2017 Medicare Part D Plan Formulary Information |
Humana Gold Plus H2012-016 (HMO) (H2012-016-0)
Benefit Details
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The Humana Gold Plus H2012-016 (HMO) (H2012-016-0) Formulary Drugs Starting with the Letter I in Russell County, VA: CMS MA Region 7 which includes: VA Plan Monthly Premium: $27.00 Deductible: $320 |
Drugs Starting with Letter I
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
IBANDRONATE 3 MG/3 ML VIAL [Boniva] ![Compare how all Medicare Part D PDP plans in VA cover IBANDRONATE 3 MG/3 ML VIAL [Boniva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P Q:3 /90Days |
IBANDRONATE SODIUM 150 MG TABLET [Boniva] ![Compare how all Medicare Part D PDP plans in VA cover IBANDRONATE SODIUM 150 MG TABLET [Boniva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | Q:1 /28Days |
IBRANCE 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover IBRANCE 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:21 /28Days |
IBRANCE 125 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover IBRANCE 125 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:21 /28Days |
IBRANCE 75 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover IBRANCE 75 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:21 /28Days |
Ibuprofen 100mg/5mL 473 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Ibuprofen 100mg/5mL 473 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | None |
IBUPROFEN 400MG TABLETS ![Compare how all Medicare Part D PDP plans in VA cover IBUPROFEN 400MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | None |
IBUPROFEN 600mg/1 500 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover IBUPROFEN 600mg/1 500 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | None |
Ibuprofen 800mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover Ibuprofen 800mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | None |
ICLUSIG 15 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover ICLUSIG 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ICLUSIG 45 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover ICLUSIG 45 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:30 /30Days |
IDAMYCIN PFS 1MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VA cover IDAMYCIN PFS 1MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P |
IDARUBICIN HCL 1MG/ML VIAL ![Compare how all Medicare Part D PDP plans in VA cover IDARUBICIN HCL 1MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P |
IFOSFAMIDE FOR INFECTION 1 GM ![Compare how all Medicare Part D PDP plans in VA cover IFOSFAMIDE FOR INFECTION 1 GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | P |
ILEVRO 0.3% OPHTH DROPS ![Compare how all Medicare Part D PDP plans in VA cover ILEVRO 0.3% OPHTH DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
IMBRUVICA 140 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover IMBRUVICA 140 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:120 /30Days |
IMFINZI 120 MG/2.4 ML VIAL ![Compare how all Medicare Part D PDP plans in VA cover IMFINZI 120 MG/2.4 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P |
IMFINZI 500 MG/10 ML VIAL ![Compare how all Medicare Part D PDP plans in VA cover IMFINZI 500 MG/10 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P |
IMIPENEM-CILASTATIN 250 MG VL ![Compare how all Medicare Part D PDP plans in VA cover IMIPENEM-CILASTATIN 250 MG VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
IMIPENEM-CILASTATIN 500 MG VL ![Compare how all Medicare Part D PDP plans in VA cover IMIPENEM-CILASTATIN 500 MG VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
IMIPRAMINE HCL 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in VA cover IMIPRAMINE HCL 10MG TABLET (100 CT).](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 |
IMIPRAMINE HCL 25MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in VA cover IMIPRAMINE HCL 25MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
IMIPRAMINE HCL 50MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in VA cover IMIPRAMINE HCL 50MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
IMIPRAMINE PAMOATE 100MG CAPSULES ![Compare how all Medicare Part D PDP plans in VA cover IMIPRAMINE PAMOATE 100MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
IMIPRAMINE PAMOATE 125MG CAPSULES ![Compare how all Medicare Part D PDP plans in VA cover IMIPRAMINE PAMOATE 125MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
