A non-government resource for the Medicare community
Powered by Q1Group LLC
A non-government Medicare community resource
  • Menu
  • Home
  • Contact
  • MAPD
  • PDP
  • 2024
  • 2025
  • FAQs
  • Articles
  • Search
  • Contact
  • 2024
  • 2025
  • FAQs
  • Articles
  • Latest Medicare News
  • Search

2024 Medicare Part D Plan’s Negotiated Retail Drug Price

Below you will find the average negotiated retail prescription drug price for your chosen Medicare Part D or Medicare Advantage plan, along with, tier cost-sharing details, your estimated cost for purchases during each coverage phase, tier cost-sharing details and your costs with explanations, and plan’s retail drug price history.
Send this chart to my email
Receive our free Part D Newsletter
 
2024 Medicare Prescription Drug Price Information
AARP Medicare Rx Basic from UHC (PDP) (S5921-349-0)
Benefits & Contact Info         
Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less.

Click on a letter below to view the
AARP Medicare Rx Basic from UHC (PDP) Formulary
A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z  0-9 
This Plan Uses Lower Cost-Sharing for Preferred Pharmacies
ORKAMBI 200 MG-125 MG TABLET  
Plan’s average negotiated retail drug price in
CMS PDP Region 4, includes: NJ
$26,665.18* 30-Day Supply
$36,840.35* 90-Day Supply
Formulary (Drug List) drug tier:Tier #5: Specialty Tier
Does this plan offer any Gap coverage?No Gap Coverage
Does this drug have Gap coverage?No, this drug IS NOT covered in the gap, but all drugs receive the donut hole discount.
Drug Usage Management Restrictions:Prior Authorization and Quantity Limit:112/28Days
Formulary (Drug List) Tier Cost-Sharing Details
Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less.
  30-Day Supply
Cost-Sharing
90-Day Supply
Cost-Sharing
Preferred Pharmacy Standard Pharmacy Mail- Order** Preferred Pharmacy Standard Pharmacy Mail- Order**
Initial $545 Deductible Cost Sharing:
 100% 100% 100% n/a n/a n/a
Initial Coverage Phase Cost-Sharing:
 25% 25% 25% n/a n/a n/a
Coverage Gap Phase Cost-Sharing Incl. Donut Hole Discount (Generics 75%):
 25% 25% 25% n/a n/a n/a
Coverage Gap Phase Cost-Sharing Incl. Donut Hole Discount (Brand 75%):
 25% 25% 25% n/a n/a n/a
Catastrophic Coverage Phase Cost-Sharing (all Formulary Drugs):
 $0$0$0 n/an/an/a
Your Estimated Cost for Purchases During Each Coverage Phase
  30-Day Supply
Cost-Sharing
90-Day Supply
Cost-Sharing
Preferred Pharmacy Standard Pharmacy Mail- Order** Preferred Pharmacy Standard Pharmacy Mail- Order**
Your Estimated Cost in Deductible Phase:
 $3,333.03 $3,333.03 $3,333.03 n/a n/a n/a
Your Estimated Cost Initial Coverage Phase:
 $3,031.84 $3,031.84 $3,031.84 n/a n/a n/a
Your Estimated Cost in Gap if Drug is Generic (75% discount):
 $6,666.29$6,666.29$6,666.29 $8,000.00n/an/a
Your Estimated Cost in Gap if Drug is Brand-Name (75% discount):
 $2,105.26$2,105.26$2,105.26 $2,000.00n/an/a
Your Estimated Cost in Catastrophic Coverage (all Formulary Drugs):
 $0$0$0 n/an/an/a
Tier Cost-Sharing Details and Your Costs with Explanations
  30-Day Supply
Cost-Sharing
90-Day Supply
Cost-Sharing
Preferred Pharmacy Standard Pharmacy Mail- Order** Preferred Pharmacy Standard Pharmacy Mail- Order**
--- If you purchase during the Initial Deductible Phase ---
Initial $545 Deductible Cost Sharing:
 100% 100% 100% n/a n/a n/a
Your Estimated Cost in Deductible Phase:
 $3,333.03 $3,333.03 $3,333.03 n/a n/a n/a
Explanation for 30-Day Preferred Pharmacy purchase:
  For a purchase of this drug made during the initial deductible phase, you cross over into other phases of your plan’s coverage (straddle claim).   So you pay 100% of the drug cost up to your deductible of $545 and the remaining amount ($26,665.18-$545) (price - deductible) falls into your initial coverage phase (ICP).   For the ICP portion of your coverage, your cost-sharing would be an additional $1,121.25 or $4,485.00 x 25% (overage up to your remaining coverage limit ($4,485.00) * cost-sharing). Since the amount of the retail drug price falling into the ICP $26,120.18 is greater than the remaining initial coverage limit $4485 ( - $545), $21,635.18 rolls into the coverage gap phase. For the portion that falls into the coverage gap phase, you would pay an additional $1,666.78 or ($6,667.11 x 25% -- 70% of the discount counts toward TrOOP and the 5% paid by your plan does not count toward TrOOP assuming this is a brand-name drug). Since the portion of the costs that fell into the coverage gap $21,635.18 x 95% exceeds the amount of TrOOP left ($6,333.75), $14,968.07 falls into the catastrophic coverage phase. For the portion that falls into the catastrophic coverage phase, you would pay an additional $0.00 or $0.00 which is greater than $0.00($sharing30P of $14,968.07).
--- If you purchase during the Initial Coverage Phase ---
Initial Coverage Phase Cost-Sharing:
 25% 25% 25% n/a n/a n/a
Your Estimated Cost Initial Coverage Phase:
 $3,031.84 $3,031.84 $3,031.84 n/a n/a n/a
Explanation for 30-Day Preferred Pharmacy purchase:
 The cost-sharing for purchases made during the initial coverage phase (ICP) would be $1,257.50 or ($5,030.00 x 25%). But since the retail drug price ($26,665.18) is greater than initial coverage limit (), the difference of $21,635.18 rolls into the coverage gap phase. For the portion that falls into the coverage gap phase, you would pay an additional $1,774.34 or ($7,097.37 x 25% -- 70% of the discount counts toward TrOOP and the 5% paid by your plan does not count toward TrOOP). The portion of the costs that fell into the coverage gap $7,097.37 exceeds the amount of TrOOP left ($6,742.50) so you only pay in the gap on the amount within the TrOOP. The excess over TrOOP, $14,537.81 falls into the catastrophic coverage phase. For the portion that falls into the catastrophic coverage phase, you would pay an additional $0.00 or $0.00 which is greater than $0.00 (0% of $14,537.81). So, your total cost for this one purchase is $3,031.84 or $1,257.50 (ICP) + $1,774.34 (Gap) + $0.00 (Cat.Cov.).
--- If you purchase during the Coverage Gap Phase (Donut Hole) ---
Your Estimated Cost in Gap if Drug is Generic (75% discount):
 $6,666.29$6,666.29$6,666.29 $8,000.00n/an/a
Explanation for 30-Day Preferred Pharmacy purchase:
 Your cost is the negotiated retail price of $26,665.18 x 25%.
Your Estimated Cost in Gap if Drug is Brand-Name (75% discount):
 $2,105.26$2,105.26$2,105.26 $2,000.00n/an/a
  Since 95% this drug’s negotiated retail price ($26,665.18) is greater than the TrOOP limit ($8,000), in the donut hole phase, you would pay $2,105.26 (($8,000 / 95%) x 25% -- 70% of the discount counts toward TrOOP and the 5% paid by your plan does not count toward TrOOP) plus $0.00 in the catastrophic phase, $0.00 because $0.00 is greater than $0.00 (0% of $18,244.12).  Although it rarely happens that you would be responsible for the entire $8,000 for a purchase in the coverage gap, it can occur, for example on an expensive generic drug with a $0 copay in the initial coverage phase.
--- If you purchase during the Catastrophic Coverage Phase ---
Catastrophic Coverage Phase Cost-Sharing (all Formulary Drugs):
 $0$0$0 n/an/an/a
Your Estimated Cost in Catastrophic Coverage (all Formulary Drugs):
 $0$0$0 n/an/an/a
Explanation for 30-Day Preferred Pharmacy purchase:
 Beginning with plan year 2024, the Inflation Reduction Act (IRA) of 2022 eliminates beneficiary cost-sharing once your TrOOP reaches $8,000 -- the established maximum cap on out-of-pocket spending for Part D formulary drugs (RxMOOP).
AARP Medicare Rx Basic from UHC (PDP)
Average Negotiated Retail Drug Price History
 30-Day Supply90 Day Supply
March, 2024: $26,665.18$36,840.35
January, 2024: $24,945.22$34,478.66
September, 2023: $25,367.34$34,387.89
June, 2023: $25,320.00$34,320.72
March, 2023: $25,282.80$34,228.32
January, 2023: $25,274.40$34,250.16
September, 2022: $25,155.60$34,492.08
June, 2022: $25,155.60$34,492.08
March, 2022: $25,155.60$34,534.08
January, 2022: $24,006.00$70,588.80
September, 2021: $23,772.00$70,099.20
June, 2021: $23,780.40$70,102.80
March, 2021: $23,780.40$69,973.20
January, 2021: $23,748.00$69,901.20
September, 2020: $23,821.20$68,641.20
June, 2020: $23,821.20$68,641.20
March, 2020: $23,821.20$68,641.20
January, 2020: $23,821.20$68,641.20
September, 2019: $23,908.90$67,873.70
June, 2019: $23,941.20$67,897.40
March, 2019: $23,963.20$67,819.10
January, 2019: $23,915.70$67,472.10
September, 2018: $23,828.00$67,350.90
June, 2018: $23,828.00$67,350.90
March, 2018: $23,842.00$67,287.00
January, 2018: $23,841.90$67,286.90
September, 2017: $23,676.40$68,202.70
June, 2017: $22,549.00$64,955.00
March, 2017: $22,515.70$64,558.80
January, 2017: $22,161.20$61,653.60
September, 2016: $22,055.68$61,619.07
June, 2016: $22,055.68$61,619.07
April, 2016: $22,046.20$61,603.12
January, 2016: n/an/a
September, 2015: n/an/a
June, 2015: n/an/a
April, 2015: n/an/a
January, 2015: n/an/a
September, 2014: n/an/a
June, 2014: n/an/a
March, 2014: n/an/a
January, 2014: n/an/a
October, 2013: n/an/a
January, 2013: n/a--
April, 2012: n/a--
September, 2010: n/a--
Notes:
*The Medicare drug plan’s average negotiated retail drug price is based on several variables: the medication, the quantity of your prescription, the specific Medicare Part D plan, and the pharmacies in the plan’s service area. In this case, the average of the ORKAMBI 200 MG-125 MG TABLET prices that the AARP Medicare Rx Basic from UHC (PDP) has negotiated with each of the retail pharmacies in the plan’s service area (CMS PDP Region 4, includes: NJ). In other words, when you use the AARP Medicare Rx Basic from UHC (PDP) to purchase ORKAMBI 200 MG-125 MG TABLET, you may pay slightly more or slightly less than the figures shown in the table above depending on the pharmacy where you fill your prescription and the quantity of your prescription. The example average retail prices used above are based on a quantity of 120 for the 30-day supply and a quantity of 168 for the 90-day supply.

**The mail-order cost-sharing is the plan’s "preferred" mail-order cost-sharing.

Return to the AARP Medicare Rx Basic from UHC (PDP) 2024 Formulary Browser by choosing a letter below:
A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z  0-9 
Send this chart to my email
Receive our free Part D Newsletter
 

Chart Legend:

What does all this mean? Below are a few notes to help you understand the above 2024 Medicare Part D AARP Medicare Rx Basic from UHC (PDP) Plan Formulary.






Tips & Disclaimers
  • Q1Medicare®, Q1Rx®, and Q1Group® are registered Service Marks of Q1Group LLC and may not be used in any advertising, publicity, or for commercial purposes without the express authorization of Q1Group.
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDPCompare.com and MACompare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
    Statement required by Medicare:
    "We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options."
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.