JANUMET XR 50/500 mg Tablet, Film Coated, Extended Release
Also known as Sitagliptin And Metformin Hydrochloride. Coverage in Alabama and Tennessee (CMS PDP Region 12).
8 of 12 stand-alone Part D plans in Alabama and Tennessee cover this drug on tier 3.
Lowest 30-day cost $47.00 at a preferred pharmacy. 8 of 8 plans apply a prior authorization, step therapy or quantity limit.
211 Medicare Advantage plans in AL, TN do cover it
Medicare Advantage plans carry their own formularies, separate from stand-alone Part D. A patient on an MA-PD plan may have coverage even where no PDP lists the drug. AL: 89 plans · TN: 122 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $5.1247 | $30.756 units |
|
| Wellcare Classic (PDP)$3.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $5.1247 | $30.756 units |
|
| BlueRx Essential (PDP)$76.20/mo premium · $615.00 deductible | 3Preferred Brand | 19% | 19% | $5.6603 | $16.983 units |
|
| HealthSpring Extra Rx (PDP)$77.50/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $5.2165 | $31.306 units |
|
| HealthSpring Assurance Rx (PDP)$87.20/mo premium · $615.00 deductible | 3Preferred Brand | 22% | 22% | $5.2315 | $31.396 units |
|
| SilverScript Choice (PDP)$97.30/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $5.3468 | $32.086 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$119.30/mo premium · $130.00 deductible | 3Preferred Brand | 17% | 17% | $5.6425 | $16.933 units |
|
| BlueRx Enhanced Plus (PDP)$129.50/mo premium · $150.00 deductible | 3Preferred Brand | $47.00 | $94.00 | $5.6603 | $16.983 units |
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Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity.