ACARBOSE 100 MG TABLET (100 EA ) (NDC: 69543012210)
2019 Medicare Prescription Drug Plan (MAPD) Information
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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 (HMO)
|
$0.00 |
$195* | No additional gap coverage, only the Donut Hole Discount | 1* |
Preferred Generic |
$3.00 | $0.00 | Q:90 /30Days | $39.44 |
Browse Plan Formulary |
AARP MedicareComplete Choice (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 1* |
Preferred Generic |
$3.00 | $0.00 | Q:90 /30Days | $38.83 |
Browse Plan Formulary |
AARP MedicareComplete Choice Plan 2 (Regional PPO)
|
$0.00 |
$395* | to be determined | 1* |
Preferred Generic |
$3.00 | $0.00 | Q:90 /30Days | $37.88 |
Browse Plan Formulary |
AARP MedicareComplete Focus (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 1 |
Preferred Generic |
$3.00 | $0.00 | Q:90 /30Days | $39.00 |
Browse Plan Formulary |
Aetna Medicare Choice Plan (HMO-POS)
|
$0.00 |
$195* | Yes, but No Gap Coverage for this drug. | 1* |
Preferred Generic |
$0.00 | $0.00 | Q:90 /30Days | $9.03 |
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 |
Aetna Medicare Premier Plan (PPO)
|
$0.00 |
$295* | Yes, but No Gap Coverage for this drug. | 1* |
Preferred Generic |
$0.00 | $0.00 | Q:90 /30Days | $8.83 |
Browse Plan Formulary |
Allwell Medicare (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 6 |
Select Care Drugs |
$0.00 | $0.00 | Q:3 /1Days | $37.58 |
Browse Plan Formulary |
BayCarePlus Complete (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$4.00 | $0.00 | Q:90 /30Days | $26.27 |
Browse Plan Formulary |
BayCarePlus Rewards (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$10.00 | $0.00 | Q:90 /30Days | $26.27 |
Browse Plan Formulary |
BlueMedicare Classic (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$10.00 | $30.00 | Q:90 /30Days | $38.87 |
Browse Plan Formulary |
BlueMedicare Classic Plus (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$0.00 | $0.00 | Q:90 /30Days | $40.13 |
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 |
CareFree (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$35.00 | $95.00 | None | $49.37 |
Browse Plan Formulary |
CareOne PLUS (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$10.00 | $20.00 | None | $49.37 |
Browse Plan Formulary |
Coventry Medicare Summit Plan (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 1 |
Preferred Generic |
$0.00 | $0.00 | Q:90 /30Days | $7.48 |
Browse Plan Formulary |
Devoted Health Greater Tampa Bay (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$15.00 | $37.50 | None | $68.31 |
Browse Plan Formulary |
Freedom Medicare Plan Rx (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 1 |
Preferred Generic |
$0.00 | $0.00 | Q:90 /30Days | $69.78 |
Browse Plan Formulary |
Freedom VIP Care (HMO SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 1 |
Preferred Generic |
$0.00 | $0.00 | Q:90 /30Days | $70.01 |
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 (HMO SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 1 |
Preferred Generic |
$0.00 | $0.00 | Q:90 /30Days | $70.01 |
Browse Plan Formulary |
Freedom VIP Savings COPD (HMO SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 1 |
Preferred Generic |
$0.00 | $0.00 | Q:90 /30Days | $70.01 |
Browse Plan Formulary |
Humana Gold Plus - Diabetes (HMO SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$10.00 | $20.00 | None | $49.39 |
Browse Plan Formulary |
Humana Gold Plus H1036-025 (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$5.00 | $5.00 | None | $49.38 |
Browse Plan Formulary |
Humana Gold Plus H1036-265 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $125.00 | None | $49.47 |
Browse Plan Formulary |
Humana Gold Plus H1036-265 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$45.00 | $125.00 | None | $49.38 |
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 |
HumanaChoice Florida H5216-072 (PPO)
|
$0.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | None | $49.39 |
Browse Plan Formulary |
HumanaChoice R5826-074 (Regional PPO)
|
$0.00 |
$395 | to be determined | 3 |
Preferred Brand |
$47.00 | $131.00 | None | $49.39 |
Browse Plan Formulary |
Optimum Diamond Rewards (HMO SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 1 |
Preferred Generic |
$0.00 | $0.00 | Q:90 /30Days | $69.93 |
Browse Plan Formulary |
Optimum Diamond Rewards COPD (HMO SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 1 |
Preferred Generic |
$0.00 | $0.00 | Q:90 /30Days | $69.93 |
Browse Plan Formulary |
Optimum Gold Rewards Plan (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 1 |
Preferred Generic |
$0.00 | $0.00 | Q:90 /30Days | $69.77 |
Browse Plan Formulary |
Optimum Platinum Plan (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 1 |
Preferred Generic |
$0.00 | $0.00 | Q:90 /30Days | $69.77 |
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 Level (HMO SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 1 |
Preferred Generic |
$0.00 | $0.00 | Q:90 /30Days | $53.80 |
Browse Plan Formulary |
Simply More (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 1 |
Preferred Generic |
$0.00 | $0.00 | Q:90 /30Days | $53.80 |
Browse Plan Formulary |
Solis Health Plans (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$0.00 | $0.00 | None | $38.98 |
Browse Plan Formulary |
UnitedHealthcare Dual Complete RP ONE (Regional PPO SNP)
|
$0.00 |
$415 | to be determined | 1 |
All Formulary Drugs |
$0.00 | $0.00 | Q:90 /30Days | $37.88 |
Browse Plan Formulary |
WellCare Champion (HMO SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$5.00 | $0.00 | None | $25.72 |
Browse Plan Formulary |
WellCare Dividend (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$0.00 | $0.00 | None | $26.96 |
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 |
WellCare Dividend Prime (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$10.00 | $0.00 | None | $26.72 |
Browse Plan Formulary |
WellCare Elite (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$0.00 | $0.00 | None | $26.72 |
Browse Plan Formulary |
WellCare Essential (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$0.00 | $0.00 | None | $25.37 |
Browse Plan Formulary |
WellCare Guardian (HMO SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$0.00 | $0.00 | None | $25.72 |
Browse Plan Formulary |
CareNeeds PLUS (HMO SNP)
|
$5.40 |
$400 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | None | $49.37 |
Browse Plan Formulary |
CareNeeds (HMO SNP)
|
$9.40 |
$415 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | None | $49.37 |
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 H1036-251 (HMO SNP)
|
$18.00 |
$415 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | None | $49.39 |
Browse Plan Formulary |
UnitedHealthcare Dual Complete LP (HMO SNP)
|
$21.60 |
$415 | No additional gap coverage, only the Donut Hole Discount | 1 |
All Formulary Drugs |
15% | 15% | Q:90 /30Days | $38.02 |
Browse Plan Formulary |
WellCare Access (HMO SNP)
|
$23.80 |
$415 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | None | $27.29 |
Browse Plan Formulary |
Humana Gold Plus SNP-DE H1036-102 (HMO SNP)
|
$23.90 |
$360 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | None | $49.39 |
Browse Plan Formulary |
WellCare Reserve (HMO SNP)
|
$24.70 |
$415 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | None | $26.72 |
Browse Plan Formulary |
UnitedHealthcare Dual Complete RP (Regional PPO SNP)
|
$25.30 |
$415 | to be determined | 1 |
All Formulary Drugs |
15% | 15% | Q:90 /30Days | $37.88 |
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 |
Coventry Medicare Summit Plan (HMO SNP)
|
$25.40 |
$415* | Yes, but No Gap Coverage for this drug. | 1* |
Preferred Generic |
$0.00 | $0.00 | Q:90 /30Days | $10.20 |
Browse Plan Formulary |
WellCare Liberty (HMO SNP)
|
$26.60 |
$415 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | None | $27.29 |
Browse Plan Formulary |
WellCare Select (HMO SNP)
|
$26.80 |
$415 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | None | $28.17 |
Browse Plan Formulary |
Molina Medicare Options Plus (HMO SNP)
|
$30.20 |
$415 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | None | $77.35 |
Browse Plan Formulary |
Allwell Dual Medicare (HMO SNP)
|
$30.30 |
$415* | Yes, but No Gap Coverage for this drug. | 6* |
Select Care Drugs |
$0.00 | $0.00 | Q:3 /1Days | $28.15 |
Browse Plan Formulary |
BlueMedicare Complete (HMO SNP)
|
$30.30 |
$415* | Yes, but No Gap Coverage for this drug. | 2* |
Generic |
$0.00 | $0.00 | Q:90 /30Days | $37.79 |
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 |
Devoted Health Prime Greater Tampa Bay (HMO)
|
$30.30 |
$415 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | None | $68.31 |
Browse Plan Formulary |
Freedom Medi-Medi Full (HMO SNP)
|
$30.30 |
$415* | No additional gap coverage, only the Donut Hole Discount | 1* |
Preferred Generic |
$0.00 | $0.00 | Q:90 /30Days | $69.86 |
Browse Plan Formulary |
Freedom Medi-Medi Partial (HMO SNP)
|
$30.30 |
$415* | No additional gap coverage, only the Donut Hole Discount | 1* |
Preferred Generic |
$0.00 | $0.00 | Q:90 /30Days | $69.86 |
Browse Plan Formulary |
Optimum Emerald Full (HMO SNP)
|
$30.30 |
$415* | No additional gap coverage, only the Donut Hole Discount | 1* |
Preferred Generic |
$0.00 | $0.00 | Q:90 /30Days | $69.86 |
Browse Plan Formulary |
Optimum Emerald Partial (HMO SNP)
|
$30.30 |
$415* | No additional gap coverage, only the Donut Hole Discount | 1* |
Preferred Generic |
$0.00 | $0.00 | Q:90 /30Days | $69.86 |
Browse Plan Formulary |
Simply Advantage (HMO SNP)
|
$30.30 |
$415* | Yes, but No Gap Coverage for this drug. | 1* |
Preferred Generic |
$0.00 | $0.00 | Q:90 /30Days | $53.92 |
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 Care (HMO SNP)
|
$30.30 |
$415 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$5.00 | n/a | Q:90 /30Days | $53.80 |
Browse Plan Formulary |
Simply Comfort (HMO SNP)
|
$30.30 |
$415* | Yes, but No Gap Coverage for this drug. | 1* |
Preferred Generic |
$0.00 | n/a | Q:90 /30Days | $53.80 |
Browse Plan Formulary |
Simply Complete (HMO SNP)
|
$30.30 |
$415* | Yes, but No Gap Coverage for this drug. | 1* |
Preferred Generic |
$0.00 | $0.00 | Q:90 /30Days | $53.92 |
Browse Plan Formulary |
Simply Select (HMO)
|
$30.30 |
$415* | Yes, but No Gap Coverage for this drug. | 1* |
Preferred Generic |
$0.00 | $0.00 | Q:90 /30Days | $53.80 |
Browse Plan Formulary |
Solis Health Plans (HMO SNP)
|
$30.30 |
$0 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
0% | 0% | None | $38.98 |
Browse Plan Formulary |
UnitedHealthcare Nursing Home Plan (PPO SNP)
|
$30.30 |
$415 | No additional gap coverage, only the Donut Hole Discount | 1 |
All Formulary Drugs |
25% | 25% | Q:90 /30Days | $43.71 |
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 |
HumanaChoice R5826-005 (Regional PPO)
|
$31.30 |
$100 | to be determined | 3 |
Preferred Brand |
$45.00 | $125.00 | None | $49.39 |
Browse Plan Formulary |
BlueMedicare Choice (Regional PPO)
|
$41.00 |
$250* | to be determined | 2* |
Generic |
$10.00 | $30.00 | Q:90 /30Days | $40.09 |
Browse Plan Formulary |
BlueMedicare Select (PPO)
|
$147.80 |
$305 | Yes, but No Gap Coverage for this drug. | 2 |
Generic |
$10.00 | $30.00 | Q:90 /30Days | $39.71 |
Browse Plan Formulary |