IMIPRAMINE PAMOATE 150MG CAPSULES ![Compare how all Medicare Part D PDP plans in VA cover IMIPRAMINE PAMOATE 150MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
IMIPRAMINE PAMOATE 75MG CAPSULES ![Compare how all Medicare Part D PDP plans in VA cover IMIPRAMINE PAMOATE 75MG CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
IMIQUIMOD 5% CREAM ![Compare how all Medicare Part D PDP plans in VA cover IMIQUIMOD 5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:12 /30Days |
IMOGAM RABIES-HT 150 UNIT/ML ![Compare how all Medicare Part D PDP plans in VA cover IMOGAM RABIES-HT 150 UNIT/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P |
IMOVAX RABIES VACCINE ![Compare how all Medicare Part D PDP plans in VA cover IMOVAX RABIES VACCINE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | P |
IMURAN 50MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover IMURAN 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P |
Increlex 40mg/4mL 1 VIAL, MULTI-DOSE per CARTON / 4 mL in 1 VIAL, MULTI-DOSE ![Compare how all Medicare Part D PDP plans in VA cover Increlex 40mg/4mL 1 VIAL, MULTI-DOSE per CARTON / 4 mL in 1 VIAL, MULTI-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
INCRUSE ELLIPTA 62.5 MCG INH ![Compare how all Medicare Part D PDP plans in VA cover INCRUSE ELLIPTA 62.5 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days |
Indapamide 1.25mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in VA cover Indapamide 1.25mg/1 100 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | None |
INDAPAMIDE 2.5MG TABLET USP (1000 CT) ![Compare how all Medicare Part D PDP plans in VA cover INDAPAMIDE 2.5MG TABLET USP (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | None |
Indomethacin 25 mg capsule ![Compare how all Medicare Part D PDP plans in VA cover Indomethacin 25 mg capsule.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
INDOMETHACIN 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover INDOMETHACIN 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
INDOMETHACIN 75MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in VA cover INDOMETHACIN 75MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
INGREZZA 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover INGREZZA 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:60 /30Days |
INLYTA 1 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover INLYTA 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:180 /30Days |
INLYTA 5 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover INLYTA 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:60 /30Days |
INTELENCE 100MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover INTELENCE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | Q:120 /30Days |
Intelence 200mg/1 ![Compare how all Medicare Part D PDP plans in VA cover Intelence 200mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
INTELENCE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover INTELENCE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:120 /30Days |
INTRALIPID 20% IV FAT EMUL ![Compare how all Medicare Part D PDP plans in VA cover INTRALIPID 20% IV FAT EMUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P |
INTRALIPID 30% IV FAT EMUL ![Compare how all Medicare Part D PDP plans in VA cover INTRALIPID 30% IV FAT EMUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P |
INTRON A 10 MILLION UNITS VIAL ![Compare how all Medicare Part D PDP plans in VA cover INTRON A 10 MILLION UNITS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P |
INTRON A 18 MILLION UNITS VIAL ![Compare how all Medicare Part D PDP plans in VA cover INTRON A 18 MILLION UNITS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P |
INTRON A 25 MILLION UNIT/2.5ML ![Compare how all Medicare Part D PDP plans in VA cover INTRON A 25 MILLION UNIT/2.5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P |
INTRON A 50 MILLION UNITS VIAL ![Compare how all Medicare Part D PDP plans in VA cover INTRON A 50 MILLION UNITS VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P |
INTRON A 6MMU/ML VIAL ![Compare how all Medicare Part D PDP plans in VA cover INTRON A 6MMU/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P |
Introvale 3 CARTON in 1 BOX / 1 KIT per CARTON ![Compare how all Medicare Part D PDP plans in VA cover Introvale 3 CARTON in 1 BOX / 1 KIT per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
INVANZ 1GM VIAL ![Compare how all Medicare Part D PDP plans in VA cover INVANZ 1GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
INVEGA 3MG TABLET SR OSMOTIC PUSH 24HR ![Compare how all Medicare Part D PDP plans in VA cover INVEGA 3MG TABLET SR OSMOTIC PUSH 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
INVEGA 6MG TABLET SR OSMOTIC PUSH 24HR ![Compare how all Medicare Part D PDP plans in VA cover INVEGA 6MG TABLET SR OSMOTIC PUSH 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:60 /30Days |
INVEGA 9MG TABLET SR OSMOTIC PUSH 24HR ![Compare how all Medicare Part D PDP plans in VA cover INVEGA 9MG TABLET SR OSMOTIC PUSH 24HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:30 /30Days |
INVEGA ER 1.5mg/ 30 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover INVEGA ER 1.5mg/ 30 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:30 /30Days |
Invega Sustenna 117 mg/0.75mL Prefilled Syringe ![Compare how all Medicare Part D PDP plans in VA cover Invega Sustenna 117 mg/0.75mL Prefilled Syringe.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | Q:2 /28Days |
Invega Sustenna 156 mg/mL Prefilled Syringe ![Compare how all Medicare Part D PDP plans in VA cover Invega Sustenna 156 mg/mL Prefilled Syringe.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | Q:1 /28Days |
Invega Sustenna 234 mg/1.5mL Prefilled Syringe ![Compare how all Medicare Part D PDP plans in VA cover Invega Sustenna 234 mg/1.5mL Prefilled Syringe.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | Q:2 /28Days |
Invega Sustenna 39 mg/0.25mL Prefilled Syringe ![Compare how all Medicare Part D PDP plans in VA cover Invega Sustenna 39 mg/0.25mL Prefilled Syringe.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:2 /28Days |
Invega Sustenna 78 mg/0.5mL Prefilled Syringe ![Compare how all Medicare Part D PDP plans in VA cover Invega Sustenna 78 mg/0.5mL Prefilled Syringe.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:2 /28Days |
INVEGA TRINZA 273 MG/0.875 ML ![Compare how all Medicare Part D PDP plans in VA cover INVEGA TRINZA 273 MG/0.875 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | Q:1 /90Days |
INVEGA TRINZA 410 MG/1.315 ML ![Compare how all Medicare Part D PDP plans in VA cover INVEGA TRINZA 410 MG/1.315 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | Q:1 /90Days |
INVEGA TRINZA 546 MG/1.75 ML ![Compare how all Medicare Part D PDP plans in VA cover INVEGA TRINZA 546 MG/1.75 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | Q:2 /90Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
INVEGA TRINZA 819 MG/2.625 ML ![Compare how all Medicare Part D PDP plans in VA cover INVEGA TRINZA 819 MG/2.625 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | Q:3 /90Days |
INVIRASE 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover INVIRASE 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | Q:300 /30Days |
INVIRASE 500MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover INVIRASE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | Q:120 /30Days |
INVOKAMET 150-1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover INVOKAMET 150-1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:60 /30Days |
INVOKAMET 150-500 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover INVOKAMET 150-500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:60 /30Days |
INVOKAMET 50-1,000 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover INVOKAMET 50-1,000 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:60 /30Days |
INVOKAMET 50-500 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover INVOKAMET 50-500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:60 /30Days |
INVOKAMET XR 150-1,000 MG TAB ![Compare how all Medicare Part D PDP plans in VA cover INVOKAMET XR 150-1,000 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:60 /30Days |
INVOKAMET XR 150-500 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover INVOKAMET XR 150-500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:60 /30Days |
INVOKAMET XR 50-1,000 MG TAB ![Compare how all Medicare Part D PDP plans in VA cover INVOKAMET XR 50-1,000 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:60 /30Days |
INVOKAMET XR 50-500 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover INVOKAMET XR 50-500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
INVOKANA 100 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover INVOKANA 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days |
INVOKANA 300 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover INVOKANA 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days |
IONOSOL B-D5W IV SOLUTION ![Compare how all Medicare Part D PDP plans in VA cover IONOSOL B-D5W IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
IONOSOL MB-D5W IV SOLUTION ![Compare how all Medicare Part D PDP plans in VA cover IONOSOL MB-D5W IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
IOPIDINE 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in VA cover IOPIDINE 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
IPOL VIAL 40;8;32; UNT ![Compare how all Medicare Part D PDP plans in VA cover IPOL VIAL 40;8;32; UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
Ipratropium Bromide 0.5mg/2.5mL 1 POUCH per CARTON / 30 VIAL in 1 POUCH / 2.5 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in VA cover Ipratropium Bromide 0.5mg/2.5mL 1 POUCH per CARTON / 30 VIAL in 1 POUCH / 2.5 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | P |
Ipratropium Bromide 42ug/1 1 BOTTLE, SPRAY per CARTON / 165 SPRAY, METERED in 1 BOTTLE, SPRAY ![Compare how all Medicare Part D PDP plans in VA cover Ipratropium Bromide 42ug/1 1 BOTTLE, SPRAY per CARTON / 165 SPRAY, METERED in 1 BOTTLE, SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | Q:45 /30Days |
IPRATROPIUM BROMIDE and ALBUTEROL SULFATE 2.5; 0.5mg/3mL; mg/3mL 6 POUCH per CARTON / 5 VIAL, PLAS ![Compare how all Medicare Part D PDP plans in VA cover IPRATROPIUM BROMIDE and ALBUTEROL SULFATE 2.5; 0.5mg/3mL; mg/3mL 6 POUCH per CARTON / 5 VIAL, PLAS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | P |
IPRATROPIUM BROMIDE NASAL SPRAY ![Compare how all Medicare Part D PDP plans in VA cover IPRATROPIUM BROMIDE NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | Q:30 /30Days |
IRBESARTAN 150 MG TABLET [Avapro] ![Compare how all Medicare Part D PDP plans in VA cover IRBESARTAN 150 MG TABLET [Avapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
IRBESARTAN 300 MG TABLET [Avapro] ![Compare how all Medicare Part D PDP plans in VA cover IRBESARTAN 300 MG TABLET [Avapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | Q:30 /30Days |
IRBESARTAN 75 MG TABLET [Avapro] ![Compare how all Medicare Part D PDP plans in VA cover IRBESARTAN 75 MG TABLET [Avapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | Q:30 /30Days |
IRBESARTAN-HCTZ 150-12.5 MG TB [Avalide] ![Compare how all Medicare Part D PDP plans in VA cover IRBESARTAN-HCTZ 150-12.5 MG TB [Avalide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | Q:30 /30Days |
Irbesartan-hctz 300-12.5 mg tb [Avalide] ![Compare how all Medicare Part D PDP plans in VA cover Irbesartan-hctz 300-12.5 mg tb [Avalide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | Q:30 /30Days |
IRESSA 250 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover IRESSA 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P Q:30 /30Days |
irinotecan hcl 100 mg/5 ml vl ![Compare how all Medicare Part D PDP plans in VA cover irinotecan hcl 100 mg/5 ml vl.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P |
ISENTRESS 100 MG POWDER PACKET ![Compare how all Medicare Part D PDP plans in VA cover ISENTRESS 100 MG POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | Q:300 /30Days |
ISENTRESS 100 MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in VA cover ISENTRESS 100 MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | Q:180 /30Days |
ISENTRESS 25 MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in VA cover ISENTRESS 25 MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:180 /30Days |
ISENTRESS 400MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover ISENTRESS 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | Q:120 /30Days |
ISOLYTE P IN 5% DEXTROSE INJECTION ![Compare how all Medicare Part D PDP plans in VA cover ISOLYTE P IN 5% DEXTROSE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ISOLYTE S IV SOLUTION-EXCEL ![Compare how all Medicare Part D PDP plans in VA cover ISOLYTE S IV SOLUTION-EXCEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ISONIAZID 100 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover ISONIAZID 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | None |
ISONIAZID 300 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover ISONIAZID 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | None |
ISONIAZID 50MG/5ML SYRUP ![Compare how all Medicare Part D PDP plans in VA cover ISONIAZID 50MG/5ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ISONIAZID INJ 100MG/ML ![Compare how all Medicare Part D PDP plans in VA cover ISONIAZID INJ 100MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | None |
ISOPTO CARPINE 10mg/mL 15 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover ISOPTO CARPINE 10mg/mL 15 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ISOPTO CARPINE 20mg/mL 15 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover ISOPTO CARPINE 20mg/mL 15 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ISOPTO CARPINE 40mg/mL 15 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in VA cover ISOPTO CARPINE 40mg/mL 15 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ISORDIL 40 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover ISORDIL 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P |
ISORDIL TITRADOSE 5 MG TAB ![Compare how all Medicare Part D PDP plans in VA cover ISORDIL TITRADOSE 5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P |
ISOSORBIDE DINITRATE 40MG TABLETS EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in VA cover ISOSORBIDE DINITRATE 40MG TABLETS EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ISOSORBIDE DN 10 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover ISOSORBIDE DN 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
ISOSORBIDE DN 20MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover ISOSORBIDE DN 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
ISOSORBIDE DN 30MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover ISOSORBIDE DN 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
ISOSORBIDE DN 5 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover ISOSORBIDE DN 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
ISOSORBIDE MN 10 MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover ISOSORBIDE MN 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
ISOSORBIDE MONONITRATE 20MG TABLET ![Compare how all Medicare Part D PDP plans in VA cover ISOSORBIDE MONONITRATE 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
ISOSORBIDE MONONITRATE ER TABLET 120MG (100 CT) ![Compare how all Medicare Part D PDP plans in VA cover ISOSORBIDE MONONITRATE ER TABLET 120MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
ISOSORBIDE MONONITRATE ER TABLET 30MG (100 CT) ![Compare how all Medicare Part D PDP plans in VA cover ISOSORBIDE MONONITRATE ER TABLET 30MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
ISOSORBIDE MONONITRATE TABLETS EXTENDED RELEASE 60MG 100 TABLETS BOT ![Compare how all Medicare Part D PDP plans in VA cover ISOSORBIDE MONONITRATE TABLETS EXTENDED RELEASE 60MG 100 TABLETS BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
ISOTON GENTAMICIN 80MG/100ML ![Compare how all Medicare Part D PDP plans in VA cover ISOTON GENTAMICIN 80MG/100ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
ISOTONIC GENTAMICIN 100 MG/100 ML ![Compare how all Medicare Part D PDP plans in VA cover ISOTONIC GENTAMICIN 100 MG/100 ML.](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 |
ISOTONIC GENTAMICIN 80 MG/50 ML ![Compare how all Medicare Part D PDP plans in VA cover ISOTONIC GENTAMICIN 80 MG/50 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
ISRADIPINE CAPSULES 2.5MG (100 CT) ![Compare how all Medicare Part D PDP plans in VA cover ISRADIPINE CAPSULES 2.5MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ISRADIPINE CAPSULES 5MG (100 CT) ![Compare how all Medicare Part D PDP plans in VA cover ISRADIPINE CAPSULES 5MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
ISTODAX 10 MG VIAL ![Compare how all Medicare Part D PDP plans in VA cover ISTODAX 10 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
26% | N/A | P |
ITRACONAZOLE 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in VA cover ITRACONAZOLE 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:120 /30Days |
IVERMECTIN 3 MG TABLET [Stromectol, Sklice] ![Compare how all Medicare Part D PDP plans in VA cover IVERMECTIN 3 MG TABLET [Stromectol, Sklice].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3* |
Preferred Brand |
$47.00 | $131.00 | None |
IXIARO JAPANESE ENCEPHALITIS VACCINE 6MCG/.5ML ![Compare how all Medicare Part D PDP plans in VA cover IXIARO JAPANESE ENCEPHALITIS VACCINE 6MCG/.5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |