2021 Medicare Part D Plan Formulary Information |
Dean Advantage Assurance (HMO-POS) (H9096-001-0)
Benefit Details
![Email Prescription and/or Health Benefit details for Dean Advantage Assurance (HMO-POS). This function does not email the formulary drug list.](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) This plan covers select insulin pay $35 copay.
See individual insulin cost-sharing below. |
The Dean Advantage Assurance (HMO-POS) (H9096-001-0) Formulary Drugs Starting with the Letter E in Jefferson County, WI: CMS MA Region 14 which includes: WI Plan Monthly Premium: $40.00 Deductible: $150 |
Drugs Starting with Letter E
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
ECONAZOLE NITRATE 1% CREAM (G) [Spectazole] ![Compare how all Medicare Part D PDP plans in WI cover ECONAZOLE NITRATE 1% CREAM (G) [Spectazole].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $7.00 | Q:255 /30Days |
EDURANT 27.5mg/1 ![Compare how all Medicare Part D PDP plans in WI cover EDURANT 27.5mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | None |
EFAVIR-EMTRI-TENOF 600-200-300 TABLET [Atripla] ![Compare how all Medicare Part D PDP plans in WI cover EFAVIR-EMTRI-TENOF 600-200-300 TABLET [Atripla].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | None |
EFAVIR-LAMIV-TENOF 400-300-300 TABLET [SYMFI LO] ![Compare how all Medicare Part D PDP plans in WI cover EFAVIR-LAMIV-TENOF 400-300-300 TABLET [SYMFI LO].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
EFAVIR-LAMIV-TENOF 600-300-300 TABLET [SYMFI] ![Compare how all Medicare Part D PDP plans in WI cover EFAVIR-LAMIV-TENOF 600-300-300 TABLET [SYMFI].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
EFAVIRENZ 200 MG CAPSULE [Sustiva] ![Compare how all Medicare Part D PDP plans in WI cover EFAVIRENZ 200 MG CAPSULE [Sustiva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
EFAVIRENZ 50 MG CAPSULE [Sustiva] ![Compare how all Medicare Part D PDP plans in WI cover EFAVIRENZ 50 MG CAPSULE [Sustiva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
EFAVIRENZ 600 MG TABLET [Sustiva] ![Compare how all Medicare Part D PDP plans in WI cover EFAVIRENZ 600 MG TABLET [Sustiva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ELETRIPTAN HBR 20 MG TABLET [Relpax] ![Compare how all Medicare Part D PDP plans in WI cover ELETRIPTAN HBR 20 MG TABLET [Relpax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | Q:18 /30Days |
ELETRIPTAN HBR 40 MG TABLET [Relpax] ![Compare how all Medicare Part D PDP plans in WI cover ELETRIPTAN HBR 40 MG TABLET [Relpax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | Q:18 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ELIGARD 22.5 MG SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover ELIGARD 22.5 MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | None |
ELIGARD 30 MG SYRINGE KIT ![Compare how all Medicare Part D PDP plans in WI cover ELIGARD 30 MG SYRINGE KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | None |
ELIGARD 45 MG SYRINGE KIT ![Compare how all Medicare Part D PDP plans in WI cover ELIGARD 45 MG SYRINGE KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | None |
ELIGARD 7.5 MG SYRINGE KIT ![Compare how all Medicare Part D PDP plans in WI cover ELIGARD 7.5 MG SYRINGE KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | None |
ELIQUIS 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ELIQUIS 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
ELIQUIS 5 MG STARTER PACK ![Compare how all Medicare Part D PDP plans in WI cover ELIQUIS 5 MG STARTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
ELIQUIS 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ELIQUIS 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
ELMIRON 100mg GELATIN COATED 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover ELMIRON 100mg GELATIN COATED 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
ELURYNG VAGINAL RING [NuvaRing] ![Compare how all Medicare Part D PDP plans in WI cover ELURYNG VAGINAL RING [NuvaRing].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | None |
EMCYT 140MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover EMCYT 140MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
EMGALITY 120 MG/ML PEN INJCTR ![Compare how all Medicare Part D PDP plans in WI cover EMGALITY 120 MG/ML PEN INJCTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EMGALITY 120 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover EMGALITY 120 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | P |
EMGALITY 300 MG (100 MG X3SYR) SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover EMGALITY 300 MG (100 MG X3SYR) SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | P |
EMOQUETTE 28 DAY TABLET [Solia] ![Compare how all Medicare Part D PDP plans in WI cover EMOQUETTE 28 DAY TABLET [Solia].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
Empagliflozin 5 MG / Metformin hydrochloride 500 MG Oral Tablet [Synjardy] ![Compare how all Medicare Part D PDP plans in WI cover Empagliflozin 5 MG / Metformin hydrochloride 500 MG Oral Tablet [Synjardy].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | Q:60 /30Days |
EMSAM TRANSDERMAL SYSTEM PATCHES 12MG/24H ![Compare how all Medicare Part D PDP plans in WI cover EMSAM TRANSDERMAL SYSTEM PATCHES 12MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | None |
EMSAM TRANSDERMAL SYSTEM PATCHES 6MG/24H ![Compare how all Medicare Part D PDP plans in WI cover EMSAM TRANSDERMAL SYSTEM PATCHES 6MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | None |
EMSAM TRANSDERMAL SYSTEM PATCHES 9MG/24H ![Compare how all Medicare Part D PDP plans in WI cover EMSAM TRANSDERMAL SYSTEM PATCHES 9MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | None |
EMTRICITABINE 200 MG CAPSULE [Emtriva] ![Compare how all Medicare Part D PDP plans in WI cover EMTRICITABINE 200 MG CAPSULE [Emtriva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
EMTRICITABINE-TENOFV 100-150MG TABLET [Truvada] ![Compare how all Medicare Part D PDP plans in WI cover EMTRICITABINE-TENOFV 100-150MG TABLET [Truvada].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | None |
EMTRICITABINE-TENOFV 133-200MG TABLET [Truvada] ![Compare how all Medicare Part D PDP plans in WI cover EMTRICITABINE-TENOFV 133-200MG TABLET [Truvada].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | None |
EMTRICITABINE-TENOFV 167-250MG TABLET [Truvada] ![Compare how all Medicare Part D PDP plans in WI cover EMTRICITABINE-TENOFV 167-250MG TABLET [Truvada].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EMTRICITABINE-TENOFV 200-300MG TABLET [Truvada] ![Compare how all Medicare Part D PDP plans in WI cover EMTRICITABINE-TENOFV 200-300MG TABLET [Truvada].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
EMTRIVA 10MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover EMTRIVA 10MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
EMTRIVA 200MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover EMTRIVA 200MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
ENALAPRIL MALEATE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ENALAPRIL MALEATE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $7.00 | None |
ENALAPRIL MALEATE 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ENALAPRIL MALEATE 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $7.00 | None |
ENALAPRIL MALEATE 20 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ENALAPRIL MALEATE 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $7.00 | None |
ENALAPRIL MALEATE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ENALAPRIL MALEATE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $7.00 | None |
ENALAPRIL-HCTZ 10-25 MG TABLET [Vaseretic] ![Compare how all Medicare Part D PDP plans in WI cover ENALAPRIL-HCTZ 10-25 MG TABLET [Vaseretic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $7.00 | None |
ENALAPRIL-HCTZ 5-12.5 MG TABLET [Vaseretic] ![Compare how all Medicare Part D PDP plans in WI cover ENALAPRIL-HCTZ 5-12.5 MG TABLET [Vaseretic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $7.00 | None |
ENBREL 25 MG/0.5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover ENBREL 25 MG/0.5 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P |
ENBREL 25 MG/0.5 ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover ENBREL 25 MG/0.5 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ENBREL 25MG KIT ![Compare how all Medicare Part D PDP plans in WI cover ENBREL 25MG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P |
