.00 | $175.00 | P Q:30 /30Days | |
Browse Plan Formulary | |||||||||
SilverScript Plus![]() ![]() |
$45.30 | $50 | Many Generics | 4 | Preferred Brand | $35.00 | $82.00 | None | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Value Plus![]() ![]() |
$45.50 | $0 | No Gap Coverage | 3 | Tier 3 Non-Preferred Brand or Generic | $75.00 | $187.50 | P 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:90 /90Days | |
Browse Plan Formulary | |||||||||
Health Net Value Orange Option 2![]() ![]() |
$47.40 | $0 | No Gap Coverage | 3 | Non-Preferred Brand | $75.00 | $188.00 | P Q:1 /1Days | |
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 | 4 | Tier 4 NonPreferred Brand | $75.00 | $225.00 | None | |
Browse Plan Formulary | |||||||||
Community CCRx Gold![]() ![]() |
$59.20 | $0 | All Generics | 3 | Non-Preferred Brand | $60.00 | n/a | S Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Plus![]() ![]() |
$61.20 | $0 | Some Generics | 4 | Tier 4 - Non-Preferred Brand | $77.00 | $154.00 | S Q:1 /1Days | |
Browse Plan Formulary | |||||||||
SilverScript Complete![]() ![]() |
$62.00 | $0 | Many Generics | 3 | Preferred Brand | $39.00 | $92.00 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three![]() ![]() |
$67.60 | $0 | Some Generics | 3 | Tier 3 | $60.00 | $150.00 | P Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Prescriba Rx Platinum![]() ![]() |
$72.50 | $0 | All Generics | 2 | Brand | $44.00 | $88.00 | 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 |
|
Medco Medicare Prescription Plan - Access![]() ![]() |
$78.90 | $0 | All Generics | 2 | Preferred Brand | $35.00 | $87.50 | Q:90 /90Days | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced![]() ![]() |
$81.70 | $0 | Many Generics | 2 | Tier 2 - Generic and Preferred Brand | $39.00 | $102.00 | Q:31 /31Days | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Premier![]() ![]() |
$81.80 | $0 | Many Generics | 3 | Tier 3 Non-Preferred Brand or Generic | $75.00 | $187.50 | P Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5884-098![]() ![]() |
$100.20 | $0 | Many Generics | 3 | Non-Preferred Brand | $70.00 | $175.00 | P Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier![]() ![]() |
$101.70 | $0 | Many Generics | 4 | Tier 4 - Non-Preferred Brand | $65.00 | $130.00 | S Q:1 /1Days | |
Browse Plan Formulary |
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