Key
C | Covered - No restrictions |
Q | Has quantity limits |
S | Has step therapy |
P | Has prior authorization |
N | Not Covered |
| AARP MedicareRx Saver Plus (PDP) S5921-373 | Humana Preferred Rx Plan (PDP) S5884-112 | SmartD Rx Saver (PDP) S0064-029 | WellCare Classic (PDP) S5967-166 |
| Q | Q | N | QP |
| Q | Q | N | QP |
| N | N | N | N |
| N | N | N | N |
| N | N | N | N |
| C | P | N | C |
| P | C | N | C |
| N | N | N | Q |
| N | N | N | Q |
| C | N | N | C |
| P | P | N | P |
| C | Q | N | Q |
| N | N | N | N |
| N | N | N | N |
| Q | N | N | C S |
| C | Q | N | Q |
| N | N | N | N |
| P | N | N | N |
| C | N | N | N |
| N | N | N | N |
| N | N | N | N |
| N | N | N | N |
| C | N | N | N |
| C | N | N | N |
| C | C | N | N |
| AARP MedicareRx Saver Plus (PDP) S5921-373 | Humana Preferred Rx Plan (PDP) S5884-112 | SmartD Rx Saver (PDP) S0064-029 | WellCare Classic (PDP) S5967-166 |
| C | P | N | P |
| C | Q | N | N |
| C | Q | N | N |
| N | N | N | P |
| N | N | N | N |
| P | QP | N | N |
| C | Q S | N | C |
| C | N | N | C |
| C | C | N | C |
| N | Q | N | N |
| C | C | N | C |
| C | C | N | C |
| N | N | N | C |
| P | P | N | P |
| C | Q | N | Q |
| C | Q | N | C |
| P | QP | N | QP |
| N | N | N | N |
| P | P | N | P |
| C | C | N | C |
| C | Q | N | C |
| N | N | N | N |
| C S | C | N | P |
| N | N | N | N |
| Q | Q | N | Q |
| P | QP | N | N |
| AARP MedicareRx Saver Plus (PDP) S5921-373 | Humana Preferred Rx Plan (PDP) S5884-112 | SmartD Rx Saver (PDP) S0064-029 | WellCare Classic (PDP) S5967-166 |
| C | Q | N | Q |
| C | N | N | C |
| N | N | N | N |
| N | N | N | N |
| C S | Q | N | Q |
| N | Q | N | N |
| Q | Q | N | Q |
| N | N | N | N |
| N | N | N | N |
| C | N | N | N |
| P | Q S | N | QP |
| C | N | N | C |
| C | Q | N | N |
| C | C | N | Q |
| N | Q | N | Q |
| N | C | N | Q |
| N | C | N | Q |
| N | C | N | Q |
| N | C | N | Q |
| N | N | N | QP |
| N | N | N | N |
| Q | Q S | N | QP |
| N | N | N | N |
| P | QP | N | P |
| N | N | N | N |
| C | Q | N | N |
| N | N | N | N |
| N | N | N | N |
| AARP MedicareRx Saver Plus (PDP) S5921-373 | Humana Preferred Rx Plan (PDP) S5884-112 | SmartD Rx Saver (PDP) S0064-029 | WellCare Classic (PDP) S5967-166 |
| C | C | N | Q |
| N | N | N | N |
| P | C | N | C |
| Q | QP | N | Q |
| C | N | N | C |
| C | Q | N | C |
| N | N | N | N |
| C | Q | N | Q |
| N | N | N | N |
| P | QP | N | N |
| C | N | N | N |
| N | N | N | N |
| C | Q | N | C |
| P | N | N | P |
| C | Q | N | C |
| Q | Q | N | Q |
| C | N | N | N |
| C | QP | N | Q |
| C | Q | N | C |
| P | QP | N | P |
| C | N | N | C |
| C | N | N | N |
| C | N | N | C |
| C | C | N | Q S |
| N | C | N | Q S |
| C | C | N | Q S |
| N | Q | N | N |
| AARP MedicareRx Saver Plus (PDP) S5921-373 | Humana Preferred Rx Plan (PDP) S5884-112 | SmartD Rx Saver (PDP) S0064-029 | WellCare Classic (PDP) S5967-166 |
| C | Q | N | C |
| P | QP | N | C |
| P | QP | N | P |
| P | QP | N | C |
| C | Q S | N | Q |
| N | N | N | N |
| N | N | N | N |
| C | Q | N | C |
| C | C | N | C |
| N | N | N | N |
| QP | Q | N | Q |
| N | N | N | N |
| N | N | N | N |
| N | N | N | N |
| P | QP | N | P |
| P | P | N | P |
| P | QP | N | Q S |
| C | P | N | P |
| C | P | N | P |
| C | N | N | C |
| N | N | N | N |
| QP | N | N | N |
| P | N | N | N |
| C | N | N | Q |
| C S | Q S | N | Q |
| AARP MedicareRx Saver Plus (PDP) S5921-373 | Humana Preferred Rx Plan (PDP) S5884-112 | SmartD Rx Saver (PDP) S0064-029 | WellCare Classic (PDP) S5967-166 |
| P | N | N | N |
| P | C | N | P |
| N | N | N | N |
| P | N | N | N |
| N | N | N | N |
| C | Q | N | Q |
| C | Q | N | Q |
| N | N | N | N |
| N | N | N | N |
| N | N | N | N |
| C | Q | N | Q |
| N | N | N | N |
| N | N | N | N |
| C | Q | N | Q |
| C | Q | N | C |
| N | N | N | N |
| C | C | N | C |
| C | N | N | N |
| C | Q | N | C |
| N | N | N | N |
| N | N | N | N |
| C S | N | N | C S |
| N | N | N | N |
| P | P | N | P |
| C | N | N | C |
| AARP MedicareRx Saver Plus (PDP) S5921-373 | Humana Preferred Rx Plan (PDP) S5884-112 | SmartD Rx Saver (PDP) S0064-029 | WellCare Classic (PDP) S5967-166 |
| N | N | N | N |
| N | N | N | N |
| N | N | N | Q |
| P | Q | N | Q |
| C | QP | N | C S |
| N | N | N | N |
| N | N | N | N |
| N | N | N | N |
| C | Q | N | Q |
| Q | Q | N | Q |
| C | N | N | N |
| N | Q | N | N |
| N | N | N | N |
| P | C | N | QP |