MedicarePartD.guide

A non-government resource built from CMS public data

JANUMET 50/1000 mg Tablet, Film Coated

Also known as Sitagliptin And Metformin Hydrochloride. Coverage in North Carolina (CMS PDP Region 08).

8 of 12 stand-alone Part D plans in North Carolina cover this drug on tier 3.

Lowest 30-day cost $45.00 at a preferred pharmacy. 8 of 8 plans apply a prior authorization, step therapy or quantity limit.

160 Medicare Advantage plans in NC 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. NC: 160 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible3Preferred Brand25%25%$5.0695$30.426 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$4.70/mo premium · $615.00 deductible3Preferred Brand25%25%$5.0695$30.426 units
  • Quantity limit 6 per 30 days
HealthSpring Extra Rx (PDP)$78.00/mo premium · $615.00 deductible3Preferred Brand17%17%$5.2063$31.246 units
  • Quantity limit 6 per 30 days
Blue Medicare Rx Standard (PDP)$83.90/mo premium · $615.00 deductible3Preferred Brand20%20%$9.3940$56.366 units
  • Quantity limit 6 per 30 days
SilverScript Choice (PDP)$90.20/mo premium · $615.00 deductible3Preferred Brand18%18%$5.3471$32.086 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$110.40/mo premium · $615.00 deductible3Preferred Brand22%22%$5.2106$31.266 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$119.80/mo premium · $130.00 deductible3Preferred Brand17%17%$5.6362$33.826 units
  • Quantity limit 6 per 30 days
Blue Medicare Rx Enhanced (PDP)$163.20/mo premium · $0.00 deductible3Preferred Brand$45.00$135.00$9.3940$56.366 units
  • Quantity limit 6 per 30 days

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.

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