2016 Medicare Part D Plan Formulary Information |
Humana Gold Plus H2012-029 (HMO) (H2012-029-0)
Benefit Details
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The Humana Gold Plus H2012-029 (HMO) (H2012-029-0) Formulary Drugs Starting with the Letter R in Chesapeake City County, VA: CMS MA Region 7 which includes: VA Plan Monthly Premium: $23.00 Deductible: $360 |
Drugs Starting with Letter R
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
RABAVERT RABIES VACCINE KIT ![Compare how all Medicare Part D PDP plans in VA cover RABAVERT RABIES VACCINE KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | P |
Raloxifene HCl 60 mg tablet [Evista] ![Compare how all Medicare Part D PDP plans in VA cover Raloxifene HCl 60 mg tablet [Evista].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days |
RAMIPRIL 1.25MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RAMIPRIL 1.25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | None |
RAMIPRIL 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RAMIPRIL 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | None |
RAMIPRIL 2.5MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RAMIPRIL 2.5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | None |
RAMIPRIL 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RAMIPRIL 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | None |
RANEXA ER 1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RANEXA ER 1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | S Q:120 /30Days |
RANEXA ER 500 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RANEXA ER 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | S Q:120 /30Days |
RANITIDINE 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RANITIDINE 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
Ranitidine 16.8mg/mL 473 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Ranitidine 16.8mg/mL 473 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Ranitidine 300mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Ranitidine 300mg/1 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
RANITIDINE HCL 150 MG/6 ML VL ![Compare how all Medicare Part D PDP plans in VA cover RANITIDINE HCL 150 MG/6 ML VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
Ranitidine Hydrochloride 150mg/1 1000 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Ranitidine Hydrochloride 150mg/1 1000 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
Ranitidine Hydrochloride 300mg/1 30 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Ranitidine Hydrochloride 300mg/1 30 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
RAPAFLO CAPSULES 4MG 30 BOT ![Compare how all Medicare Part D PDP plans in VA cover RAPAFLO CAPSULES 4MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days |
RAPAFLO CAPSULES 8MG 90 BOT ![Compare how all Medicare Part D PDP plans in VA cover RAPAFLO CAPSULES 8MG 90 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days |
RAPAMUNE 0.5MG TABLETS ![Compare how all Medicare Part D PDP plans in VA cover RAPAMUNE 0.5MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | P |
RAPAMUNE 1MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RAPAMUNE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | P |
RAPAMUNE 1MG/ML ORAL TUBEX ![Compare how all Medicare Part D PDP plans in VA cover RAPAMUNE 1MG/ML ORAL TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | P |
RAPAMUNE 2MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RAPAMUNE 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | P |
REBETOL 40MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in VA cover REBETOL 40MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:1000 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REBIF 22ug/0.5mL 12 SYRINGE, GLASS per CARTON / 0.5 mL in 1 SYRINGE, GLASS ![Compare how all Medicare Part D PDP plans in VA cover REBIF 22ug/0.5mL 12 SYRINGE, GLASS per CARTON / 0.5 mL in 1 SYRINGE, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:6 /28Days |
REBIF 44ug/0.5mL 12 SYRINGE, GLASS per CARTON / 0.5 mL in 1 SYRINGE, GLASS ![Compare how all Medicare Part D PDP plans in VA cover REBIF 44ug/0.5mL 12 SYRINGE, GLASS per CARTON / 0.5 mL in 1 SYRINGE, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:6 /28Days |
REBIF REBIDOSE 22 MCG/0.5 ML ![Compare how all Medicare Part D PDP plans in VA cover REBIF REBIDOSE 22 MCG/0.5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:6 /28Days |
REBIF REBIDOSE 44 MCG/0.5 ML ![Compare how all Medicare Part D PDP plans in VA cover REBIF REBIDOSE 44 MCG/0.5 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:6 /28Days |
REBIF REBIDOSE TITRATION PACK ![Compare how all Medicare Part D PDP plans in VA cover REBIF REBIDOSE TITRATION PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:4 /28Days |
REBIF TITRTN SOL PACK 8.8MCG/22 VIAL ![Compare how all Medicare Part D PDP plans in VA cover REBIF TITRTN SOL PACK 8.8MCG/22 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:4 /28Days |
RECLIPSEN 0.15-0.03 TABLET ![Compare how all Medicare Part D PDP plans in VA cover RECLIPSEN 0.15-0.03 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | None |
RECOMBIVAX HB 10 MCG/ML SYR ![Compare how all Medicare Part D PDP plans in VA cover RECOMBIVAX HB 10 MCG/ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | P |
RECOMBIVAX HB 40MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in VA cover RECOMBIVAX HB 40MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | P |
RECOMBIVAX HB 5 MCG/0.5 ML SYR ![Compare how all Medicare Part D PDP plans in VA cover RECOMBIVAX HB 5 MCG/0.5 ML SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | P |
RECTIV 0.4% OINTMENT ![Compare how all Medicare Part D PDP plans in VA cover RECTIV 0.4% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REGRANEX 0.01% GEL ![Compare how all Medicare Part D PDP plans in VA cover REGRANEX 0.01% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
RELENZA 5MG DISKHALER ![Compare how all Medicare Part D PDP plans in VA cover RELENZA 5MG DISKHALER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:60 /180Days |
RELISTOR 12 MG/0.6 ML SYRINGE ![Compare how all Medicare Part D PDP plans in VA cover RELISTOR 12 MG/0.6 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:36 /28Days |
RELISTOR 12 MG/0.6 ML VIAL ![Compare how all Medicare Part D PDP plans in VA cover RELISTOR 12 MG/0.6 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:36 /28Days |
RELISTOR 8 MG/0.4 ML SYRINGE ![Compare how all Medicare Part D PDP plans in VA cover RELISTOR 8 MG/0.4 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:12 /30Days |
REMICADE 100MG VIAL ![Compare how all Medicare Part D PDP plans in VA cover REMICADE 100MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
REMODULIN 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VA cover REMODULIN 10MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
REMODULIN 1MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VA cover REMODULIN 1MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
REMODULIN 2.5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VA cover REMODULIN 2.5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
REMODULIN 5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VA cover REMODULIN 5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
RENVELA 800MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RENVELA 800MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:540 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Repaglinide 0.5 MG Tablet [Prandin] ![Compare how all Medicare Part D PDP plans in VA cover Repaglinide 0.5 MG Tablet [Prandin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | None |
Repaglinide 1 MG Tablet [Prandin] ![Compare how all Medicare Part D PDP plans in VA cover Repaglinide 1 MG Tablet [Prandin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | None |
Repaglinide 2 MG Tablet [Prandin] ![Compare how all Medicare Part D PDP plans in VA cover Repaglinide 2 MG Tablet [Prandin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | None |
RESCRIPTOR 100mg/1 360 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover RESCRIPTOR 100mg/1 360 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:360 /30Days |
RESCRIPTOR 200 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RESCRIPTOR 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:180 /30Days |
RESERPINE 0.1MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RESERPINE 0.1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
Reserpine 0.25mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Reserpine 0.25mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
RESTASIS CYCLOSPORINE OPTHALMIC EMULSION .05% 30 X 0.4 ML VIALSU ![Compare how all Medicare Part D PDP plans in VA cover RESTASIS CYCLOSPORINE OPTHALMIC EMULSION .05% 30 X 0.4 ML VIALSU.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:60 /30Days |
RETROVIR 10mg/mL 10 VIAL, SINGLE-USE in 1 TRAY / 20 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in VA cover RETROVIR 10mg/mL 10 VIAL, SINGLE-USE in 1 TRAY / 20 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | None |
REVATIO 10 MG/ML ORAL SUSP ![Compare how all Medicare Part D PDP plans in VA cover REVATIO 10 MG/ML ORAL SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:180 /30Days |
REVLIMID 10MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in VA cover REVLIMID 10MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:28 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REVLIMID 15MG CAPSULE 21 BOT ![Compare how all Medicare Part D PDP plans in VA cover REVLIMID 15MG CAPSULE 21 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:28 /28Days |
REVLIMID 2.5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover REVLIMID 2.5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:28 /28Days |
REVLIMID 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover REVLIMID 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:28 /28Days |
REVLIMID 25MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in VA cover REVLIMID 25MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:28 /28Days |
REVLIMID 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover REVLIMID 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:28 /28Days |
REXULTI 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover REXULTI 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:30 /30Days |
REXULTI 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover REXULTI 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:30 /30Days |
REXULTI 1 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover REXULTI 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:30 /30Days |
REXULTI 2 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover REXULTI 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:30 /30Days |
REXULTI 3 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover REXULTI 3 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:30 /30Days |
REXULTI 4 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover REXULTI 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
REYATAZ 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover REYATAZ 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:60 /30Days |
REYATAZ 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover REYATAZ 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:60 /30Days |
REYATAZ 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover REYATAZ 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:30 /30Days |
REYATAZ 50 MG POWDER PACKET ![Compare how all Medicare Part D PDP plans in VA cover REYATAZ 50 MG POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | None |
RHEUMATREX 2.5 MG TABLET 12 EA ![Compare how all Medicare Part D PDP plans in VA cover RHEUMATREX 2.5 MG TABLET 12 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | P |
RHEUMATREX 2.5 MG TABLET 16 EA ![Compare how all Medicare Part D PDP plans in VA cover RHEUMATREX 2.5 MG TABLET 16 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | P |
RHEUMATREX 2.5 MG TABLET 20 EA ![Compare how all Medicare Part D PDP plans in VA cover RHEUMATREX 2.5 MG TABLET 20 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | P |
RHEUMATREX 2.5 MG TABLET 8 EA ![Compare how all Medicare Part D PDP plans in VA cover RHEUMATREX 2.5 MG TABLET 8 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | P |
RHEUMATREX 2.5MG TABLET DOSE PACK ![Compare how all Medicare Part D PDP plans in VA cover RHEUMATREX 2.5MG TABLET DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | P |
RIBASPHERE 200MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RIBASPHERE 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:168 /28Days |
RIBASPHERE CAPSULES 200MG 42 BOT ![Compare how all Medicare Part D PDP plans in VA cover RIBASPHERE CAPSULES 200MG 42 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:168 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RIBAVIRIN 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RIBAVIRIN 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:168 /28Days |
RIBAVIRIN 200MG TABLET 168 BOT ![Compare how all Medicare Part D PDP plans in VA cover RIBAVIRIN 200MG TABLET 168 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:168 /28Days |
RIDAURA 3MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RIDAURA 3MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
RIFABUTIN 150 MG CAPSULE [Mycobutin] ![Compare how all Medicare Part D PDP plans in VA cover RIFABUTIN 150 MG CAPSULE [Mycobutin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | None |
RIFAMATE 150/300 CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RIFAMATE 150/300 CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | None |
RIFAMPIN 150MG CAPSULE (30 CT) ![Compare how all Medicare Part D PDP plans in VA cover RIFAMPIN 150MG CAPSULE (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
RIFAMPIN 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover RIFAMPIN 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
Rifampin IV 600 MG Vial ![Compare how all Medicare Part D PDP plans in VA cover Rifampin IV 600 MG Vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
RIFATER 50/300/120 TABLET ![Compare how all Medicare Part D PDP plans in VA cover RIFATER 50/300/120 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | None |
riluzole 50 mg tablet [Rilutek] ![Compare how all Medicare Part D PDP plans in VA cover riluzole 50 mg tablet [Rilutek].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | None |
Rimantadine 100mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Rimantadine 100mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RINGERS 33/30/860 INJECTION ![Compare how all Medicare Part D PDP plans in VA cover RINGERS 33/30/860 INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | None |
RINGERS IRRIGATION 860-30 12X1000ML BAG ![Compare how all Medicare Part D PDP plans in VA cover RINGERS IRRIGATION 860-30 12X1000ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | None |
RISEDRONATE SODIUM 150 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in VA cover RISEDRONATE SODIUM 150 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:1 /30Days |
RISEDRONATE SODIUM 30 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in VA cover RISEDRONATE SODIUM 30 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:30 /30Days |
RISEDRONATE SODIUM 35 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in VA cover RISEDRONATE SODIUM 35 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:4 /28Days |
RISEDRONATE SODIUM 35 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in VA cover RISEDRONATE SODIUM 35 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:4 /28Days |
RISEDRONATE SODIUM 35 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in VA cover RISEDRONATE SODIUM 35 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:4 /28Days |
RISEDRONATE SODIUM 5 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in VA cover RISEDRONATE SODIUM 5 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:30 /30Days |
RISEDRONATE SODIUM DR 35 MG TABLET [Actonel] ![Compare how all Medicare Part D PDP plans in VA cover RISEDRONATE SODIUM DR 35 MG TABLET [Actonel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:4 /28Days |
RISPERDAL CONSTA 25MG SYR ![Compare how all Medicare Part D PDP plans in VA cover RISPERDAL CONSTA 25MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:4 /28Days |
RISPERDAL CONSTA 37.5MG SYR ![Compare how all Medicare Part D PDP plans in VA cover RISPERDAL CONSTA 37.5MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:4 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RISPERDAL CONSTA 50MG SYR ![Compare how all Medicare Part D PDP plans in VA cover RISPERDAL CONSTA 50MG SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:4 /28Days |
RISPERDAL CONSTA FOR INJECTION 12.5MG/VIAL ![Compare how all Medicare Part D PDP plans in VA cover RISPERDAL CONSTA FOR INJECTION 12.5MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:4 /28Days |
RISPERIDONE 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RISPERIDONE 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | Q:60 /30Days |
RISPERIDONE 0.5 MG 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover RISPERIDONE 0.5 MG 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | Q:120 /30Days |
RISPERIDONE 0.5 MG ODT ![Compare how all Medicare Part D PDP plans in VA cover RISPERIDONE 0.5 MG ODT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:120 /30Days |
RISPERIDONE 1 MG 7 BLISTER PACK per CARTON / 4 TABLET, ORALLY DISINTEGRATING per BLISTER PACK ![Compare how all Medicare Part D PDP plans in VA cover RISPERIDONE 1 MG 7 BLISTER PACK per CARTON / 4 TABLET, ORALLY DISINTEGRATING per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:60 /30Days |
RISPERIDONE 1 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RISPERIDONE 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | Q:60 /30Days |
RISPERIDONE 1 MG/ML 30 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover RISPERIDONE 1 MG/ML 30 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
RISPERIDONE 2 MG 60 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in VA cover RISPERIDONE 2 MG 60 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | Q:60 /30Days |
RISPERIDONE 2 MG ODT ![Compare how all Medicare Part D PDP plans in VA cover RISPERIDONE 2 MG ODT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:60 /30Days |
RISPERIDONE 3 MG 60 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in VA cover RISPERIDONE 3 MG 60 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
RISPERIDONE 4 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover RISPERIDONE 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | Q:60 /30Days |
RISPERIDONE TABLET 0.25MG 4 IN 1 BLPK ![Compare how all Medicare Part D PDP plans in VA cover RISPERIDONE TABLET 0.25MG 4 IN 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:60 /30Days |
RISPERIDONE TABLETS 3MG 4 IN 1 BLPK ![Compare how all Medicare Part D PDP plans in VA cover RISPERIDONE TABLETS 3MG 4 IN 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:60 /30Days |
RISPERIDONE TABLETS 4MG 4 IN 1 BLPK ![Compare how all Medicare Part D PDP plans in VA cover RISPERIDONE TABLETS 4MG 4 IN 1 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:60 /30Days |
RITUXAN 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VA cover RITUXAN 10MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
RIVASTIGMINE TARTRATE 3MG CAPSULES ![Compare how all Medicare Part D PDP plans in VA cover RIVASTIGMINE TARTRATE 3MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:90 /30Days |
RIVASTIGMINE TARTRATE 4.5MG CAPSULES ![Compare how all Medicare Part D PDP plans in VA cover RIVASTIGMINE TARTRATE 4.5MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:60 /30Days |
RIVASTIGMINE TARTRATE 6MG CAPSULES ![Compare how all Medicare Part D PDP plans in VA cover RIVASTIGMINE TARTRATE 6MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:60 /30Days |
RIVASTIGMINE TARTRATE1.5MG CAPSULES ![Compare how all Medicare Part D PDP plans in VA cover RIVASTIGMINE TARTRATE1.5MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:90 /30Days |
Rizatriptan 10 mg odt ![Compare how all Medicare Part D PDP plans in VA cover Rizatriptan 10 mg odt.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:12 /30Days |
Rizatriptan 10 mg tablet ![Compare how all Medicare Part D PDP plans in VA cover Rizatriptan 10 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:12 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Rizatriptan 5 mg odt ![Compare how all Medicare Part D PDP plans in VA cover Rizatriptan 5 mg odt.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:12 /30Days |
Rizatriptan 5 mg tablet ![Compare how all Medicare Part D PDP plans in VA cover Rizatriptan 5 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:12 /30Days |
ROPINIROLE HCL 0.5MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover ROPINIROLE HCL 0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
ROPINIROLE HCL TABLET 1 MG ![Compare how all Medicare Part D PDP plans in VA cover ROPINIROLE HCL TABLET 1 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
ROPINIROLE HCL TABLET 2 MG ![Compare how all Medicare Part D PDP plans in VA cover ROPINIROLE HCL TABLET 2 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
ROPINIROLE HCL TABLET 3 MG ![Compare how all Medicare Part D PDP plans in VA cover ROPINIROLE HCL TABLET 3 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
ROPINIROLE HCL TABLET 4 MG ![Compare how all Medicare Part D PDP plans in VA cover ROPINIROLE HCL TABLET 4 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
ROPINIROLE HCL TABLET 5 MG ![Compare how all Medicare Part D PDP plans in VA cover ROPINIROLE HCL TABLET 5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
ROPINIROLE HYDROCLORIDE 0.25MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover ROPINIROLE HYDROCLORIDE 0.25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
ROPINIROLE TAB 12MG ER ![Compare how all Medicare Part D PDP plans in VA cover ROPINIROLE TAB 12MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:90 /30Days |
ROPINIROLE TAB 2MG ER ![Compare how all Medicare Part D PDP plans in VA cover ROPINIROLE TAB 2MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:90 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ROPINIROLE TAB 4MG ER ![Compare how all Medicare Part D PDP plans in VA cover ROPINIROLE TAB 4MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:90 /30Days |
ROPINIROLE TAB 6MG ER ![Compare how all Medicare Part D PDP plans in VA cover ROPINIROLE TAB 6MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:90 /30Days |
ROPINIROLE TAB 8MG ER ![Compare how all Medicare Part D PDP plans in VA cover ROPINIROLE TAB 8MG ER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | Q:90 /30Days |
ROTARIX VACCINE SUSPENSION ![Compare how all Medicare Part D PDP plans in VA cover ROTARIX VACCINE SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | None |
ROTATEQ VACCINE ![Compare how all Medicare Part D PDP plans in VA cover ROTATEQ VACCINE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$97.00 | $281.00 | None |
Roweepra 500 mg tablet ![Compare how all Medicare Part D PDP plans in VA cover Roweepra 500 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |