MedicarePartD.guide

A non-government resource built from CMS public data

DUAVEE .45/20 mg Tablet, Film Coated

Also known as Conjugated Estrogens/Bazedoxifene. Coverage in South Carolina (CMS PDP Region 09).

8 of 11 stand-alone Part D plans in South Carolina cover this drug on tier 4.

5 of 8 plans apply a prior authorization, step therapy or quantity limit.

53 Medicare Advantage plans in SC 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. SC: 53 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$10.10/mo premium · $615.00 deductible4Non-Preferred Drug30%—$6.5432$19.633 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$65.60/mo premium · $601.00 deductible4Non-Preferred Drug34%—$6.5432$19.633 units
  • Prior authorization
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$6.3871—
  • Prior authorization
SilverScript Choice (PDP)$98.40/mo premium · $615.00 deductible4Non-Preferred Drug33%33%$6.6535—None
AARP Medicare Rx Saver from UHC (PDP)$122.10/mo premium · $615.00 deductible4Non-Preferred Drug36%—$6.8227—None
AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible4Non-Preferred Drug35%—$6.8227—None
Humana Premier Rx Plan (PDP)$145.60/mo premium · $0.00 deductible4Non-Preferred Drug50%50%$6.5432$19.633 units
  • Prior authorization
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$152.50/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$6.4138—
  • Prior authorization

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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