ENBREL 50 MG/ML MINI CARTRIDGE ![Compare how all Medicare Part D PDP plans in WI cover ENBREL 50 MG/ML MINI CARTRIDGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P |
ENBREL 50 MG/ML SURECLICK PEN INJECTOR ![Compare how all Medicare Part D PDP plans in WI cover ENBREL 50 MG/ML SURECLICK PEN INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P |
ENBREL 50 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover ENBREL 50 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P |
ENDARI 5 GRAM POWDER PACKET ![Compare how all Medicare Part D PDP plans in WI cover ENDARI 5 GRAM POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:180 /30Days |
ENDOCET 10MG-325MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ENDOCET 10MG-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | Q:360 /30Days |
ENDOCET 5/325 TABLET ![Compare how all Medicare Part D PDP plans in WI cover ENDOCET 5/325 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | Q:360 /30Days |
ENDOCET 7.5-325MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ENDOCET 7.5-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | Q:360 /30Days |
ENGERIX B INJECTION ![Compare how all Medicare Part D PDP plans in WI cover ENGERIX B INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | P |
ENGERIX-B 20 MCG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover ENGERIX-B 20 MCG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | P |
ENOXAPARIN 100 MG/ML SYRINGE [Lovenox] ![Compare how all Medicare Part D PDP plans in WI cover ENOXAPARIN 100 MG/ML SYRINGE [Lovenox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ENOXAPARIN 120 MG/0.8 ML SYRINGE [Lovenox] ![Compare how all Medicare Part D PDP plans in WI cover ENOXAPARIN 120 MG/0.8 ML SYRINGE [Lovenox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | Q:48 /30Days |
ENOXAPARIN 150 MG/ML SYRINGE [Lovenox] ![Compare how all Medicare Part D PDP plans in WI cover ENOXAPARIN 150 MG/ML SYRINGE [Lovenox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | Q:60 /30Days |
ENOXAPARIN 30 MG/0.3 ML SYRINGE [Lovenox] ![Compare how all Medicare Part D PDP plans in WI cover ENOXAPARIN 30 MG/0.3 ML SYRINGE [Lovenox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | Q:18 /30Days |
ENOXAPARIN 40 MG/0.4 ML SYRINGE [Lovenox] ![Compare how all Medicare Part D PDP plans in WI cover ENOXAPARIN 40 MG/0.4 ML SYRINGE [Lovenox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | Q:24 /30Days |
ENOXAPARIN 60 MG/0.6 ML SYRINGE [Lovenox] ![Compare how all Medicare Part D PDP plans in WI cover ENOXAPARIN 60 MG/0.6 ML SYRINGE [Lovenox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | Q:36 /30Days |
ENOXAPARIN 80 MG/0.8 ML SYRINGE [Lovenox] ![Compare how all Medicare Part D PDP plans in WI cover ENOXAPARIN 80 MG/0.8 ML SYRINGE [Lovenox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | Q:48 /30Days |
ENSKYCE 28 TABLET [Solia] ![Compare how all Medicare Part D PDP plans in WI cover ENSKYCE 28 TABLET [Solia].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ENSPRYNG 120 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in WI cover ENSPRYNG 120 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:1 /28Days |
ENTACAPONE 200 MG TABLET [Comtan] ![Compare how all Medicare Part D PDP plans in WI cover ENTACAPONE 200 MG TABLET [Comtan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ENTECAVIR 0.5 MG TABLET [Baraclude] ![Compare how all Medicare Part D PDP plans in WI cover ENTECAVIR 0.5 MG TABLET [Baraclude].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ENTECAVIR 1 MG TABLET [Baraclude] ![Compare how all Medicare Part D PDP plans in WI cover ENTECAVIR 1 MG TABLET [Baraclude].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ENTRESTO 24 MG-26 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ENTRESTO 24 MG-26 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | Q:60 /30Days |
ENTRESTO 49 MG-51 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ENTRESTO 49 MG-51 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | Q:60 /30Days |
ENTRESTO 97 MG-103 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ENTRESTO 97 MG-103 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | Q:60 /30Days |
ENULOSE 10 GM/15 ML SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover ENULOSE 10 GM/15 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $7.00 | None |
ENVARSUS XR 0.75 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ENVARSUS XR 0.75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | P |
ENVARSUS XR 1 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ENVARSUS XR 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | P |
ENVARSUS XR 4 MG TABLET ER 24H ![Compare how all Medicare Part D PDP plans in WI cover ENVARSUS XR 4 MG TABLET ER 24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | P |
EPIDIOLEX 100 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover EPIDIOLEX 100 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | P |
EPIDUO FORTE 0.3-2.5% GEL PUMP ![Compare how all Medicare Part D PDP plans in WI cover EPIDUO FORTE 0.3-2.5% GEL PUMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | P |
EPINASTINE HCL 0.05% EYE DROPS ![Compare how all Medicare Part D PDP plans in WI cover EPINASTINE HCL 0.05% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
EPINEPHRINE 0.15 MG AUTO-INJECT [Twinject] ![Compare how all Medicare Part D PDP plans in WI cover EPINEPHRINE 0.15 MG AUTO-INJECT [Twinject].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | Q:2 /15Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EPINEPHRINE 0.3 MG AUTO-INJECT [Twinject] ![Compare how all Medicare Part D PDP plans in WI cover EPINEPHRINE 0.3 MG AUTO-INJECT [Twinject].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | Q:2 /15Days |
EPITOL 200MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover EPITOL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
EPIVIR HBV 25MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in WI cover EPIVIR HBV 25MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
EPLERENONE 25 MG TABLET [Inspra] ![Compare how all Medicare Part D PDP plans in WI cover EPLERENONE 25 MG TABLET [Inspra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
EPLERENONE 50 MG TABLET [Inspra] ![Compare how all Medicare Part D PDP plans in WI cover EPLERENONE 50 MG TABLET [Inspra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
EQUETRO CAPSULES 200MG 120 BOT ![Compare how all Medicare Part D PDP plans in WI cover EQUETRO CAPSULES 200MG 120 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | None |
EQUETRO CAPSULES 300MG 120 BOT ![Compare how all Medicare Part D PDP plans in WI cover EQUETRO CAPSULES 300MG 120 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | None |
EQUETRO EXTENDED RELEASE CAPSULES 100MG 120 BOT ![Compare how all Medicare Part D PDP plans in WI cover EQUETRO EXTENDED RELEASE CAPSULES 100MG 120 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | None |
ERAXIS 100mg/30mL 30 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in WI cover ERAXIS 100mg/30mL 30 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
ERAXIS(WATER DIL) 50 MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover ERAXIS(WATER DIL) 50 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
ERGOLOID MESYLATES TABLETS 1MG 100 BOT ![Compare how all Medicare Part D PDP plans in WI cover ERGOLOID MESYLATES TABLETS 1MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ERIVEDGE 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ERIVEDGE 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P |
ERLEADA 60 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ERLEADA 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:120 /30Days |
ERLOTINIB HCL 100 MG TABLET [Tarceva] ![Compare how all Medicare Part D PDP plans in WI cover ERLOTINIB HCL 100 MG TABLET [Tarceva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | P |
ERLOTINIB HCL 150 MG TABLET [Tarceva] ![Compare how all Medicare Part D PDP plans in WI cover ERLOTINIB HCL 150 MG TABLET [Tarceva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | P |
ERLOTINIB HCL 25 MG TABLET [Tarceva] ![Compare how all Medicare Part D PDP plans in WI cover ERLOTINIB HCL 25 MG TABLET [Tarceva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | P |
ERRIN 0.35 MG TABLET [Sharobel 28-Day] ![Compare how all Medicare Part D PDP plans in WI cover ERRIN 0.35 MG TABLET [Sharobel 28-Day].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ERTAPENEM 1 GRAM VIAL [Invanz] ![Compare how all Medicare Part D PDP plans in WI cover ERTAPENEM 1 GRAM VIAL [Invanz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
