There are 52 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
SINGULAIR 4MG GRANULES (30 PKT) (NDC: 00006384130) 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 |
$13.70 | $175 | No Gap Coverage | 2 | Preferred Brand | $20.00 | n/a | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
AdvantraRx Value |
$23.10 | $0 | No Gap Coverage | 2 | Preferred Brand | $24.00 | $48.00 | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Saver |
$28.70 | $295 | No Gap Coverage | 2 | Tier 2 - Generic and Preferred Brand | $22.00 | $51.00 | S Q:31 /31Days | |
Browse Plan Formulary | |||||||||
Community CCRx Basic |
$31.00 | $295 | No Gap Coverage | 2 | Preferred Brand | 30% | n/a | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
First Health Part D-Premier |
$31.10 | $0 | No Gap Coverage | 2 | Preferred Brand | $27.00 | 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 |
|
Prescriba Rx Bronze |
$31.30 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Advantage Star Plan by RxAmerica |
$33.60 | $295 | No Gap Coverage | 2 | Preferred Brand | 25% | 30% | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Choice |
$34.40 | $0 | No Gap Coverage | 2 | Preferred Brand | $38.00 | $95.00 | Q:90 /90Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials |
$34.60 | $200 | No Gap Coverage | 3 | Tier 3 - Preferred Brand | $30.00 | $60.00 | Q:1 /1Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan One |
$34.80 | $295 | No Gap Coverage | 2 | Tier 2 | $33.00 | $82.50 | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Gold |
$34.90 | $0 | No Gap Coverage | 2 | Brand | $44.00 | $88.00 | 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 |
|
BravoRx |
$35.00 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | Q:90 /90Days | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 1 |
$35.00 | $295 | No Gap Coverage | 2 | Preferred Brand | $44.00 | $88.00 | Q:1 /1Days | |
Browse Plan Formulary | |||||||||
SilverScript Value |
$35.10 | $295 | No Gap Coverage | 2 | Preferred Brand | $37.50 | $84.50 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Enhanced S5884-014 |
$35.70 | $0 | No Gap Coverage | 3 | Non-Preferred Brand | $70.00 | $175.00 | S Q:30 /30Days | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Silver |
$36.20 | $295 | No Gap Coverage | 4 | Tier 4 NonPreferred Brand | $75.00 | $225.00 | P S | |
Browse Plan Formulary | |||||||||
HealthSpring Prescription Drug Plan-Reg 16 |
$36.30 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | 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 |
|
Blue MedicareRx Value |
$36.60 | $130 | No Gap Coverage | 2 | Tier 2 Preferred Brand | $42.00 | $105.00 | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Value |
$36.60 | $295 | No Gap Coverage | 2 | Preferred Brand | 23% | 23% | Q:90 /90Days | |
Browse Plan Formulary | |||||||||
Community CCRx Choice |
$37.10 | $0 | No Gap Coverage | 2 | Preferred Brand | $30.00 | n/a | Q:30 /30Days | |
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 | 2 | Preferred Brand | $25.00 | $50.00 | None | |
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 |
|
AdvantraRx Premier |
$39.30 | $0 | No Gap Coverage | 2 | Preferred Brand | $30.00 | $60.00 | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
WPS MedicareRx Standard Plan |
$39.30 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | Q:90 /90Days | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred |
$39.40 | $0 | No Gap Coverage | 2 | Tier 2 - Generic and Preferred Brand | $38.00 | $99.00 | S Q:31 /31Days | |
Browse Plan Formulary | |||||||||
DeanCare Rx Value |
$39.90 | $0 | No Gap Coverage | 2 | Tier 2 | $28.00 | $56.00 | None | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Plus |
