SUBOXONE 8MG-2MG TABLET (NDC: 12496130602)
2013 Medicare Prescription Drug Plan (MAPD) Information
Click here for the Chart Legend |
Plan Name |
Monthly Prem. |
De- duct- ible | Does Plan Offer Additional Gap Coverage | Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Plan’s Avg. Retail Drug Price 30-Day |
Tier Nbr. |
Tier Desc. |
30-Day Prfrd. Pharm |
90-Day Mail Order |
AARP MedicareComplete Choice Plan 2 (Regional PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Brand |
$95.00 | $275.00 | None | $594.97 |
Browse Plan Formulary |
AARP MedicareComplete Plan 1 (HMO)
|
$0.00 |
$0 | Some Generics | 4 |
Non-Preferred Brand |
$30.00 | $80.00 | None | $595.07 |
Browse Plan Formulary |
AARP MedicareComplete Plus (HMO-POS)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Brand |
$30.00 | $80.00 | None | $595.07 |
Browse Plan Formulary |
Aetna Medicare Value Plan (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Brand |
$95.00 | $190.00 | P Q:3 /1Days | $597.23 |
Browse Plan Formulary |
Amerivantage Classic+ Rx Plan (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Brand |
$80.00 | $160.00 | P Q:120 /30Days | $595.03 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AvMed Medicare Choice (HMO)
|
$0.00 |
$0 | Many Generics, Few Brands | 4 |
Non-Preferred Brand |
$50.00 | $150.00 | None | $604.24 |
Browse Plan Formulary |
BlueMedicare HMO (HMO)
|
$0.00 |
$0 | All Generics | 4 |
Non-Preferred Brand |
$50.00 | $150.00 | Q:90 /30Days | $595.71 |
Browse Plan Formulary |
BlueMedicare Regional PPO (Regional PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Brand |
$95.00 | $285.00 | Q:90 /30Days | $595.97 |
Browse Plan Formulary |
CareFree PLUS (HMO)
|
$0.00 |
$0 | Few Generics, Few Brands | 4 |
Non-Preferred Brand |
$40.00 | $110.00 | P Q:90 /30Days | $592.17 |
Browse Plan Formulary |
CareHeart (HMO SNP)
|
$0.00 |
$0 | Many Generics, Few Brands | 4 |
Non-Preferred Brand |
$25.00 | $65.00 | P Q:90 /30Days | $592.17 |
Browse Plan Formulary |
CareOne PLUS (HMO)
|
$0.00 |
$0 | Many Generics, Few Brands | 4 |
Non-Preferred Brand |
$25.00 | $65.00 | P Q:90 /30Days | $592.17 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Clear Skies (HMO SNP)
|
$0.00 |
$0 | All Generics | 3 |
Non-Preferred Brand |
$20.00 | $60.00 | Q:90 /30Days | $614.06 |
Browse Plan Formulary |
Day Break (HMO)
|
$0.00 |
$0 | All Generics | 3 |
Non-Preferred Brand |
$20.00 | $60.00 | Q:90 /30Days | $614.06 |
Browse Plan Formulary |
Freedom Medicare Plan Rx (HMO)
|
$0.00 |
$0 | Many Generics | 3 |
Non-Preferred Brand |
$60.00 | $120.00 | None | $606.42 |
Browse Plan Formulary |
Freedom VIP Care (HMO SNP)
|
$0.00 |
$0 | Many Generics | 3 |
Non-Preferred Brand |
$60.00 | $120.00 | None | $606.07 |
Browse Plan Formulary |
Freedom VIP Care COPD (HMO SNP)
|
$0.00 |
$0 | Many Generics | 3 |
Non-Preferred Brand |
$60.00 | $120.00 | None | $606.07 |
Browse Plan Formulary |
Freedom VIP Savings (HMO SNP)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Non-Preferred Brand |
