There are 41 stand-alone Medicare Part D plans in New York 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
XENAZINE TABLET 25 MG (112 BOT) (NDC: 67386042201) 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 |
||||||
GHI Medicare Prescription Drug Plan |
$19.60 | $295 | No Gap Coverage | 3 | Tier 3 | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
HIP Part D New York |
$21.00 | $295 | No Gap Coverage | 3 | Tier 3 | 40% | 40% | None | |
Browse Plan Formulary | |||||||||
Advantage Star Plan by RxAmerica |
$25.30 | $295 | No Gap Coverage | 2 | Preferred Brand | 25% | 30% | P | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Value |
$25.90 | $295 | No Gap Coverage | 4 | Specialty | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
SilverScript Value |
$26.10 | $295 | No Gap Coverage | 4 | Specialty | 25% | n/a | P | |
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 |
|
First Health Part D-Secure |
$26.40 | $175 | No Gap Coverage | 4 | Specialty-Generic and Brand | 28% | n/a | P Q:60 /30Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan One |
$27.30 | $295 | No Gap Coverage | 4 | Tier 4 | 25% | 25% | P | |
Browse Plan Formulary | |||||||||
BravoRx |
$27.50 | $295 | No Gap Coverage | 3 | Tier 3 | 25% | 25% | P Q:120 /30Days | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 1 |
$28.50 | $295 | No Gap Coverage | 5 | Specialty | 25% | n/a | P | |
Browse Plan Formulary | |||||||||
Advantage Freedom Plan by RxAmerica |
$29.30 | $0 | No Gap Coverage | 2 | Preferred Brand | 35% | 40% | P | |
Browse Plan Formulary | |||||||||
First Health Part D-Premier |
$29.30 | $0 | No Gap Coverage | 4 | Specialty-Generic and Brand | 33% | n/a | P Q:60 /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 |
|
AdvantraRx Value |
$30.60 | $0 | No Gap Coverage | 4 | Specialty-Generic and Brand | 33% | n/a | P Q:60 /30Days | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Silver |
$32.00 | $295 | No Gap Coverage | 5 | Tier 5 Specialty Drugs | 25% | n/a | None | |
Browse Plan Formulary | |||||||||
Sterling Rx |
$32.10 | $295 | No Gap Coverage | 4 | Specialty | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Essentials |
$32.70 | $205 | No Gap Coverage | 5 | Tier 5 - Specialty | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Saver |
$33.80 | $295 | No Gap Coverage | 4 | Tier 4 - Specialty (Generic, Brand) | 25% | 25% | P | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Preferred |
$34.80 | $0 | No Gap Coverage | 4 | Tier 4 - Specialty (Generic, Brand) | 33% | 30% | P | |
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 S5552-001 |
$36.00 | $0 | No Gap Coverage | 4 | Specialty | 33% | n/a | P Q:120 /30Days | |
Browse Plan Formulary | |||||||||
MedicareRx Rewards Value |
$37.60 | $130 | No Gap Coverage | 5 | Tier 5. | 29% | n/a | P | |
Browse Plan Formulary | |||||||||
First UA Medicare Part D Rx Covg - Silver |
$38.80 | $150 | No Gap Coverage | 4 | Specialty | 25% | 25% | None | |
Browse Plan Formulary | |||||||||
HIP Enhanced Part D New York |
$39.00 | $0 | Many Generics | 3 | Tier 3 | 50% | 50% | None | |
Browse Plan Formulary | |||||||||
SmartHealth RX |
$40.50 | $0 | No Gap Coverage | 4 | Specialty Injectables | 33% | 27% | None | |
Browse Plan Formulary | |||||||||
First UA Medicare Part D Prescription Drug |
$40.70 | $0 | No Gap Coverage | 4 | Specialty | 33% | 33% | 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 |
|
Medco Medicare Prescription Plan - Choice |
$41.30 | $0 | No Gap Coverage | 4 | Specialty | 33% | 33% | None | |
Browse Plan Formulary | |||||||||
Simply Prescriptions Rx 1 |
$42.80 | $295 | No Gap Coverage | 2 | Tier 2 | 25% | 25% | P Q:120 /30Days | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Two |
$45.00 | $0 | No Gap Coverage | 5 | Tier 5 | 33% | 33% | P | |
Browse Plan Formulary | |||||||||
UnitedHealth Rx Basic |
$45.20 | $0 | No Gap Coverage | 4 | Tier 4 - Specialty (Generic, Brand) | 33% | 30% | P | |
Browse Plan Formulary | |||||||||
SilverScript Plus |
$45.40 | $50 | Many Generics | 6 | Specialty | 31% | n/a | P | |
Browse Plan Formulary | |||||||||
Simply Prescriptions Rx 3 |
$48.10 | $100 | No Gap Coverage | 4 | Specialty | 25% | 25% | P Q:120 /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 |
|
AdvantraRx Premier |
$48.20 | $0 | No Gap Coverage | 4 | Specialty-Generic and Brand | 33% | n/a | P Q:60 /30Days | |
Browse Plan Formulary | |||||||||
Health Net Orange Option 2 |
$48.40 | $0 | No Gap Coverage | 5 | Specialty | 33% | n/a | P | |
Browse Plan Formulary | |||||||||
Humana PDP Standard S5552-003 |
$55.20 | $295 | No Gap Coverage | 3 | Other - Non-Preferred (Gen/Brand) | 42% | 42% | P Q:120 /30Days | |
Browse Plan Formulary | |||||||||
AdvantraRx Premier Plus |
$65.90 | $0 | Many Generics | 4 | Specialty-Generic and Brand | 33% | n/a | P Q:60 /30Days | |
Browse Plan Formulary | |||||||||
SilverScript Complete |
$68.10 | $0 | Many Generics | 5 | Specialty | 33% | n/a | P | |
Browse Plan Formulary | |||||||||
Medco Medicare Prescription Plan - Access |
$69.20 | $0 | All Generics | 4 | Specialty | 33% | 33% | 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 |
$69.50 | $0 | Some Generics | 5 | Tier 5 - Specialty | 33% | 33% | None | |
Browse Plan Formulary | |||||||||
EnvisionRxPlus Gold |
$70.60 | $0 | No Gap Coverage | 5 | Tier 5 Specialty | 33% | n/a | None | |
Browse Plan Formulary | |||||||||
AARP MedicareRx Enhanced |
$75.50 | $0 | Many Generics | 4 | Tier 4 - Specialty (Generic, Brand) | 33% | 30% | P | |
Browse Plan Formulary | |||||||||
CIGNA Medicare Rx Plan Three |
$78.70 | $0 | Some Generics | 4 | Tier 4 | 33% | 33% | P | |
Browse Plan Formulary | |||||||||
Humana PDP Complete S5552-002 |
$100.80 | $0 | Many Generics | 4 | Specialty | 33% | n/a | P Q:120 /30Days | |
Browse Plan Formulary | |||||||||
Aetna Medicare Rx Premier |
$136.80 | $0 | Many Generics | 5 | Tier 5 - Specialty | 33% | 33% | None | |
Browse Plan Formulary |
|