There are 48 stand-alone Medicare Part D plans in Ohio 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
SUSTIVA 100MG CAPSULE (30 BOT) (NDC: 00056047330) 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 |
$16.90 | $175 | No Gap Coverage | 2 | Preferred Brand | $20.00 | n/a | None | |
Browse Plan Formulary | |||||||||
First Health Part D-Premier |
$23.00 | $0 | No Gap Coverage | 2 | Preferred Brand | $29.00 | n/a | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Value |
$23.40 | $0 | No Gap Coverage | 2 | Preferred Brand | $24.00 | $48.00 | None | |
Browse Plan Formulary | |||||||||
SilverScript Value |
$25.10 | $295 | No Gap Coverage | 2 | Preferred Brand | $35.50 | $80.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Saver |
$25.80 | $295 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $62.20 | $171.60 | 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 Bronze |
$27.30 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
Community CCRx Basic |
$27.90 | $295 | No Gap Coverage | 2 | Preferred Brand | 25% | n/a | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Value |
$28.50 | $295 | No Gap Coverage | 2 | Preferred Brand | 23% | 23% | None | |
Browse Plan Formulary | |||||||||
Advantage Star Plan by RxAmerica |
$28.60 | $295 | No Gap Coverage | 2 | Preferred Brand | 25% | 30% | None | |
Browse Plan Formulary | |||||||||
HealthSpring Prescription Drug Plan-Reg 14 |
$29.60 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Silver |
$30.30 | $295 | No Gap Coverage | 3 | Tier 3 Preferred Brand | $22.00 | $66.00 | 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 |
$30.90 | $295 | No Gap Coverage | 2 | Preferred Brand | $42.00 | $84.00 | None | |
Browse Plan Formulary | |||||||||
BravoRx |
$31.00 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
Advantage Freedom Plan by RxAmerica |
$31.20 | $0 | No Gap Coverage | 2 | Preferred Brand | 35% | 40% | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials |
$31.80 | $200 | No Gap Coverage | 3 | Tier 3 - Preferred Brand | $30.00 | $60.00 | None | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Value |
$32.00 | $130 | No Gap Coverage | 2 | Tier 2 Preferred Brand | $41.50 | $103.75 | None | |
Browse Plan Formulary | |||||||||
Prescriba Rx Gold |
$32.10 | $0 | No Gap Coverage | 2 | Brand | $44.00 | $88.00 | 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 |
|
WellCare Signature |
$33.50 | $0 | No Gap Coverage | 2 | Tier 2 | $39.00 | $117.00 | None | |
Browse Plan Formulary | |||||||||
WellCare Classic |
$37.00 | $295 | No Gap Coverage | 2 | Tier 2 | $30.00 | $90.00 | None | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Rx Covg - Silver Plan |
$37.80 | $130 | No Gap Coverage | 2 | Preferred Brand | $40.00 | $100.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred |
$38.20 | $0 | No Gap Coverage | 2 | Tier 2 - Generic and Preferred Brand | $38.00 | $99.00 | None | |
Browse Plan Formulary | |||||||||
Sterling Rx |
$38.20 | $295 | No Gap Coverage | 2 | Preferred Brand | $25.00 | $50.00 | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier |
$39.50 | $0 | No Gap Coverage | 2 | Preferred Brand | $30.00 | $60.00 | 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 |
|
Humana PDP Enhanced S5884-012 |
$39.50 | $0 | No Gap Coverage | 2 | Preferred Brand | $40.00 | $100.00 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Choice |
$40.90 | $0 | No Gap Coverage | 2 | Preferred Brand | $38.00 | $95.00 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan One |
$41.10 | $295 | No Gap Coverage | 2 | Tier 2 | $31.00 | $77.50 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two |
$41.40 | $0 | No Gap Coverage | 3 | Tier 3 | $38.00 | $95.00 | None | |
Browse Plan Formulary | |||||||||
Health Net Value Orange Option 2 |
$41.50 | $0 | No Gap Coverage | 2 | Preferred Brand | $39.00 | $78.00 | None | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Plus |
$42.40 | $0 | No Gap Coverage | 2 | Tier 2 Preferred Brand | $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 |
|
Humana PDP Standard S5884-072 |
$42.70 | $295 | No Gap Coverage | 2 | Preferred Brand | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
UnitedHealth Rx Basic |
$42.80 | $0 | No Gap Coverage | 3 | Tier 3 - Other Non Preferred (Generic, Brand) | $98.00 | $279.00 | None | |
Browse Plan Formulary | |||||||||
UPMC for Life Prescription Drug Plan |
$44.10 | $0 | No Gap Coverage | 2 | Preferred Brand | $32.00 | $80.00 | None | |
Browse Plan Formulary | |||||||||
UA Medicare Part D Prescription Drug Cov |
$45.80 | $0 | No Gap Coverage | 2 | Preferred Brand | $31.00 | $62.00 | None | |
Browse Plan Formulary | |||||||||
Community CCRx Choice |
$46.10 | $0 | No Gap Coverage | 2 | Preferred Brand | $30.00 | n/a | None | |
Browse Plan Formulary | |||||||||
SilverScript Plus |
$50.10 | $50 | Many Generics | 4 | Preferred Brand | $35.00 | $82.00 | 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 - Costco Plus Plan |
$51.60 | $0 | Some Generics | 3 | Tier 3 - Preferred Brand | $35.00 | $80.00 | None | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier Plus |
$56.10 | $0 | Many Generics | 2 | Preferred Brand | $30.00 | $60.00 | None | |
Browse Plan Formulary | |||||||||
SierraRx Basic |
$61.40 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | Q:180 /30Days | |
Browse Plan Formulary | |||||||||
Prescriba Rx Platinum |
$65.40 | $0 | All Generics | 2 | Brand | $44.00 | $88.00 | None | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three |
$65.50 | $0 | Some Generics | 2 | Tier 2 | $35.00 | $87.50 | None | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Access |
$66.40 | $0 | All Generics | 2 | Preferred Brand | $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 |
|
SilverScript Complete |
$67.50 | $0 | Many Generics | 3 | Preferred Brand | $39.00 | $92.00 | None | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Gold |
$70.40 | $0 | No Gap Coverage | 3 | Tier 3 Preferred Brand | $40.00 | $120.00 | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced |
$73.30 | $0 | Many Generics | 2 | Tier 2 - Generic and Preferred Brand | $39.00 | $102.00 | None | |
Browse Plan Formulary | |||||||||
Blue MedicareRx Premier |
$77.80 | $0 | Many Generics | 2 | Tier 2 Preferred Brand | $35.00 | $87.50 | None | |
Browse Plan Formulary | |||||||||
Community CCRx Gold |
$78.40 | $0 | All Generics | 2 | Preferred Brand | $30.00 | n/a | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier |
$94.90 | $0 | Many Generics | 3 | Tier 3 - Preferred Brand | $30.00 | $60.00 | 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 |
|
Humana PDP Complete S5884-042 |
$97.50 | $0 | Many Generics | 2 | Preferred Brand | $40.00 | $100.00 | None | |
Browse Plan Formulary |
|