2022 Medicare Part D Plan Formulary Information |
Aetna Medicare Assure Premier (HMO D-SNP) (H3192-009-0)
Benefit Details
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The Aetna Medicare Assure Premier (HMO D-SNP) (H3192-009-0) Formulary Drugs Starting with the Letter E in Johnson County, IN: CMS MA Region 13 which includes: IN
|
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 IN cover ECONAZOLE NITRATE 1% CREAM (G) [Spectazole].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | Q:85 /30Days |
EDARBI 40 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EDARBI 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | Q:30 /30Days |
EDARBI 80 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EDARBI 80 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | Q:30 /30Days |
EDARBYCLOR 40-12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EDARBYCLOR 40-12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | Q:30 /30Days |
EDARBYCLOR 40-25 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EDARBYCLOR 40-25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | Q:30 /30Days |
EDURANT 27.5mg/1 ![Compare how all Medicare Part D PDP plans in IN cover EDURANT 27.5mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
EFAVIR-EMTRI-TENOF 600-200-300 TABLET [Atripla] ![Compare how all Medicare Part D PDP plans in IN cover EFAVIR-EMTRI-TENOF 600-200-300 TABLET [Atripla].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
EFAVIR-LAMIV-TENOF 400-300-300 TABLET [SYMFI LO] ![Compare how all Medicare Part D PDP plans in IN cover EFAVIR-LAMIV-TENOF 400-300-300 TABLET [SYMFI LO].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
EFAVIR-LAMIV-TENOF 600-300-300 TABLET [SYMFI] ![Compare how all Medicare Part D PDP plans in IN cover EFAVIR-LAMIV-TENOF 600-300-300 TABLET [SYMFI].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
EFAVIRENZ 200 MG CAPSULE [Sustiva] ![Compare how all Medicare Part D PDP plans in IN cover EFAVIRENZ 200 MG CAPSULE [Sustiva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EFAVIRENZ 50 MG CAPSULE [Sustiva] ![Compare how all Medicare Part D PDP plans in IN cover EFAVIRENZ 50 MG CAPSULE [Sustiva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
EFAVIRENZ 600 MG TABLET [Sustiva] ![Compare how all Medicare Part D PDP plans in IN cover EFAVIRENZ 600 MG TABLET [Sustiva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
ELETRIPTAN HBR 20 MG TABLET [Relpax] ![Compare how all Medicare Part D PDP plans in IN cover ELETRIPTAN HBR 20 MG TABLET [Relpax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:12 /30Days |
ELETRIPTAN HBR 40 MG TABLET [Relpax] ![Compare how all Medicare Part D PDP plans in IN cover ELETRIPTAN HBR 40 MG TABLET [Relpax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:12 /30Days |
ELIQUIS 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ELIQUIS 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:60 /30Days |
ELIQUIS 5 MG STARTER PACK ![Compare how all Medicare Part D PDP plans in IN cover ELIQUIS 5 MG STARTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:74 /30Days |
ELIQUIS 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ELIQUIS 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:74 /30Days |
ELMIRON 100mg GELATIN COATED 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in IN cover ELMIRON 100mg GELATIN COATED 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | Q:90 /30Days |
ELURYNG VAGINAL RING [NuvaRing] ![Compare how all Medicare Part D PDP plans in IN cover ELURYNG VAGINAL RING [NuvaRing].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
EMCYT 140MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover EMCYT 140MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
EMEND 125 MG POWDER PACKET ![Compare how all Medicare Part D PDP plans in IN cover EMEND 125 MG POWDER PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EMOQUETTE 28 DAY TABLET [Solia] ![Compare how all Medicare Part D PDP plans in IN cover EMOQUETTE 28 DAY TABLET [Solia].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $15.00 | None |
