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) S5921-371 | Cigna Secure Rx (PDP) S5617-128 | Elixir RxSecure (PDP) S7694-026 | Humana Basic Rx Plan (PDP) S5884-110 | SilverScript Choice (PDP) S5601-052 | Wellcare Classic (PDP) S4802-090 |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | P | P | N | P |
| N | N | N | N | N | N |
| N | N | Q | N | N | Q |
| N | N | Q | N | N | Q |
| N | N | N | N | N | N |
| N | N | C | Q | N | C |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | Q | Q | N | Q |
| N | N | Q | Q | N | Q |
| N | N | N | N | N | N |
| N | N | QP | N | N | QP |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| AARP MedicareRx Saver Plus (PDP) S5921-371 | Cigna Secure Rx (PDP) S5617-128 | Elixir RxSecure (PDP) S7694-026 | Humana Basic Rx Plan (PDP) S5884-110 | SilverScript Choice (PDP) S5601-052 | Wellcare Classic (PDP) S4802-090 |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | QP | QP | N | QP |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | Q |
| N | N | N | N | N | Q |
| N | N | Q | Q | N | N |
| N | N | C | Q | N | C |
| N | N | N | N | N | N |
| N | N | C | C | N | C |
| N | N | C | C | N | C |
| N | N | N | N | N | N |
| N | N | Q | Q | N | Q |
| N | N | N | P | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | QP | QP | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | Q S | N | N | N |
| N | N | P | C | N | C |
| N | N | N | N | N | N |
| N | N | C | C | N | C |
| N | N | Q | Q | N | Q |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| AARP MedicareRx Saver Plus (PDP) S5921-371 | Cigna Secure Rx (PDP) S5617-128 | Elixir RxSecure (PDP) S7694-026 | Humana Basic Rx Plan (PDP) S5884-110 | SilverScript Choice (PDP) S5601-052 | Wellcare Classic (PDP) S4802-090 |
| N | N | Q | Q | N | C |
| N | N | Q | N | N | C S |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | C | Q | N | C |
| N | N | Q | Q | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | Q | Q | N | QP |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | QP | N | P |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | Q | N | N | P |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | Q | Q | N | Q |
| N | N | N | N | N | N |
| N | N | Q | Q | N | C |
| N | N | N | N | N | N |
| N | N | Q | Q | N | Q |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| AARP MedicareRx Saver Plus (PDP) S5921-371 | Cigna Secure Rx (PDP) S5617-128 | Elixir RxSecure (PDP) S7694-026 | Humana Basic Rx Plan (PDP) S5884-110 | SilverScript Choice (PDP) S5601-052 | Wellcare Classic (PDP) S4802-090 |
| N | N | C | C | N | C |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | QP | Q | N | Q |
| N | N | N | C | N | C |
| N | N | C | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | Q | N | N | N |
| N | N | C | Q | N | C |
| N | N | N | N | N | N |
| N | N | P | QP | N | P |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | C | Q | N | C |
| N | N | Q | QP | N | P |
| N | N | Q | QP | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | C | Q | N | Q |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | C | N | N | C |
| N | N | C | C | N | C |
| N | N | C | C | N | C |
| N | N | C | C | N | C |
| N | N | N | N | N | N |
| AARP MedicareRx Saver Plus (PDP) S5921-371 | Cigna Secure Rx (PDP) S5617-128 | Elixir RxSecure (PDP) S7694-026 | Humana Basic Rx Plan (PDP) S5884-110 | SilverScript Choice (PDP) S5601-052 | Wellcare Classic (PDP) S4802-090 |
| N | N | Q | Q | N | Q |
| N | N | C | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | P | QP | N | C |
| N | N | N | N | N | N |
| N | N | Q | Q | N | Q |
| N | N | N | N | N | QP |
| N | N | N | N | N | N |
| N | N | Q | Q | N | C |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | QP | N | N |
| N | N | N | N | N | N |
| N | N | N | Q | N | Q |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | QP | QP | N | P |
| N | N | P | P | N | P |
| N | N | Q | Q | N | Q |
| N | N | C | C | N | P |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | Q |
| N | N | N | N | N | Q |
| N | N | N | N | N | N |
| N | N | Q | Q | N | C |
| AARP MedicareRx Saver Plus (PDP) S5921-371 | Cigna Secure Rx (PDP) S5617-128 | Elixir RxSecure (PDP) S7694-026 | Humana Basic Rx Plan (PDP) S5884-110 | SilverScript Choice (PDP) S5601-052 | Wellcare Classic (PDP) S4802-090 |
| N | N | N | N | N | N |
| N | N | QP | P | N | QP |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | Q | Q | N | Q |
| N | N | Q | Q | N | Q |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | Q | Q | N | QP |
| N | N | C | C | N | Q |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | C |
| N | N | Q | C | N | C |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | C | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | C | C | N | C |
| N | N | N | N | N | N |
| AARP MedicareRx Saver Plus (PDP) S5921-371 | Cigna Secure Rx (PDP) S5617-128 | Elixir RxSecure (PDP) S7694-026 | Humana Basic Rx Plan (PDP) S5884-110 | SilverScript Choice (PDP) S5601-052 | Wellcare Classic (PDP) S4802-090 |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | C | QP | N | P |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | Q | C | N | Q |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |
| N | N | N | N | N | N |