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APOKYN 30 MG/3 ML CARTRIDGE (300 mls )
ex: Lipitor
 
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  ex: 00071015694

$  max: $156
$  max: $415
Requires Prior Authorization:
Yes No Show either
Uses Step Therapy:
Yes No Show either
Has Quantity Limits:
Yes No Show either

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Please note:  The plan’s average retail drug price (30-day supply) shown below is from the September 2019 dataset. Your actual retail drug price may differ significantly from the average shown. Please contact the Medicare plan or Medicare (1-800-Medicare) for more specific pricing based on your chosen pharmacy.

There are 29 Tennessee 2019 stand-alone Medicare Part D plans meeting your criteria.

Click Details button below to access plan details and contact information.

APOKYN 30 MG/3 ML CARTRIDGE (300 mls ) (NDC: 27505000401)
2019 Medicare Part D Plan Information
Click here to jump to the Chart Legend
Reference Information -- Estimated cost using a drug discount card:
APOKYN 30 MG/3 ML CARTRIDGE (300 mls ): $1,099.42.  Compare prices at pharmacies near you.
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
WellCare Value Script (PDP)
 
$15.50 $415 No additional gap coverage, only the Donut Hole Discount 5 Specialty Tier 25%n/aP Q:60
/30Days
$1,060.60
Browse Plan Formulary
Aetna Medicare Rx Select (PDP)
 
$17.10 $365 Yes, but No Gap Coverage for this drug. 5 Specialty Tier 25%n/aP Q:60
/30Days
$1,073.64
Browse Plan Formulary
Cigna-HealthSpring Rx Secure-Essential (PDP)
 
$21.90 $415 No additional gap coverage, only the Donut Hole Discount 5 Specialty Tier 25%n/aP Q:60
/30Days
$1,111.78
Browse Plan Formulary
Express Scripts Medicare - Saver (PDP)
 
$24.50 $415 No additional gap coverage, only the Donut Hole Discount 5 Specialty Tier 25%n/aP Q:60
/30Days
$1,035.09
Browse Plan Formulary
AARP MedicareRx Walgreens (PDP)
 
$28.10 $415 No additional gap coverage, only the Donut Hole Discount 5 Specialty Tier 25%25%P Q:90
/30Days
$1,114.26
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 Walmart Rx Plan (PDP)
 
$28.80 $415 No additional gap coverage, only the Donut Hole Discount 5 Specialty Tier 25%n/aQ:84
/28Days
$1,078.16
Browse Plan Formulary
Mutual of Omaha Rx Value (PDP)
 
$28.80 $415 No additional gap coverage, only the Donut Hole Discount 5 Specialty Tier 25%n/aP Q:60
/30Days
$1,035.14
Browse Plan Formulary
Aetna Medicare Rx Saver (PDP)
 
$29.10 $295 No additional gap coverage, only the Donut Hole Discount 5 Specialty Tier 27%n/aP Q:60
/30Days
$1,073.79
Browse Plan Formulary
Humana Preferred Rx Plan (PDP)
 
$29.20 $415 No additional gap coverage, only the Donut Hole Discount 5 Specialty Tier 25%n/aQ:84
/28Days
$1,078.16
Browse Plan Formulary
SilverScript Choice (PDP)
 
$29.60 $0 No additional gap coverage, only the Donut Hole Discount 5 Specialty Tier 33%n/aP Q:60
/30Days
$1,060.60
Browse Plan Formulary
WellCare Classic (PDP)
 
$29.90 $415 No additional gap coverage, only the Donut Hole Discount 5 Specialty Tier 25%n/aP Q:60
/30Days
$1,060.60
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
AARP MedicareRx Saver Plus (PDP)
 
$30.20 $415 No additional gap coverage, only the Donut Hole Discount 5 Specialty Tier 25%25%P Q:90
/30Days
$1,129.41
Browse Plan Formulary
Express Scripts Medicare - Value (PDP)
 
$30.20 $415 No additional gap coverage, only the Donut Hole Discount 5 Specialty Tier 25%n/aP Q:60
/30Days
$1,035.10
Browse Plan Formulary
BlueRx Essential (PDP)
 
$34.40 $415 No additional gap coverage, only the Donut Hole Discount 5 Specialty Tier 25%25%P Q:60
/30Days
$1,073.96
Browse Plan Formulary
Mutual of Omaha Rx Plus (PDP)
 
$45.40 $415 No additional gap coverage, only the Donut Hole Discount 5 Specialty Tier 25%n/aP Q:60
/30Days
$1,035.14
Browse Plan Formulary
SilverScript Plus (PDP)
 
$49.50 $0 Yes, but No Gap Coverage for this drug. 5 Specialty Tier 33%n/aP Q:60
/30Days
$1,060.57
Browse Plan Formulary
EnvisionRxPlus (PDP)
 
$50.40 $415 No additional gap coverage, only the Donut Hole Discount 5 Specialty Tier 25%n/aP Q:60
/28Days
$1,131.57
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
Cigna-HealthSpring Rx Secure (PDP)
 
$53.50 $415 No additional gap coverage, only the Donut Hole Discount 5 Specialty Tier 25%n/aP Q:60
/30Days
$1,111.78
Browse Plan Formulary
Cigna-HealthSpring Rx Secure-Extra (PDP)
 
$57.90 $100 Yes, but No Gap Coverage for this drug. 5 Specialty Tier 31%n/aP Q:60
/30Days
$1,111.78
Browse Plan Formulary
Aetna Medicare Rx Value Plus (PDP)
 
$58.70 $0 Yes, but No Gap Coverage for this drug. 5 Specialty Tier 33%n/aP Q:60
/30Days
$1,073.79
Browse Plan Formulary
Farm Bureau Essential Rx (PDP)
 
$59.10 $415 No additional gap coverage, only the Donut Hole Discount 5 Specialty Tier 25%25%P Q:90
/30Days
$1,120.46
Browse Plan Formulary
AARP MedicareRx Preferred (PDP)
 
$71.00 $0 No additional gap coverage, only the Donut Hole Discount 5 Specialty Tier 33%33%P Q:90
/30Days
$1,132.91
Browse Plan Formulary
BlueRx Enhanced (PDP)
 
$71.50 $350 No additional gap coverage, only the Donut Hole Discount 5 Specialty Tier 25%25%P Q:60
/30Days
$1,058.05
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 Extra (PDP)
 
$71.80 $0 No additional gap coverage, only the Donut Hole Discount 5 Specialty Tier 33%n/aP Q:60
/30Days
$1,060.60
Browse Plan Formulary
Humana Enhanced (PDP)
 
$76.40 $0 No additional gap coverage, only the Donut Hole Discount 5 Specialty Tier 33%n/aQ:84
/28Days
$1,078.16
Browse Plan Formulary
SilverScript Allure (PDP)
 
$80.00 $0 No additional gap coverage, only the Donut Hole Discount 5 Specialty Tier 33%n/aP Q:60
/30Days
$1,060.57
Browse Plan Formulary
Express Scripts Medicare - Choice (PDP)
 
$87.10 $350 Yes, but No Gap Coverage for this drug. 5 Specialty Tier 26%n/aP Q:60
/30Days
$1,035.10
Browse Plan Formulary
Farm Bureau Select Rx (PDP)
 
$99.00 $0 No additional gap coverage, only the Donut Hole Discount 5 Specialty Tier 33%33%P Q:90
/30Days
$1,120.46
Browse Plan Formulary
BlueRx Enhanced Plus (PDP)
 
$119.90 $0 No additional gap coverage, only the Donut Hole Discount 5 Specialty Tier 33%33%P Q:60
/30Days
$1,058.05
Browse Plan Formulary

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Chart Legend:

What does all this mean? Below are a few notes to help you understand the above 2019 Medicare Part D Plan Formulary.

  • Plan Name: This is the official Medicare Part D prescription drug plan name from the Centers for Medicare and Medicaid Services (CMS). The same Medicare Part D plan name generally has a different Plan ID in each state (or CMS Region). The plan name is followed by the plan type (PDP, HMO, HMO-POS, PPO, PFFS, etc.)

  • Monthly Premium: This is the amount you must pay each month for this prescription drug plan. This monthly premium must be paid even if you are in the initial deductible phase or the coverage gap (donut hole) phase.

  • Deductible: If your Part D plan has an initial deductible, you are 100% responsible for your drug costs until your expenses exceed this value and you begin your Initial Coverage Phase.
    • Many Medicare Part D plans use the standard $415 deductible as provided in the CMS "Standard" plan design.
    • Some Part D plan providers offer an initial deductible lower than the Standard deductible.
    • Many prescription drug plans do not have a deductible (also called first dollar coverage or a $0 deductible), however the monthly premium for a plan with a $0 deductible may be slightly higher.
    • *Some Part D plans exclude some drug tiers from the deductible. If the deductible field above is followed by * (example: $415*), then this drug tier is excluded from the deductible.


  • Gap Coverage (the Donut Hole): In the CMS Standard Plan, the beneficiary, or others on their behalf (e.g. the brand-name drug manufacturer discount), pay(s) up to $3,834 in drug costs, depending on your mix of generics and brand-name drugs. The Healthcare Reform provides that for plan year 2019, ALL formulary generics will have at least a 63% discount and ALL brand-name drugs will have at least a 75% discount in the coverage gap. The Gap Coverage Types discussed in this section are in addition to the Healthcare Reform mandated discounts. In our chart, you will see one of the following:
    • No Gap Coverage: you pay up to $3,834 depending on your mix of generics and brand-name drugs. Read more...
    • Yes: This plan offers some level of gap coverage. See plan details for a description of the gap coverage. It will read similar to: Under this plan you may pay even less for the brand and generic drugs on the formulary. Your cost varies by tier. You will need to use your formulary to locate your drug's tier. See the chart that follows to find out how much it will cost you.

  • Drug Tier Information - Drug Tiers are the logical grouping of prescription drugs on a Part D plan formulary. These fields represent the Tier (or drug list group) - for this particular medication - on this particular plan’s Formulary or Drug List.
    • Tier Number - This is the actual numerical tier level from the formulary. Most Part D plans have five (5) tiers 1=Preferred Generics, 2=Generics, 3=Preferred Brands, 4=Non-preferred Brands, 5=Specialty Drugs. *Some Part D plans exclude one or more drug tiers from the deductible. If the drug tier field above is followed by * (example: 2*), then this drug tier is excluded from the plan’s deductible.
    • Tier Description - This is the Medicare Part D plan’s description of this particular drug tier.

  • Cost Sharing - Copay / Coinsurance - These figures apply to the initial coverage phase of your plan. This is the phase after the initial deductible has been met and before you reach the Coverage Gap (Donut Hole). Plans often cover drugs in "tiers". Tiers are specific to the list of drugs covered by the plan. Plans may have several tiers, and the copay for a drug depends on the drug’s tier. The drug Tier is shown to the left of this column. These cost sharing figures DO NOT necessarily apply to the Coverage Gap. The plan may have a separate copay/coinsurance for the same drug while in the Coverage Gap. There are two figures shown under this "Cost Sharing" category:
    • Preferred Network Pharmacy - (Preferred Pharm) - This is the cost-share amount you would pay during the intial coverage phase for a 30-Day supply (until your total retail prescription drug costs reach $3820) at a "Preferred" network pharmacy. In most cases, the "Preferred" network pharmacy cost-sharing is lower than the standard (non-preferred) network pharmacy cost-sharing.
    • Mail Order - This is the cost-share amount you would pay during the initial coverage phase for a 90-Day supply if you purchased your medication through your plan’s preferred mail order partner(s).

  • Drug Utilization Management or Coverage Rules - (Drug Usage Mgmt) - This shows the plan requires drug utilization management controls for this particular medication.
    • None - This drug does not fall under any drug utilization management controls.
    • P - Prior Authorization -This drug is subject to prior authorization.
    • S - Step Therapy -This drug is subject to step therapy.
    • Q - Quantity Limits -This drug is subject to quantity limits. The actual quantity limit is shown as Q:Amount/Days. For Example: Q:6/28Days means the quantity limit is a quantity of 6 pills per 28 days. Q:90/365Days would mean that the plan limits this drug to 90 pills for the entire year.


  • Plan’s Avg. Retail Drug Price: This is the Medicare Part D prescription drug plan’s average negotiated retail drug price. This price is calculated for each plan by averaging the negotiated retail price for a particular drug across all pharmacies in the plan’s service area. For example. The negotiated retail drug price for Quetiapine Fumarate 25MG Tables on the AARP MedicareRx Saver Plus plan in Florida (S5921-356) is determined by averaging all of the AARP MedicareRx Saver Plus plan’s negotiated retail drug prices for a Florida pharmacies.




(Chart Source: Centers for Medicare and Medicaid files: CMS Data September 2019 )

Please note: The above plan information comes from CMS. We make every attempt to keep our information up-to-date with plan/premium changes. However, the Medicare Part D plan data changes over time and we cannot guarantee the accuracy of this information. You should always verify cost and coverage information with your Part D plan provider.