Empagliflozin 5 MG / Metformin hydrochloride 500 MG Oral Tablet [Synjardy] ![Compare how all Medicare Part D PDP plans in IN 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 |
$47.00 | $141.00 | Q:120 /30Days |
EMSAM TRANSDERMAL SYSTEM PATCHES 12MG/24H ![Compare how all Medicare Part D PDP plans in IN cover EMSAM TRANSDERMAL SYSTEM PATCHES 12MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:30 /30Days |
EMSAM TRANSDERMAL SYSTEM PATCHES 6MG/24H ![Compare how all Medicare Part D PDP plans in IN cover EMSAM TRANSDERMAL SYSTEM PATCHES 6MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:30 /30Days |
EMSAM TRANSDERMAL SYSTEM PATCHES 9MG/24H ![Compare how all Medicare Part D PDP plans in IN cover EMSAM TRANSDERMAL SYSTEM PATCHES 9MG/24H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:30 /30Days |
EMTRICITABINE 200 MG CAPSULE [Emtriva] ![Compare how all Medicare Part D PDP plans in IN cover EMTRICITABINE 200 MG CAPSULE [Emtriva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
EMTRICITABINE-TENOFV 100-150MG TABLET [Truvada] ![Compare how all Medicare Part D PDP plans in IN cover EMTRICITABINE-TENOFV 100-150MG TABLET [Truvada].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:30 /30Days |
EMTRICITABINE-TENOFV 133-200MG TABLET [Truvada] ![Compare how all Medicare Part D PDP plans in IN cover EMTRICITABINE-TENOFV 133-200MG TABLET [Truvada].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:30 /30Days |
EMTRICITABINE-TENOFV 167-250MG TABLET [Truvada] ![Compare how all Medicare Part D PDP plans in IN cover EMTRICITABINE-TENOFV 167-250MG TABLET [Truvada].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:30 /30Days |
EMTRICITABINE-TENOFV 200-300MG TABLET [Truvada] ![Compare how all Medicare Part D PDP plans in IN cover EMTRICITABINE-TENOFV 200-300MG TABLET [Truvada].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:30 /30Days |
EMTRIVA 10MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover EMTRIVA 10MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EMVERM 100 MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in IN cover EMVERM 100 MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:12 /365Days |
ENALAPRIL MALEATE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ENALAPRIL MALEATE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
ENALAPRIL MALEATE 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ENALAPRIL MALEATE 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
ENALAPRIL MALEATE 20 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ENALAPRIL MALEATE 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
ENALAPRIL MALEATE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ENALAPRIL MALEATE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
ENALAPRIL-HCTZ 10-25 MG TABLET [Vaseretic] ![Compare how all Medicare Part D PDP plans in IN cover ENALAPRIL-HCTZ 10-25 MG TABLET [Vaseretic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
ENALAPRIL-HCTZ 5-12.5 MG TABLET [Vaseretic] ![Compare how all Medicare Part D PDP plans in IN 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 | $0.00 | None |
ENBREL 25 MG/0.5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in IN cover ENBREL 25 MG/0.5 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:8 /28Days |
ENBREL 25 MG/0.5 ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover ENBREL 25 MG/0.5 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:8 /28Days |
ENBREL 25MG KIT ![Compare how all Medicare Part D PDP plans in IN cover ENBREL 25MG KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:8 /28Days |
ENBREL 50 MG/ML MINI CARTRIDGE ![Compare how all Medicare Part D PDP plans in IN cover ENBREL 50 MG/ML MINI CARTRIDGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:8 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ENBREL 50 MG/ML SURECLICK PEN INJECTOR ![Compare how all Medicare Part D PDP plans in IN cover ENBREL 50 MG/ML SURECLICK PEN INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:8 /28Days |
ENBREL 50 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in IN cover ENBREL 50 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:8 /28Days |