ERY 2% PADS 2% 60 PADS JAR ![Compare how all Medicare Part D PDP plans in WI cover ERY 2% PADS 2% 60 PADS JAR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ERY-TAB 500mg/1 100 TABLET, DELAYED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover ERY-TAB 500mg/1 100 TABLET, DELAYED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | None |
ERY-TAB TABLET 250MG EC ![Compare how all Medicare Part D PDP plans in WI cover ERY-TAB TABLET 250MG EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ERY-TAB TABLET 333MG EC ![Compare how all Medicare Part D PDP plans in WI cover ERY-TAB TABLET 333MG EC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ERYTHROCIN LACT 500 MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover ERYTHROCIN LACT 500 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | None |
ERYTHROMYCIN 0.5% EYE OINTMENT [Romycin] ![Compare how all Medicare Part D PDP plans in WI cover ERYTHROMYCIN 0.5% EYE OINTMENT [Romycin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | Q:7 /7Days |
ERYTHROMYCIN 2% GEL [Erygel] ![Compare how all Medicare Part D PDP plans in WI cover ERYTHROMYCIN 2% GEL [Erygel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ERYTHROMYCIN 2% SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover ERYTHROMYCIN 2% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ERYTHROMYCIN 200 MG/5 ML ORAL SUSPENSION [EryPed] ![Compare how all Medicare Part D PDP plans in WI cover ERYTHROMYCIN 200 MG/5 ML ORAL SUSPENSION [EryPed].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
ERYTHROMYCIN 400 MG/5 ML ORAL SUSPENSION [EryPed] ![Compare how all Medicare Part D PDP plans in WI cover ERYTHROMYCIN 400 MG/5 ML ORAL SUSPENSION [EryPed].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
ERYTHROMYCIN DR 250 MG CAPSULE DR [ERYC] ![Compare how all Medicare Part D PDP plans in WI cover ERYTHROMYCIN DR 250 MG CAPSULE DR [ERYC].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
ERYTHROMYCIN DR 250 MG TABLET DR [Ery-Tab] ![Compare how all Medicare Part D PDP plans in WI cover ERYTHROMYCIN DR 250 MG TABLET DR [Ery-Tab].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | None |
ERYTHROMYCIN DR 333 MG TABLET DR [Ery-Tab] ![Compare how all Medicare Part D PDP plans in WI cover ERYTHROMYCIN DR 333 MG TABLET DR [Ery-Tab].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | None |
ERYTHROMYCIN DR 500 MG TABLET DR [Ery-Tab] ![Compare how all Medicare Part D PDP plans in WI cover ERYTHROMYCIN DR 500 MG TABLET DR [Ery-Tab].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ERYTHROMYCIN-BENZOYL GEL ![Compare how all Medicare Part D PDP plans in WI cover ERYTHROMYCIN-BENZOYL GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ESBRIET 267 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover ESBRIET 267 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P |
ESBRIET 267 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ESBRIET 267 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P |
ESBRIET 801 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ESBRIET 801 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P |
ESCITALOPRAM 10 MG TABLET [Lexapro] ![Compare how all Medicare Part D PDP plans in WI cover ESCITALOPRAM 10 MG TABLET [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $7.00 | None |
ESCITALOPRAM 20 MG TABLET [Lexapro] ![Compare how all Medicare Part D PDP plans in WI cover ESCITALOPRAM 20 MG TABLET [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $7.00 | None |
ESCITALOPRAM 5 MG TABLET [Lexapro] ![Compare how all Medicare Part D PDP plans in WI cover ESCITALOPRAM 5 MG TABLET [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $7.00 | None |
ESCITALOPRAM OXALATE 5 MG/5 ML [Lexapro] ![Compare how all Medicare Part D PDP plans in WI cover ESCITALOPRAM OXALATE 5 MG/5 ML [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ESTARYLLA 0.25-0.035 MG TABLET [VyLibra] ![Compare how all Medicare Part D PDP plans in WI cover ESTARYLLA 0.25-0.035 MG TABLET [VyLibra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
Estazolam 1mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Estazolam 1mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ESTAZOLAM 2 MG TABLET [ProSom] ![Compare how all Medicare Part D PDP plans in WI cover ESTAZOLAM 2 MG TABLET [ProSom].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
Estradiol / Norethindrone Acetate 0.5; 0.1mg/1; mg/1 1 BLISTER PACK per CARTON / 28 TABLET, FILM C ![Compare how all Medicare Part D PDP plans in WI cover Estradiol / Norethindrone Acetate 0.5; 0.1mg/1; mg/1 1 BLISTER PACK per CARTON / 28 TABLET, FILM C.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ESTRADIOL 0.01% CREAM ![Compare how all Medicare Part D PDP plans in WI cover ESTRADIOL 0.01% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
Estradiol 0.025 mg patch ![Compare how all Medicare Part D PDP plans in WI cover Estradiol 0.025 mg patch.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
ESTRADIOL 0.0375MG PATCH(2/WK) PATCH TDSW [Vivelle-Dot] ![Compare how all Medicare Part D PDP plans in WI cover ESTRADIOL 0.0375MG PATCH(2/WK) PATCH TDSW [Vivelle-Dot].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
Estradiol 0.05 mg patch ![Compare how all Medicare Part D PDP plans in WI cover Estradiol 0.05 mg patch.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
ESTRADIOL 0.05 MG PATCH (1/WK) [Climara] ![Compare how all Medicare Part D PDP plans in WI cover ESTRADIOL 0.05 MG PATCH (1/WK) [Climara].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
ESTRADIOL 0.06 MG PATCH (1/WK) [Climara] ![Compare how all Medicare Part D PDP plans in WI cover ESTRADIOL 0.06 MG PATCH (1/WK) [Climara].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
Estradiol 0.075 mg patch ![Compare how all Medicare Part D PDP plans in WI cover Estradiol 0.075 mg patch.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
Estradiol 0.1 mg patch ![Compare how all Medicare Part D PDP plans in WI cover Estradiol 0.1 mg patch.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
ESTRADIOL 0.1 MG PATCH (1/WK) [Climara] ![Compare how all Medicare Part D PDP plans in WI cover ESTRADIOL 0.1 MG PATCH (1/WK) [Climara].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
ESTRADIOL 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ESTRADIOL 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $7.00 | None |
ESTRADIOL 1 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ESTRADIOL 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $7.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ESTRADIOL 10 MCG VAGINAL INSRT ![Compare how all Medicare Part D PDP plans in WI cover ESTRADIOL 10 MCG VAGINAL INSRT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
ESTRADIOL 2MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ESTRADIOL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | $7.00 | None |
ESTRADIOL TDS 0.025 MG/DAY ![Compare how all Medicare Part D PDP plans in WI cover ESTRADIOL TDS 0.025 MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
ESTRADIOL TDS 0.0375 MG/DAY ![Compare how all Medicare Part D PDP plans in WI cover ESTRADIOL TDS 0.0375 MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
ESTRADIOL TDS 0.075 MG/DAY ![Compare how all Medicare Part D PDP plans in WI cover ESTRADIOL TDS 0.075 MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | None |
ESTRADIOL VALERATE 20mg/mL 1 VIAL, MULTI-DOSE per CARTON / 5 mL in 1 VIAL, MULTI-DOSE ![Compare how all Medicare Part D PDP plans in WI cover ESTRADIOL VALERATE 20mg/mL 1 VIAL, MULTI-DOSE per CARTON / 5 mL in 1 VIAL, MULTI-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ESTRADIOL VALERATE 40mg/mL 1 VIAL, MULTI-DOSE per CARTON / 5 mL in 1 VIAL, MULTI-DOSE ![Compare how all Medicare Part D PDP plans in WI cover ESTRADIOL VALERATE 40mg/mL 1 VIAL, MULTI-DOSE per CARTON / 5 mL in 1 VIAL, MULTI-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ESTRADIOL-NORETH 1.0-0.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ESTRADIOL-NORETH 1.0-0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ESTRING 2MG VAGINAL RING ![Compare how all Medicare Part D PDP plans in WI cover ESTRING 2MG VAGINAL RING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | S |
ESZOPICLONE 1 MG TABLET [Lunesta] ![Compare how all Medicare Part D PDP plans in WI cover ESZOPICLONE 1 MG TABLET [Lunesta].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | Q:30 /30Days |
ESZOPICLONE 2 MG TABLET [Lunesta] ![Compare how all Medicare Part D PDP plans in WI cover ESZOPICLONE 2 MG TABLET [Lunesta].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ESZOPICLONE 3 MG TABLET [Lunesta] ![Compare how all Medicare Part D PDP plans in WI cover ESZOPICLONE 3 MG TABLET [Lunesta].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | Q:30 /30Days |
ETHACRYNIC ACID 25 MG TABLET [Edecrin] ![Compare how all Medicare Part D PDP plans in WI cover ETHACRYNIC ACID 25 MG TABLET [Edecrin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | None |
ETHAMBUTOL HCL 400 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover ETHAMBUTOL HCL 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
Ethambutol Hydrochloride 100mg/1 ![Compare how all Medicare Part D PDP plans in WI cover Ethambutol Hydrochloride 100mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ETHINYL ESTRADIOL 0.03 MG / LEVONORGESTREL 0.05 MG ORAL TABLET) / 10 (ETHINYL ESTRADIOL 0.03 MG 6 ![Compare how all Medicare Part D PDP plans in WI cover ETHINYL ESTRADIOL 0.03 MG / LEVONORGESTREL 0.05 MG ORAL TABLET) / 10 (ETHINYL ESTRADIOL 0.03 MG 6.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ETHINYL ESTRADIOL 0.03 MG / NORGESTREL 0.3 MG ORAL TABLET/ 7 (INERT INGREDIENTS 1 MG ORAL TABLET 21 ![Compare how all Medicare Part D PDP plans in WI cover ETHINYL ESTRADIOL 0.03 MG / NORGESTREL 0.3 MG ORAL TABLET/ 7 (INERT INGREDIENTS 1 MG ORAL TABLET 21.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ETHOSUXIMIDE 250 MG CAPSULE [Zarontin] ![Compare how all Medicare Part D PDP plans in WI cover ETHOSUXIMIDE 250 MG CAPSULE [Zarontin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ETHOSUXIMIDE 250 MG/5 ML SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover ETHOSUXIMIDE 250 MG/5 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ETHYNODIOL-ETH ESTRA 1MG-35MCG [ZOVIA] ![Compare how all Medicare Part D PDP plans in WI cover ETHYNODIOL-ETH ESTRA 1MG-35MCG [ZOVIA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ETHYNODIOL-ETH ESTRA 1MG-50MCG [ZOVIA] ![Compare how all Medicare Part D PDP plans in WI cover ETHYNODIOL-ETH ESTRA 1MG-50MCG [ZOVIA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ETODOLAC 200 MG CAPSULE [Lodine] ![Compare how all Medicare Part D PDP plans in WI cover ETODOLAC 200 MG CAPSULE [Lodine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ETODOLAC 300 MG CAPSULE [Lodine] ![Compare how all Medicare Part D PDP plans in WI cover ETODOLAC 300 MG CAPSULE [Lodine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ETODOLAC 400 MG TABLET [Lodine] ![Compare how all Medicare Part D PDP plans in WI cover ETODOLAC 400 MG TABLET [Lodine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ETODOLAC 500 MG TABLET [Lodine] ![Compare how all Medicare Part D PDP plans in WI cover ETODOLAC 500 MG TABLET [Lodine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ETODOLAC ER 400 MG TABLET ER 24H [Lodine XL] ![Compare how all Medicare Part D PDP plans in WI cover ETODOLAC ER 400 MG TABLET ER 24H [Lodine XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ETODOLAC ER 500 MG TABLET ER 24H [Lodine XL] ![Compare how all Medicare Part D PDP plans in WI cover ETODOLAC ER 500 MG TABLET ER 24H [Lodine XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ETODOLAC ER 600 MG TABLET ER 24H [Lodine XL] ![Compare how all Medicare Part D PDP plans in WI cover ETODOLAC ER 600 MG TABLET ER 24H [Lodine XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
ETONOGESTREL-EE VAGINAL RING [NuvaRing] ![Compare how all Medicare Part D PDP plans in WI cover ETONOGESTREL-EE VAGINAL RING [NuvaRing].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | None |
EUTHYROX 100 MCG TABLET ![Compare how all Medicare Part D PDP plans in WI cover EUTHYROX 100 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
EUTHYROX 112 MCG TABLET ![Compare how all Medicare Part D PDP plans in WI cover EUTHYROX 112 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
EUTHYROX 125 MCG TABLET ![Compare how all Medicare Part D PDP plans in WI cover EUTHYROX 125 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
EUTHYROX 137 MCG TABLET ![Compare how all Medicare Part D PDP plans in WI cover EUTHYROX 137 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EUTHYROX 150 MCG TABLET ![Compare how all Medicare Part D PDP plans in WI cover EUTHYROX 150 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
EUTHYROX 175 MCG TABLET ![Compare how all Medicare Part D PDP plans in WI cover EUTHYROX 175 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
EUTHYROX 200 MCG TABLET ![Compare how all Medicare Part D PDP plans in WI cover EUTHYROX 200 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
EUTHYROX 25 MCG TABLET ![Compare how all Medicare Part D PDP plans in WI cover EUTHYROX 25 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
EUTHYROX 50 MCG TABLET ![Compare how all Medicare Part D PDP plans in WI cover EUTHYROX 50 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
EUTHYROX 75 MCG TABLET ![Compare how all Medicare Part D PDP plans in WI cover EUTHYROX 75 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
EUTHYROX 88 MCG TABLET ![Compare how all Medicare Part D PDP plans in WI cover EUTHYROX 88 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
EVAMIST 1.53 MG/SPRAY ![Compare how all Medicare Part D PDP plans in WI cover EVAMIST 1.53 MG/SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | None |
EVEROLIMUS 0.25 MG TABLET [Zortress] ![Compare how all Medicare Part D PDP plans in WI cover EVEROLIMUS 0.25 MG TABLET [Zortress].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | P |
EVEROLIMUS 0.5 MG TABLET [Zortress] ![Compare how all Medicare Part D PDP plans in WI cover EVEROLIMUS 0.5 MG TABLET [Zortress].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | P |
EVEROLIMUS 0.75 MG TABLET [Zortress] ![Compare how all Medicare Part D PDP plans in WI cover EVEROLIMUS 0.75 MG TABLET [Zortress].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | $117.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EVEROLIMUS 2.5 MG TABLET [Afinitor] ![Compare how all Medicare Part D PDP plans in WI cover EVEROLIMUS 2.5 MG TABLET [Afinitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | P Q:30 /30Days |
EVEROLIMUS 5 MG TABLET [Afinitor] ![Compare how all Medicare Part D PDP plans in WI cover EVEROLIMUS 5 MG TABLET [Afinitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | P Q:30 /30Days |
EVEROLIMUS 7.5 MG TABLET [Afinitor] ![Compare how all Medicare Part D PDP plans in WI cover EVEROLIMUS 7.5 MG TABLET [Afinitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$90.00 | $300.00 | P Q:30 /30Days |
EVOTAZ 300 MG-150 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover EVOTAZ 300 MG-150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | None |
EVRYSDI 60 MG/80 ML(0.75MG/ML) SOLUTION RECON ![Compare how all Medicare Part D PDP plans in WI cover EVRYSDI 60 MG/80 ML(0.75MG/ML) SOLUTION RECON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | P Q:200 /30Days |
EXEMESTANE 25 MG TABLET [Aromasin] ![Compare how all Medicare Part D PDP plans in WI cover EXEMESTANE 25 MG TABLET [Aromasin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | None |
EXTAVIA 0.3 MG KIT ![Compare how all Medicare Part D PDP plans in WI cover EXTAVIA 0.3 MG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
30% | N/A | None |
EZETIMIBE 10 MG TABLET [Zetia] ![Compare how all Medicare Part D PDP plans in WI cover EZETIMIBE 10 MG TABLET [Zetia].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | Q:30 /30Days |
EZETIMIBE-SIMVASTATIN 10-10 MG TABLET [Vytorin] ![Compare how all Medicare Part D PDP plans in WI cover EZETIMIBE-SIMVASTATIN 10-10 MG TABLET [Vytorin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | Q:30 /30Days |
EZETIMIBE-SIMVASTATIN 10-20 MG TABLET [Vytorin] ![Compare how all Medicare Part D PDP plans in WI cover EZETIMIBE-SIMVASTATIN 10-20 MG TABLET [Vytorin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | Q:30 /30Days |
EZETIMIBE-SIMVASTATIN 10-40 MG TABLET [Vytorin] ![Compare how all Medicare Part D PDP plans in WI cover EZETIMIBE-SIMVASTATIN 10-40 MG TABLET [Vytorin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EZETIMIBE-SIMVASTATIN 10-80 MG TABLET [Vytorin] ![Compare how all Medicare Part D PDP plans in WI cover EZETIMIBE-SIMVASTATIN 10-80 MG TABLET [Vytorin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$5.00 | $24.00 | Q:30 /30Days |