JANUMET XR 50/1000 mg Tablet, Film Coated, Extended Release
Also known as Sitagliptin And Metformin Hydrochloride. Coverage in New Mexico (CMS PDP Region 26).
7 of 11 stand-alone Part D plans in New Mexico cover this drug on tier 3.
7 of 7 plans apply a prior authorization, step therapy or quantity limit.
67 Medicare Advantage plans in NM 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. NM: 67 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $5.1205 | $30.726 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $5.1205 | $30.726 units |
|
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $5.2387 | $31.436 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible | 3Preferred Brand | 16% | 16% | $5.6785 | $34.076 units |
|
| SilverScript Choice (PDP)$104.00/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $5.3503 | $32.106 units |
|
| Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible | 3Preferred Brand | 14% | 14% | $9.2720 | $55.636 units |
|
| Blue Cross MedicareRx Basic (PDP)$145.40/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $9.4922 | $56.956 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.