ENDOCET 10MG-325MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ENDOCET 10MG-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:180 /30Days |
ENDOCET 5/325 TABLET ![Compare how all Medicare Part D PDP plans in IN cover ENDOCET 5/325 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:180 /30Days |
ENDOCET 7.5-325MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ENDOCET 7.5-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:180 /30Days |
ENGERIX B INJECTION ![Compare how all Medicare Part D PDP plans in IN cover ENGERIX B INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | P |
ENGERIX-B 20 MCG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in IN cover ENGERIX-B 20 MCG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | P |
ENOXAPARIN 100 MG/ML SYRINGE [Lovenox] ![Compare how all Medicare Part D PDP plans in IN cover ENOXAPARIN 100 MG/ML SYRINGE [Lovenox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
ENOXAPARIN 120 MG/0.8 ML SYRINGE [Lovenox] ![Compare how all Medicare Part D PDP plans in IN cover ENOXAPARIN 120 MG/0.8 ML SYRINGE [Lovenox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
ENOXAPARIN 150 MG/ML SYRINGE [Lovenox] ![Compare how all Medicare Part D PDP plans in IN cover ENOXAPARIN 150 MG/ML SYRINGE [Lovenox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
ENOXAPARIN 30 MG/0.3 ML SYRINGE [Lovenox] ![Compare how all Medicare Part D PDP plans in IN cover ENOXAPARIN 30 MG/0.3 ML SYRINGE [Lovenox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ENOXAPARIN 40 MG/0.4 ML SYRINGE [Lovenox] ![Compare how all Medicare Part D PDP plans in IN cover ENOXAPARIN 40 MG/0.4 ML SYRINGE [Lovenox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
ENOXAPARIN 60 MG/0.6 ML SYRINGE [Lovenox] ![Compare how all Medicare Part D PDP plans in IN cover ENOXAPARIN 60 MG/0.6 ML SYRINGE [Lovenox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
ENOXAPARIN 80 MG/0.8 ML SYRINGE [Lovenox] ![Compare how all Medicare Part D PDP plans in IN cover ENOXAPARIN 80 MG/0.8 ML SYRINGE [Lovenox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
ENSKYCE 28 TABLET [Solia] ![Compare how all Medicare Part D PDP plans in IN cover ENSKYCE 28 TABLET [Solia].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $15.00 | None |
ENSTILAR 0.005%-0.064% FOAM ![Compare how all Medicare Part D PDP plans in IN cover ENSTILAR 0.005%-0.064% FOAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:120 /30Days |
ENTACAPONE 200 MG TABLET [Comtan] ![Compare how all Medicare Part D PDP plans in IN cover ENTACAPONE 200 MG TABLET [Comtan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
ENTECAVIR 0.5 MG TABLET [Baraclude] ![Compare how all Medicare Part D PDP plans in IN cover ENTECAVIR 0.5 MG TABLET [Baraclude].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | Q:30 /30Days |
ENTECAVIR 1 MG TABLET [Baraclude] ![Compare how all Medicare Part D PDP plans in IN cover ENTECAVIR 1 MG TABLET [Baraclude].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | Q:30 /30Days |
ENTRESTO 24 MG-26 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ENTRESTO 24 MG-26 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
ENTRESTO 49 MG-51 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ENTRESTO 49 MG-51 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
ENTRESTO 97 MG-103 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ENTRESTO 97 MG-103 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ENULOSE 10 GM/15 ML SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover ENULOSE 10 GM/15 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $15.00 | None |
EPCLUSA 150-37.5 MG PELLET PACK ![Compare how all Medicare Part D PDP plans in IN cover EPCLUSA 150-37.5 MG PELLET PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
EPCLUSA 200 MG-50 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EPCLUSA 200 MG-50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
EPCLUSA 200-50 MG PELLET PACK ![Compare how all Medicare Part D PDP plans in IN cover EPCLUSA 200-50 MG PELLET PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
EPCLUSA 400 MG-100 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EPCLUSA 400 MG-100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
EPIDIOLEX 100 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover EPIDIOLEX 100 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:600 /30Days |
EPINASTINE HCL 0.05% EYE DROPS ![Compare how all Medicare Part D PDP plans in IN cover EPINASTINE HCL 0.05% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
EPINEPHRINE 0.15 MG AUTO-INJECT ![Compare how all Medicare Part D PDP plans in IN cover EPINEPHRINE 0.15 MG AUTO-INJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:2 /30Days |
EPINEPHRINE 0.15 MG AUTO-INJECT [Twinject] ![Compare how all Medicare Part D PDP plans in IN cover EPINEPHRINE 0.15 MG AUTO-INJECT [Twinject].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:2 /30Days |
EPINEPHRINE 0.3 MG AUTO-INJECT ![Compare how all Medicare Part D PDP plans in IN cover EPINEPHRINE 0.3 MG AUTO-INJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:2 /30Days |
EPINEPHRINE 0.3 MG AUTO-INJECT [Twinject] ![Compare how all Medicare Part D PDP plans in IN cover EPINEPHRINE 0.3 MG AUTO-INJECT [Twinject].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:2 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EPITOL 200MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EPITOL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $15.00 | None |
EPIVIR HBV 25MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in IN cover EPIVIR HBV 25MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
EPLERENONE 25 MG TABLET [Inspra] ![Compare how all Medicare Part D PDP plans in IN cover EPLERENONE 25 MG TABLET [Inspra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
EPLERENONE 50 MG TABLET [Inspra] ![Compare how all Medicare Part D PDP plans in IN cover EPLERENONE 50 MG TABLET [Inspra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
EPRONTIA 25 MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover EPRONTIA 25 MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | Q:480 /30Days |
Ergotamine-caffeine 1-100mg tablet ![Compare how all Medicare Part D PDP plans in IN cover Ergotamine-caffeine 1-100mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
ERIVEDGE 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover ERIVEDGE 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ERLEADA 60 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ERLEADA 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ERLOTINIB HCL 100 MG TABLET [Tarceva] ![Compare how all Medicare Part D PDP plans in IN cover ERLOTINIB HCL 100 MG TABLET [Tarceva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:30 /30Days |
ERLOTINIB HCL 150 MG TABLET [Tarceva] ![Compare how all Medicare Part D PDP plans in IN cover ERLOTINIB HCL 150 MG TABLET [Tarceva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:30 /30Days |
ERLOTINIB HCL 25 MG TABLET [Tarceva] ![Compare how all Medicare Part D PDP plans in IN cover ERLOTINIB HCL 25 MG TABLET [Tarceva].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:90 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ERRIN 0.35 MG TABLET [Sharobel 28-Day] ![Compare how all Medicare Part D PDP plans in IN cover ERRIN 0.35 MG TABLET [Sharobel 28-Day].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
ERTACZO 2% CREAM ![Compare how all Medicare Part D PDP plans in IN cover ERTACZO 2% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:60 /30Days |
ERTAPENEM 1 GRAM VIAL [Invanz] ![Compare how all Medicare Part D PDP plans in IN cover ERTAPENEM 1 GRAM VIAL [Invanz].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
ERY 2% PADS 2% 60 PADS JAR ![Compare how all Medicare Part D PDP plans in IN cover ERY 2% PADS 2% 60 PADS JAR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
ERYTHROCIN 250 MG FILMTAB TABLET ![Compare how all Medicare Part D PDP plans in IN cover ERYTHROCIN 250 MG FILMTAB TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
ERYTHROCIN LACT 500 MG VIAL ![Compare how all Medicare Part D PDP plans in IN cover ERYTHROCIN LACT 500 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ERYTHROMYCIN 0.5% EYE OINTMENT [Romycin] ![Compare how all Medicare Part D PDP plans in IN cover ERYTHROMYCIN 0.5% EYE OINTMENT [Romycin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $15.00 | Q:42 /30Days |
ERYTHROMYCIN 2% GEL [Erygel] ![Compare how all Medicare Part D PDP plans in IN cover ERYTHROMYCIN 2% GEL [Erygel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $15.00 | Q:60 /30Days |
ERYTHROMYCIN 2% SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover ERYTHROMYCIN 2% SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $15.00 | Q:60 /30Days |
ERYTHROMYCIN 250 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ERYTHROMYCIN 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
ERYTHROMYCIN 500 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ERYTHROMYCIN 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ERYTHROMYCIN DR 250 MG CAPSULE DR [ERYC] ![Compare how all Medicare Part D PDP plans in IN cover ERYTHROMYCIN DR 250 MG CAPSULE DR [ERYC].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
ERYTHROMYCIN DR 250 MG TABLET [Ery-Tab] ![Compare how all Medicare Part D PDP plans in IN cover ERYTHROMYCIN DR 250 MG TABLET [Ery-Tab].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
ERYTHROMYCIN DR 333 MG TABLET DR [Ery-Tab] ![Compare how all Medicare Part D PDP plans in IN cover ERYTHROMYCIN DR 333 MG TABLET DR [Ery-Tab].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
ERYTHROMYCIN DR 500 MG TABLET DR [Ery-Tab] ![Compare how all Medicare Part D PDP plans in IN cover ERYTHROMYCIN DR 500 MG TABLET DR [Ery-Tab].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
ERYTHROMYCIN ES 400 MG TABLET [E.E.S.] ![Compare how all Medicare Part D PDP plans in IN cover ERYTHROMYCIN ES 400 MG TABLET [E.E.S.].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
ERYTHROMYCIN-BENZOYL GEL [Benzamycin] ![Compare how all Medicare Part D PDP plans in IN cover ERYTHROMYCIN-BENZOYL GEL [Benzamycin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
ESBRIET 267 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover ESBRIET 267 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:270 /30Days |
ESBRIET 267 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ESBRIET 267 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:270 /30Days |
ESBRIET 801 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ESBRIET 801 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:90 /30Days |
ESCITALOPRAM 10 MG TABLET [Lexapro] ![Compare how all Medicare Part D PDP plans in IN cover ESCITALOPRAM 10 MG TABLET [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:45 /30Days |
ESCITALOPRAM 20 MG TABLET [Lexapro] ![Compare how all Medicare Part D PDP plans in IN cover ESCITALOPRAM 20 MG TABLET [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ESCITALOPRAM 5 MG TABLET [Lexapro] ![Compare how all Medicare Part D PDP plans in IN cover ESCITALOPRAM 5 MG TABLET [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:45 /30Days |
ESCITALOPRAM OXALATE 5 MG/5 ML SOLUTION [Lexapro] ![Compare how all Medicare Part D PDP plans in IN cover ESCITALOPRAM OXALATE 5 MG/5 ML SOLUTION [Lexapro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:600 /30Days |
ESOMEPRAZOLE MAG DR 20 MG CAPSULE DR [Nexium 24HR Clear Minis] ![Compare how all Medicare Part D PDP plans in IN cover ESOMEPRAZOLE MAG DR 20 MG CAPSULE DR [Nexium 24HR Clear Minis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | Q:30 /30Days |
ESOMEPRAZOLE MAG DR 40 MG CAPSULE DR [Nexium] ![Compare how all Medicare Part D PDP plans in IN cover ESOMEPRAZOLE MAG DR 40 MG CAPSULE DR [Nexium].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | Q:30 /30Days |
ESTARYLLA 0.25-0.035 MG TABLET [VyLibra] ![Compare how all Medicare Part D PDP plans in IN cover ESTARYLLA 0.25-0.035 MG TABLET [VyLibra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $15.00 | 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 IN 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) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
ESTRADIOL 0.01% CREAM ![Compare how all Medicare Part D PDP plans in IN cover ESTRADIOL 0.01% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
Estradiol 0.025 mg patch ![Compare how all Medicare Part D PDP plans in IN cover Estradiol 0.025 mg patch.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:8 /28Days |
ESTRADIOL 0.0375MG PATCH(1/WKClimara] ![Compare how all Medicare Part D PDP plans in IN cover ESTRADIOL 0.0375MG PATCH(1/WKClimara].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:4 /28Days |
ESTRADIOL 0.0375MG PATCH(2/WK) TDSW [Vivelle-Dot] ![Compare how all Medicare Part D PDP plans in IN cover ESTRADIOL 0.0375MG PATCH(2/WK) TDSW [Vivelle-Dot].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:8 /28Days |
Estradiol 0.05 mg patch ![Compare how all Medicare Part D PDP plans in IN cover Estradiol 0.05 mg patch.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:8 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ESTRADIOL 0.05 MG PATCH (1/WK) [Climara] ![Compare how all Medicare Part D PDP plans in IN cover ESTRADIOL 0.05 MG PATCH (1/WK) [Climara].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:4 /28Days |
ESTRADIOL 0.06 MG PATCH (1/WK) [Climara] ![Compare how all Medicare Part D PDP plans in IN cover ESTRADIOL 0.06 MG PATCH (1/WK) [Climara].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:4 /28Days |
Estradiol 0.075 mg patch ![Compare how all Medicare Part D PDP plans in IN cover Estradiol 0.075 mg patch.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:8 /28Days |
ESTRADIOL 0.075 MG PATCH(1/WKClimara] ![Compare how all Medicare Part D PDP plans in IN cover ESTRADIOL 0.075 MG PATCH(1/WKClimara].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:4 /28Days |
Estradiol 0.1 mg patch ![Compare how all Medicare Part D PDP plans in IN cover Estradiol 0.1 mg patch.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:8 /28Days |
ESTRADIOL 0.1 MG PATCH (1/WK) [Climara] ![Compare how all Medicare Part D PDP plans in IN cover ESTRADIOL 0.1 MG PATCH (1/WK) [Climara].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:4 /28Days |
ESTRADIOL 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ESTRADIOL 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
ESTRADIOL 1 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ESTRADIOL 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
ESTRADIOL 10 MCG VAGINAL INSRT ![Compare how all Medicare Part D PDP plans in IN cover ESTRADIOL 10 MCG VAGINAL INSRT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
ESTRADIOL 2MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ESTRADIOL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
ESTRADIOL TDS 0.025 MG/DAY ![Compare how all Medicare Part D PDP plans in IN cover ESTRADIOL TDS 0.025 MG/DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:4 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ESTRADIOL VALERATE 100 MG/5 ML VIAL [Gynogen LA] ![Compare how all Medicare Part D PDP plans in IN cover ESTRADIOL VALERATE 100 MG/5 ML VIAL [Gynogen LA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
ESTRADIOL VALERATE 200 MG/5 ML VIAL [Delestrogen] ![Compare how all Medicare Part D PDP plans in IN cover ESTRADIOL VALERATE 200 MG/5 ML VIAL [Delestrogen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
ESTRADIOL-NORETH 1.0-0.5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ESTRADIOL-NORETH 1.0-0.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
ESTRING 2MG VAGINAL RING ![Compare how all Medicare Part D PDP plans in IN cover ESTRING 2MG VAGINAL RING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | Q:1 /90Days |
ESZOPICLONE 1 MG TABLET [Lunesta] ![Compare how all Medicare Part D PDP plans in IN cover ESZOPICLONE 1 MG TABLET [Lunesta].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | P Q:30 /30Days |
ESZOPICLONE 2 MG TABLET [Lunesta] ![Compare how all Medicare Part D PDP plans in IN cover ESZOPICLONE 2 MG TABLET [Lunesta].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | P Q:30 /30Days |
ESZOPICLONE 3 MG TABLET [Lunesta] ![Compare how all Medicare Part D PDP plans in IN cover ESZOPICLONE 3 MG TABLET [Lunesta].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | P Q:30 /30Days |
ETHAMBUTOL HCL 400 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ETHAMBUTOL HCL 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
Ethambutol Hydrochloride 100mg/1 ![Compare how all Medicare Part D PDP plans in IN cover Ethambutol Hydrochloride 100mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | 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 IN 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 | $15.00 | 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 IN 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 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ETHOSUXIMIDE 250 MG CAPSULE [Zarontin] ![Compare how all Medicare Part D PDP plans in IN cover ETHOSUXIMIDE 250 MG CAPSULE [Zarontin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | None |
ETHOSUXIMIDE 250 MG/5 ML SOLUTION [Zarontin] ![Compare how all Medicare Part D PDP plans in IN cover ETHOSUXIMIDE 250 MG/5 ML SOLUTION [Zarontin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
ETHYNODIOL-ETH ESTRA 1MG-35MCG [ZOVIA] ![Compare how all Medicare Part D PDP plans in IN cover ETHYNODIOL-ETH ESTRA 1MG-35MCG [ZOVIA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $15.00 | None |
ETHYNODIOL-ETH ESTRA 1MG-50MCG [ZOVIA] ![Compare how all Medicare Part D PDP plans in IN cover ETHYNODIOL-ETH ESTRA 1MG-50MCG [ZOVIA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $15.00 | None |
ETODOLAC 200 MG CAPSULE [Lodine] ![Compare how all Medicare Part D PDP plans in IN cover ETODOLAC 200 MG CAPSULE [Lodine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:90 /30Days |
ETODOLAC 300 MG CAPSULE [Lodine] ![Compare how all Medicare Part D PDP plans in IN cover ETODOLAC 300 MG CAPSULE [Lodine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:120 /30Days |
ETODOLAC 400 MG TABLET [Lodine] ![Compare how all Medicare Part D PDP plans in IN cover ETODOLAC 400 MG TABLET [Lodine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:90 /30Days |
ETODOLAC 500 MG TABLET [Lodine] ![Compare how all Medicare Part D PDP plans in IN cover ETODOLAC 500 MG TABLET [Lodine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $141.00 | Q:60 /30Days |
ETODOLAC ER 400 MG TABLET ER 24H [Lodine XL] ![Compare how all Medicare Part D PDP plans in IN cover ETODOLAC ER 400 MG TABLET ER 24H [Lodine XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | Q:60 /30Days |
ETODOLAC ER 500 MG TABLET ER 24H [Lodine XL] ![Compare how all Medicare Part D PDP plans in IN cover ETODOLAC ER 500 MG TABLET ER 24H [Lodine XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | Q:60 /30Days |
ETODOLAC ER 600 MG TABLET ER 24H [Lodine XL] ![Compare how all Medicare Part D PDP plans in IN cover ETODOLAC ER 600 MG TABLET ER 24H [Lodine XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ETRAVIRINE 100 MG TABLET [INTELENCE] ![Compare how all Medicare Part D PDP plans in IN cover ETRAVIRINE 100 MG TABLET [INTELENCE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ETRAVIRINE 200 MG TABLET [INTELENCE] ![Compare how all Medicare Part D PDP plans in IN cover ETRAVIRINE 200 MG TABLET [INTELENCE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
EUTHYROX 100 MCG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EUTHYROX 100 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
EUTHYROX 112 MCG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EUTHYROX 112 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
EUTHYROX 125 MCG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EUTHYROX 125 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
EUTHYROX 137 MCG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EUTHYROX 137 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
EUTHYROX 150 MCG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EUTHYROX 150 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
EUTHYROX 175 MCG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EUTHYROX 175 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
EUTHYROX 200 MCG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EUTHYROX 200 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
EUTHYROX 25 MCG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EUTHYROX 25 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
EUTHYROX 50 MCG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EUTHYROX 50 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
EUTHYROX 75 MCG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EUTHYROX 75 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
EUTHYROX 88 MCG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EUTHYROX 88 MCG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
EVEROLIMUS 0.25 MG TABLET [Zortress] ![Compare how all Medicare Part D PDP plans in IN cover EVEROLIMUS 0.25 MG TABLET [Zortress].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | P |
EVEROLIMUS 0.5 MG TABLET [Zortress] ![Compare how all Medicare Part D PDP plans in IN cover EVEROLIMUS 0.5 MG TABLET [Zortress].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
EVEROLIMUS 0.75 MG TABLET [Zortress] ![Compare how all Medicare Part D PDP plans in IN cover EVEROLIMUS 0.75 MG TABLET [Zortress].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
EVEROLIMUS 1 MG TABLET [Zortress] ![Compare how all Medicare Part D PDP plans in IN cover EVEROLIMUS 1 MG TABLET [Zortress].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
EVEROLIMUS 10 MG TABLET [Afinitor] ![Compare how all Medicare Part D PDP plans in IN cover EVEROLIMUS 10 MG TABLET [Afinitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:30 /30Days |
EVEROLIMUS 2 MG TABLET FOR SUSP [Afinitor DISPERZ] ![Compare how all Medicare Part D PDP plans in IN cover EVEROLIMUS 2 MG TABLET FOR SUSP [Afinitor DISPERZ].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:150 /30Days |
EVEROLIMUS 2.5 MG TABLET [Afinitor] ![Compare how all Medicare Part D PDP plans in IN cover EVEROLIMUS 2.5 MG TABLET [Afinitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:30 /30Days |
EVEROLIMUS 3 MG TABLET FOR SUSP [Afinitor DISPERZ] ![Compare how all Medicare Part D PDP plans in IN cover EVEROLIMUS 3 MG TABLET FOR SUSP [Afinitor DISPERZ].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:90 /30Days |
EVEROLIMUS 5 MG TABLET [Afinitor] ![Compare how all Medicare Part D PDP plans in IN cover EVEROLIMUS 5 MG TABLET [Afinitor].](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 |
EVEROLIMUS 5 MG TABLET FOR SUSP [Afinitor DISPERZ] ![Compare how all Medicare Part D PDP plans in IN cover EVEROLIMUS 5 MG TABLET FOR SUSP [Afinitor DISPERZ].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:60 /30Days |
EVEROLIMUS 7.5 MG TABLET [Afinitor] ![Compare how all Medicare Part D PDP plans in IN cover EVEROLIMUS 7.5 MG TABLET [Afinitor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:30 /30Days |
EVOTAZ 300 MG-150 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover EVOTAZ 300 MG-150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
EXEMESTANE 25 MG TABLET [Aromasin] ![Compare how all Medicare Part D PDP plans in IN cover EXEMESTANE 25 MG TABLET [Aromasin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
EXKIVITY 40 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover EXKIVITY 40 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P Q:120 /30Days |
EZETIMIBE 10 MG TABLET [Zetia] ![Compare how all Medicare Part D PDP plans in IN cover EZETIMIBE 10 MG TABLET [Zetia].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
25% | 25% | None |
EZETIMIBE-SIMVASTATIN 10-10 MG TABLET [Vytorin] ![Compare how all Medicare Part D PDP plans in IN cover EZETIMIBE-SIMVASTATIN 10-10 MG TABLET [Vytorin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $15.00 | Q:30 /30Days |
EZETIMIBE-SIMVASTATIN 10-20 MG TABLET [Vytorin] ![Compare how all Medicare Part D PDP plans in IN cover EZETIMIBE-SIMVASTATIN 10-20 MG TABLET [Vytorin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $15.00 | Q:30 /30Days |
EZETIMIBE-SIMVASTATIN 10-40 MG TABLET [Vytorin] ![Compare how all Medicare Part D PDP plans in IN cover EZETIMIBE-SIMVASTATIN 10-40 MG TABLET [Vytorin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $15.00 | Q:30 /30Days |
EZETIMIBE-SIMVASTATIN 10-80 MG TABLET [Vytorin] ![Compare how all Medicare Part D PDP plans in IN cover EZETIMIBE-SIMVASTATIN 10-80 MG TABLET [Vytorin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$5.00 | $15.00 | Q:30 /30Days |