$60.00 | $120.00 | None | $606.07 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Freedom VIP Savings COPD (HMO SNP)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Non-Preferred Brand |
$60.00 | $120.00 | None | $606.07 |
Browse Plan Formulary |
Humana Gold Plus H1036-054C (HMO)
|
$0.00 |
$0 | Many Generics, Few Brands | 4 |
Non-Preferred Brand |
$25.00 | $65.00 | P Q:90 /30Days | $592.17 |
Browse Plan Formulary |
Humana Gold Plus H1036-164 (HMO)
|
$0.00 |
$0 | Few Generics, Few Brands | 4 |
Non-Preferred Brand |
$40.00 | $110.00 | P Q:90 /30Days | $592.17 |
Browse Plan Formulary |
Humana Gold Plus SNP-CVD/CHF H1036-189 (HMO SNP)
|
$0.00 |
$0 | Many Generics, Few Brands | 4 |
Non-Preferred Brand |
$25.00 | $65.00 | P Q:90 /30Days | $592.17 |
Browse Plan Formulary |
Humana Gold Plus SNP-DB H1036-188 (HMO SNP)
|
$0.00 |
$0 | Many Generics, Few Brands | 4 |
Non-Preferred Brand |
$25.00 | $65.00 | P Q:90 /30Days | $592.17 |
Browse Plan Formulary |
Leon Medical Centers Health Plans - Leon Cares (HMO)
|
$0.00 |
$0 | All Generics | 2 |
Brand |
$0.00 | n/a | Q:90 /30Days | $602.67 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medica HealthCare Plans MedicareMax (HMO)
|
$0.00 |
$0 | Many Generics | 2 |
Preferred Brand |
$5.00 | n/a | Q:360 /30Days | $630.21 |
Browse Plan Formulary |
Medica HealthCare Plans MedicareMax Chronic Care (HMO SNP)
|
$0.00 |
$0 | Many Generics | 2 |
Preferred Brand |
$5.00 | n/a | Q:360 /30Days | $630.21 |
Browse Plan Formulary |
Medica HealthCare Plans MedicareMax Value RX (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
$25.00 | n/a | Q:360 /30Days | $629.98 |
Browse Plan Formulary |
Optimum Gold Rewards Plan (HMO-POS)
|
$0.00 |
$0 | Many Generics | 3 |
Non-Preferred Brand |
$69.00 | $138.00 | None | $606.04 |
Browse Plan Formulary |
Optimum Platinum Plan (HMO-POS)
|
$0.00 |
$0 | Many Generics | 3 |
Non-Preferred Brand |
$60.00 | $120.00 | None | $606.04 |
Browse Plan Formulary |
Positive Healthcare Partners (HMO SNP)
|
$0.00 |
$325 | No additional gap coverage, only the Donut Hole Discount | 2 |
Preferred Brand |
25% | n/a | P Q:90 /30Days | $697.35 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
PUP REWARDS (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Non-Preferred Brand |
$90.00 | $270.00 | P Q:93 /31Days | $595.10 |
Browse Plan Formulary |
Simply Extra (HMO)
|
$0.00 |
$0 | Many Generics | 4 |
Non-Preferred Brand |
$45.00 | n/a | Q:90 /30Days | $614.13 |
Browse Plan Formulary |
Simply Level (HMO SNP)
|
$0.00 |
$0 | Many Generics | 4 |
Non-Preferred Brand |
$15.00 | n/a | Q:90 /30Days | $614.13 |
Browse Plan Formulary |
Simply More (HMO)
|
$0.00 |
$0 | All Generics, All Brands | 4 |
Non-Preferred Brand |
$10.00 | n/a | Q:90 /30Days | $614.13 |
Browse Plan Formulary |
Simply Options (HMO-POS)
|
$0.00 |
$0 | Many Generics | 4 |
Non-Preferred Brand |
$30.00 | n/a | Q:90 /30Days | $614.13 |
Browse Plan Formulary |
Sunrise (HMO)
|
$0.00 |
$0 | All Generics | 3 |
Non-Preferred Brand |
$20.00 | $60.00 | Q:90 /30Days | $614.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
PUP EXTRA (HMO SNP)
|
$4.90 |
$0 | to be determined | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:93 /31Days | $595.03 |
Browse Plan Formulary |
Sunny Days (HMO SNP)
|
$4.90 |
$325 | to be determined | 3 |
Tier 3 |
15% | 15% | Q:90 /30Days | $614.06 |
Browse Plan Formulary |
Humana Gold Plus SNP-DE H1036-077A (HMO SNP)
|
$17.90 |
$325 | to be determined | 4 |
Tier 4 |
$95.00 | $275.00 | P Q:90 /30Days | $592.17 |
Browse Plan Formulary |
Molina Medicare Options Plus (HMO SNP)
|
$18.70 |
$325 | to be determined | 3 |
Tier 3 |
$95.00 | $285.00 | P Q:120 /30Days | $592.50 |
Browse Plan Formulary |
CareNeeds (HMO SNP)
|
$20.30 |
$325 | to be determined | 4 |
Tier 4 |
$95.00 | $275.00 | P Q:90 /30Days | $592.17 |
Browse Plan Formulary |
Humana Gold Plus SNP-I H1036-187 (HMO SNP)
|
$21.30 |
$325 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Brand |
$95.00 | $275.00 | P Q:90 /30Days | $592.17 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus SNP-DE H1036-163 (HMO SNP)
|
$21.90 |
$325 | to be determined | 4 |
Tier 4 |
$95.00 | $275.00 | P Q:90 /30Days | $592.17 |
Browse Plan Formulary |
Freedom Medi-Medi Full (HMO SNP)
|
$23.10 |
$325 | to be determined | 1 |
Tier 1 |
n/a | n/a | None | $606.36 |
Browse Plan Formulary |
Medica HealthCare Plans MedicareMax Plus (HMO SNP)
|
$23.40 |
$325 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:360 /30Days | $629.98 |
Browse Plan Formulary |
Sunshine State Health Plan (HMO SNP)
|
$24.00 |
$325 | to be determined | 2 |
Tier 2 |
$45.00 | $45.00 | None | $602.81 |
Browse Plan Formulary |
Amerivantage Specialty + Rx (HMO SNP)
|
$24.70 |
$325 | Some Generics | 4 |
Non-Preferred Brand |
25% | 25% | P Q:120 /30Days | $595.03 |
Browse Plan Formulary |
Freedom Medi-Medi Partial (HMO SNP)
|
$24.70 |
$325 | to be determined | 1 |
Tier 1 |
15% | 15% | None | $606.36 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CareNeeds PLUS (HMO SNP)
|
$24.80 |
$325 | to be determined | 4 |
Tier 4 |
$95.00 | $275.00 | P Q:90 /30Days | $592.17 |
Browse Plan Formulary |
Optimum Emerald Full (HMO SNP)
|
$24.80 |
$325 | to be determined | 1 |
Tier 1 |
n/a | n/a | None | $606.20 |
Browse Plan Formulary |
Optimum Emerald Partial (HMO SNP)
|
$24.80 |
$325 | to be determined | 1 |
Tier 1 |
15% | 15% | None | $606.20 |
Browse Plan Formulary |
Simply Care (HMO SNP)
|
$24.80 |
$0 | Many Generics | 4 |
Non-Preferred Brand |
$25.00 | n/a | Q:90 /30Days | $613.93 |
Browse Plan Formulary |
Simply Complete (HMO SNP)
|
$24.80 |
$0 | to be determined | 4 |
Tier 4 |
$75.00 | n/a | Q:90 /30Days | $614.13 |
Browse Plan Formulary |
UnitedHealthcare Dual Complete RP (Regional PPO SNP)
|
$24.80 |
$325 | to be determined | 4 |
Tier 4 |
15% | 15% | None | $594.97 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simply Comfort (HMO SNP)
|
$25.80 |
$0 | Many Generics | 4 |
Non-Preferred Brand |
$25.00 | n/a | Q:90 /30Days | $613.93 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
|
$33.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Brand |
$95.00 | $190.00 | P Q:3 /1Days | $597.03 |
Browse Plan Formulary |