$40.40 | $0 | No Gap Coverage | 2 | Tier 2 Preferred Brand | $35.00 | $87.50 | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two |
$40.70 | $0 | No Gap Coverage | 3 | Tier 3 | $35.00 | $87.50 | 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 |
|
UnitedHealth Rx Basic |
$41.90 | $0 | No Gap Coverage | 2 | Tier 2 - Generic and Preferred Brand | $35.00 | $90.00 | S Q:31 /31Days | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Rx Covg - Silver Plan |
$43.30 | $130 | No Gap Coverage | 2 | Preferred Brand | $40.00 | $100.00 | Q:90 /90Days | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5884-074 |
$43.80 | $295 | No Gap Coverage | 3 | Other - Non-Preferred (Gen/Brand) | 45% | 45% | S Q:30 /30Days | |
Browse Plan Formulary | |||||||||
WPS MedicareRx Enhanced Plan 1 |
$43.90 | $0 | No Gap Coverage | 2 | Preferred Brand | $37.00 | $92.50 | Q:90 /90Days | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Prescription Drug Cov |
$45.10 | $0 | No Gap Coverage | 2 | Preferred Brand | $32.00 | $64.00 | Q:90 /90Days | |
Browse Plan Formulary | |||||||||
Health Net Value Orange Option 2 |
$46.70 | $0 | No Gap Coverage | 2 | Preferred Brand | $39.00 | $78.00 | Q:1 /1Days | |
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 |
$49.50 | $0 | No Gap Coverage | 2 | Preferred Brand | 35% | 40% | None | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Gold |
$51.00 | $0 | No Gap Coverage | 4 | Tier 4 NonPreferred Brand | $75.00 | $225.00 | P S | |
Browse Plan Formulary | |||||||||
SilverScript Plus |
$52.80 | $50 | Many Generics | 4 | Preferred Brand | $35.00 | $82.00 | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier Plus |
$54.60 | $0 | Many Generics | 2 | Preferred Brand | $30.00 | $60.00 | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Plus |
$61.60 | $0 | Some Generics | 3 | Tier 3 - Preferred Brand | $36.00 | $72.00 | Q:1 /1Days | |
Browse Plan Formulary | |||||||||
Community CCRx Gold |
$62.30 | $0 | All Generics | 2 | Preferred Brand | $30.00 | 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 |
|
Medco Medicare Prescription Plan - Access |
$62.80 | $0 | All Generics | 2 | Preferred Brand | $35.00 | $87.50 | Q:90 /90Days | |
Browse Plan Formulary | |||||||||
DeanCare Rx Classic |
$64.00 | $295 | No Gap Coverage | 2 | Tier 2 | $40.00 | $80.00 | None | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Premier |
$70.70 | $0 | Many Generics | 2 | Tier 2 Preferred Brand | $35.00 | $87.50 | Q:30 /30Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three |
$71.70 | $0 | Some Generics | 2 | Tier 2 | $35.00 | $87.50 | None | |
Browse Plan Formulary | |||||||||
SilverScript Complete |
$71.90 | $0 | Many Generics | 3 | Preferred Brand | $39.00 | $92.00 | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Platinum |
$73.60 | $0 | All Generics | 2 | Brand | $44.00 | $88.00 | 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 |
|
WPS MedicareRx Enhanced Plan 2 |
$75.00 | $0 | All Generics | 2 | Preferred Brand | $37.00 | $92.50 | Q:90 /90Days | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced |
$77.40 | $0 | Many Generics | 2 | Tier 2 - Generic and Preferred Brand | $39.00 | $102.00 | S Q:31 /31Days | |
Browse Plan Formulary | |||||||||
DeanCare Rx Enhanced |
$93.70 | $0 | Many Generics, Few Brands |
2 | Tier 2 | $35.00 | $70.00 | None | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5884-044 |
$95.00 | $0 | Many Generics | 3 | Non-Preferred Brand | $70.00 | $175.00 | S Q:30 /30Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier |
$102.70 | $0 | Many Generics | 3 | Tier 3 - Preferred Brand | $30.00 | $60.00 | Q:1 /1Days | |
Browse Plan Formulary |
|