ARALAST NP 1,000 MG VIAL (1 EA ) (NDC: 00944281501)
2024 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 Medicare Advantage from UHC ME-0002 (PPO)
|
$0.00 |
$245 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ME-0002 (PPO)
|
$0.00 |
$245 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ME-0002 (PPO)
|
$0.00 |
$245 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ME-0002 (PPO)
|
$0.00 |
$245 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ME-0002 (PPO)
|
$0.00 |
$245 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
AARP Medicare Advantage from UHC ME-0002 (PPO)
|
$0.00 |
$245 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ME-0002 (PPO)
|
$0.00 |
$245 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ME-0002 (PPO)
|
$0.00 |
$245 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ME-0002 (PPO)
|
$0.00 |
$245 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ME-0002 (PPO)
|
$0.00 |
$245 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ME-0005 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
|
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 |
AARP Medicare Advantage from UHC ME-0005 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ME-0005 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ME-0005 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ME-0005 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ME-0005 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ME-0005 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
AARP Medicare Advantage from UHC ME-0005 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ME-0005 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ME-0005 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Value Plus (HMO-POS)
|
$0.00 |
$300 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
28% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Value Plus (HMO-POS)
|
$0.00 |
$300 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
28% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Value Plus (HMO-POS)
|
$0.00 |
$300 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
28% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
Martin's Point Generations Advantage Value Plus (HMO-POS)
|
$0.00 |
$300 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
28% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Value Plus (HMO-POS)
|
$0.00 |
$300 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
28% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Value Plus (HMO-POS)
|
$0.00 |
$300 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
28% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Value Plus (HMO-POS)
|
$0.00 |
$300 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
28% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Value Plus (HMO-POS)
|
$0.00 |
$300 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
28% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Value Plus (HMO-POS)
|
$0.00 |
$300 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
28% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
Martin's Point Generations Advantage Value Plus (HMO-POS)
|
$0.00 |
$300 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
28% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Value Plus (HMO-POS)
|
$0.00 |
$300 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
28% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Value Plus (HMO-POS)
|
$0.00 |
$300 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
28% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Value Plus (HMO-POS)
|
$0.00 |
$300 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
28% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Northern Light Health ME-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Northern Light Health ME-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
UHC Northern Light Health ME-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Northern Light Health ME-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Northern Light Health ME-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Northern Light Health ME-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Northern Light Health ME-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Northern Light Health ME-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
UHC Northern Light Health ME-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Northern Light Health ME-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Northern Light Health ME-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Northern Light Health ME-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Northern Light Health ME-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Northern Light Health ME-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
UHC Northern Light Health ME-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Northern Light Health ME-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Northern Light Health ME-0004 (PPO)
|
$0.00 |
$295 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
28% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Northern Light Health ME-0004 (PPO)
|
$0.00 |
$295 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
28% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Northern Light Health ME-0004 (PPO)
|
$0.00 |
$295 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
28% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Northern Light Health ME-0004 (PPO)
|
$0.00 |
$295 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
28% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
UHC Northern Light Health ME-0004 (PPO)
|
$0.00 |
$295 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
28% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Northern Light Health ME-0004 (PPO)
|
$0.00 |
$295 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
28% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback (HMO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback (HMO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback (HMO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback (HMO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 Giveback (HMO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback (HMO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback (HMO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback (HMO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback (HMO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback (HMO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 Giveback (HMO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback (HMO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback (HMO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback (HMO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback (HMO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback (HMO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 No Premium (HMO)
|
$0.00 |
$275 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
29% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$275 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
29% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$275 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
29% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$275 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
29% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$275 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
29% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$275 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
29% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 No Premium (HMO)
|
$0.00 |
$275 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
29% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$275 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
29% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$275 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
29% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$275 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
29% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$275 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
29% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$275 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
29% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 No Premium (HMO)
|
$0.00 |
$275 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
29% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$275 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
29% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$275 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
29% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$275 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
29% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 No Premium Open (PPO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 No Premium Open (PPO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 No Premium Open (PPO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist Open (PPO)
|
$21.90 |
$485 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist Open (PPO)
|
$21.90 |
$485 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist Open (PPO)
|
$21.90 |
$485 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist Open (PPO)
|
$21.90 |
$485 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 Assist Open (PPO)
|
$21.90 |
$485 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist Open (PPO)
|
$21.90 |
$485 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist Open (PPO)
|
$21.90 |
$485 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist Open (PPO)
|
$21.90 |
$485 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist Open (PPO)
|
$21.90 |
$485 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist Open (PPO)
|
$21.90 |
$485 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 Assist Open (PPO)
|
$21.90 |
$485 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist Open (PPO)
|
$21.90 |
$485 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist Open (PPO)
|
$21.90 |
$485 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist Open (PPO)
|
$21.90 |
$485 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist Open (PPO)
|
$21.90 |
$485 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist Open (PPO)
|
$21.90 |
$485 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | n/a | P | $619.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$25.10 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$25.10 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$25.10 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$25.10 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$25.10 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$25.10 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$25.10 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$25.10 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$25.10 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$25.10 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$25.10 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$25.10 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 Dual Access (HMO D-SNP)
|
$26.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$26.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$26.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$26.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$26.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$26.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 Dual Access (HMO D-SNP)
|
$26.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$26.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$26.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$26.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$26.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$26.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 Dual Access (HMO D-SNP)
|
$26.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$26.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$26.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$26.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$26.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$26.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 Dual Liberty (HMO D-SNP)
|
$26.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$26.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$26.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$26.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$26.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$26.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 Dual Liberty (HMO D-SNP)
|
$26.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$26.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$26.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$26.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$26.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$26.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 Dual Liberty (HMO D-SNP)
|
$26.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$26.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$29.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$29.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$29.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$29.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$29.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$29.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$29.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$29.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan EX-F003 (PPO I-SNP)
|
$33.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | 25% | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan EX-F003 (PPO I-SNP)
|
$33.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | 25% | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
UHC Nursing Home Plan EX-F003 (PPO I-SNP)
|
$33.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | 25% | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan EX-F003 (PPO I-SNP)
|
$33.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | 25% | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan EX-F003 (PPO I-SNP)
|
$33.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | 25% | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan EX-F003 (PPO I-SNP)
|
$33.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | 25% | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan EX-F003 (PPO I-SNP)
|
$33.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
25% | 25% | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete ME-S001 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
UHC Dual Complete ME-S001 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete ME-S001 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete ME-S001 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete ME-S001 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete ME-S001 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete ME-S001 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
UHC Dual Complete ME-S001 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete ME-S001 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete ME-S001 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete ME-S003 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete ME-S003 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete ME-S003 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
UHC Dual Complete ME-S003 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete ME-S003 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete ME-S003 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete ME-S003 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete ME-S003 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete ME-S003 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
UHC Dual Complete ME-S003 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Northern Light Health Dual Complete ME-S002 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Northern Light Health Dual Complete ME-S002 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Northern Light Health Dual Complete ME-S002 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Northern Light Health Dual Complete ME-S002 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Northern Light Health Dual Complete ME-S002 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
UHC Northern Light Health Dual Complete ME-S002 (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 5 |
Tier 5 |
$0.00 | $0.00 | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 Dual Access Open (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 Dual Access Open (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$36.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P | $620.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ME-0003 (PPO)
|
$54.00 |
$150 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
30% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
AARP Medicare Advantage from UHC ME-0003 (PPO)
|
$54.00 |
$150 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
30% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ME-0003 (PPO)
|
$54.00 |
$150 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
30% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ME-0003 (PPO)
|
$54.00 |
$150 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
30% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ME-0003 (PPO)
|
$54.00 |
$150 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
30% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ME-0003 (PPO)
|
$54.00 |
$150 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
30% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ME-0003 (PPO)
|
$54.00 |
$150 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
30% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
AARP Medicare Advantage from UHC ME-0003 (PPO)
|
$54.00 |
$150 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
30% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ME-0003 (PPO)
|
$54.00 |
$150 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
30% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ME-0003 (PPO)
|
$54.00 |
$150 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
30% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC MH-0001 (Regional PPO)
|
$58.00 |
$295 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
28% | n/a | P | $681.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$89.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$89.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$89.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$89.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$89.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$89.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$89.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$89.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$89.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Prime (HMO-POS)
|
$89.00 |
$0 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
33% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Select (PPO)
|
$99.00 |
$275 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Select (PPO)
|
$99.00 |
$275 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Select (PPO)
|
$99.00 |
$275 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Select (PPO)
|
$99.00 |
$275 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
Martin's Point Generations Advantage Select (PPO)
|
$99.00 |
$275 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Select (PPO)
|
$99.00 |
$275 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Select (PPO)
|
$99.00 |
$275 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Select (PPO)
|
$99.00 |
$275 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Select (PPO)
|
$99.00 |
$275 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Select (PPO)
|
$99.00 |
$275 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
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 |
Martin's Point Generations Advantage Select (PPO)
|
$99.00 |
$275 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Select (PPO)
|
$99.00 |
$275 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Select (PPO)
|
$99.00 |
$275 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Select (PPO)
|
$99.00 |
$275 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Select (PPO)
|
$99.00 |
$275 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |
Martin's Point Generations Advantage Select (PPO)
|
$99.00 |
$275 | Yes, but No Gap Coverage for this drug. | 5 |
Tier 5 |
29% | n/a | P | $633.20 |
Browse Plan Formulary all covered insulin pay $35 or less |