SOLIQUA 100/33 100/33 U/mL/ug/mL Injection, Solution
Also known as Insulin Glargine And Lixisenatide. Package: 5 SYRINGE in 1 CARTON (0024-5761-05) / 3 mL in 1 SYRINGE (0024-5761-02). NDC 00024576105.
- Plans covering it
- 320
- across 39 regions checked
- Lowest tier
- 3
- lower tiers cost less
- Plans with restrictions
- 319
- prior auth, step therapy or quantity limit
Coverage by region
Covered by at least one plan in 39 of 39 CMS regions.
| Region | Plans covering | Tiers | Lowest 30-day cost | Restrictions |
|---|---|---|---|---|
| Pennsylvania and West Virginia | 12 of 12 | 3 | $45.00 | 12 of 12 plans |
| Connecticut, Massachusetts, Rhode Island and Vermont | 11 of 11 | 3 | $30.00 | 11 of 11 plans |
| Michigan | 11 of 12 | 3 | $45.00 | 11 of 11 plans |
| Arkansas | 11 of 12 | 3 | $45.00 | 11 of 11 plans |
| South Carolina | 10 of 11 | 3 | $45.00 | 9 of 10 plans |
| Indiana and Kentucky | 10 of 10 | 3 | $45.00 | 10 of 10 plans |
| Wisconsin | 10 of 10 | 3 | $45.00 | 10 of 10 plans |
| Louisiana | 10 of 10 | 3 | $45.00 | 10 of 10 plans |
| Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming | 10 of 11 | 3 | $45.00 | 10 of 10 plans |
| Idaho and Utah | 10 of 10 | 3 | $45.00 | 10 of 10 plans |
| New York | 9 of 10 | 3 | $45.00 | 9 of 9 plans |
| New Jersey | 9 of 12 | 3 | $45.00 | 9 of 9 plans |
| Delaware, DC and Maryland | 9 of 10 | 3 | $45.00 | 9 of 9 plans |
| North Carolina | 9 of 12 | 3 | $45.00 | 9 of 9 plans |
| Georgia | 9 of 10 | 3 | $45.00 | 9 of 9 plans |
| Alabama and Tennessee | 9 of 12 | 3 | $45.00 | 9 of 9 plans |
| Ohio | 9 of 10 | 3 | $45.00 | 9 of 9 plans |
| Illinois | 9 of 12 | 3 | $45.00 | 9 of 9 plans |
| Missouri | 9 of 10 | 3 | $45.00 | 9 of 9 plans |
| Mississippi | 9 of 10 | 3 | $45.00 | 9 of 9 plans |
| Texas | 9 of 12 | 3 | $45.00 | 9 of 9 plans |
| Oklahoma | 9 of 11 | 3 | $45.00 | 9 of 9 plans |
| Colorado | 9 of 10 | 3 | $45.00 | 9 of 9 plans |
| Arizona | 9 of 10 | 3 | $45.00 | 9 of 9 plans |
| Nevada | 9 of 10 | 3 | $45.00 | 9 of 9 plans |
| Oregon and Washington | 9 of 10 | 3 | $45.00 | 9 of 9 plans |
| California | 9 of 12 | 3 | $45.00 | 9 of 9 plans |
| Maine and New Hampshire | 8 of 9 | 3 | $45.00 | 8 of 8 plans |
| Virginia | 8 of 9 | 3 | $45.00 | 8 of 8 plans |
| Kansas | 8 of 12 | 3 | $45.00 | 8 of 8 plans |
| New Mexico | 8 of 11 | 3 | $45.00 | 8 of 8 plans |
| Hawaii | 8 of 8 | 3 | $45.00 | 8 of 8 plans |
| Alaska | 8 of 9 | 3 | $45.00 | 8 of 8 plans |
| Florida | 7 of 10 | 3 | $45.00 | 7 of 7 plans |
| Puerto Rico | 3 of 3 | 3 | — | 3 of 3 plans |
| American Samoa | 1 of 1 | 3 | — | 1 of 1 plans |
| Guam | 1 of 1 | 3 | — | 1 of 1 plans |
| Northern Mariana Islands | 1 of 1 | 3 | — | 1 of 1 plans |
| U.S. Virgin Islands | 1 of 1 | 3 | — | 1 of 1 plans |
Plan-by-plan detail
Open a region to see every plan that covers this drug, with tier, cost-sharing and restrictions.
Pennsylvania and West Virginia — 12 plans, 12 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$6.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.0079 | $1,083.1519 units |
|
| Wellcare Value Script (PDP)$8.20/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.5833 | $982.5018 units |
|
| Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.5833 | $982.5018 units |
|
| Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.0079 | $1,083.1519 units |
|
| SilverScript Choice (PDP)$22.70/mo premium · $615.00 deductible | 3Preferred Brand | 19% | 19% | $58.4419 | $1,051.9518 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$43.50/mo premium · $615.00 deductible | 3Preferred Brand | 16% | 16% | $60.3783 | $1,147.1919 units |
|
| HealthSpring Extra Rx (PDP)$62.60/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $52.2261 | $992.3019 units |
|
| HealthSpring Assurance Rx (PDP)$74.00/mo premium · $615.00 deductible | 3Preferred Brand | 21% | 21% | $52.2734 | $993.1919 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$121.90/mo premium · $130.00 deductible | 3Preferred Brand | 16% | 16% | $60.3783 | $1,147.1919 units |
|
| Humana Premier Rx Plan (PDP)$123.60/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.0079 | $1,083.1519 units |
|
| Blue Rx PDP Complete (PDP)$164.80/mo premium · $200.00 deductible | 3Preferred Brand | 25% | 25% | $56.4089 | $1,015.3618 units |
|
| Blue Rx PDP Plus (PDP)$193.20/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $56.0386 | $1,008.6918 units |
|
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 — elsewhere it depends on what is prescribed.
Connecticut, Massachusetts, Rhode Island and Vermont — 11 plans, 11 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$8.40/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.3323 | $1,089.3119 units |
|
| Wellcare Value Script (PDP)$16.40/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.5508 | $981.9118 units |
|
| Blue MedicareRx Value Plus (PDP)$20.70/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $56.6822 | $1,020.2818 units |
|
| Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.5508 | $981.9118 units |
|
| SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible | 3Preferred Brand | 19% | 19% | $58.4409 | $1,051.9418 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $60.6355 | $1,152.0719 units |
|
| Humana Value Rx Plan (PDP)$73.60/mo premium · $601.00 deductible | 3Preferred Brand | 18% | 13% | $57.3323 | $1,089.3119 units |
|
| Humana Premier Rx Plan (PDP)$138.60/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.3323 | $1,089.3119 units |
|
| HealthSpring Assurance Rx (PDP)$139.30/mo premium · $615.00 deductible | 3Preferred Brand | 21% | 21% | $53.0240 | $1,007.4619 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible | 3Preferred Brand | 15% | 15% | $60.6355 | $1,152.0719 units |
|
| Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible | 3Preferred Brand | $30.00 | $60.00 | $56.6822 | $1,020.2818 units |
|
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 — elsewhere it depends on what is prescribed.
Michigan — 11 plans, 11 with restrictions
| 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% | $54.9118 | $988.4118 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.9118 | $988.4118 units |
|
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $53.2605 | $1,011.9519 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.2794 | $1,088.3119 units |
|
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.2794 | $1,088.3119 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$14.10/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $60.7110 | $1,153.5119 units |
|
| HealthSpring Extra Rx (PDP)$50.40/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $53.2222 | $1,011.2219 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$78.30/mo premium · $130.00 deductible | 3Preferred Brand | 18% | 18% | $60.7110 | $1,153.5119 units |
|
| Prescription Blue Select (PDP)$78.40/mo premium · $615.00 deductible | 3Preferred Brand | 20% | 20% | $56.9645 | $113.932 units |
|
| Humana Premier Rx Plan (PDP)$98.10/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.2794 | $1,088.3119 units |
|
| Prescription Blue Premium (PDP)$106.70/mo premium · $0.00 deductible | 3Preferred Brand | 24% | 24% | $56.9645 | $113.932 units |
|
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 — elsewhere it depends on what is prescribed.
Arkansas — 11 plans, 11 with restrictions
| 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% | $54.7813 | $986.0618 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.7813 | $986.0618 units |
|
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $53.0169 | $1,007.3219 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $56.8367 | $1,079.9019 units |
|
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $56.8367 | $1,079.9019 units |
|
| BlueMedicare Value Rx (PDP)$52.50/mo premium · $615.00 deductible | 3Preferred Brand | 19% | 19% | $57.7034 | $1,038.6618 units |
|
| HealthSpring Extra Rx (PDP)$54.50/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $52.9828 | $1,006.6719 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$65.10/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $61.2624 | $1,163.9919 units |
|
| Humana Premier Rx Plan (PDP)$92.40/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $56.8367 | $1,079.9019 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$114.90/mo premium · $130.00 deductible | 3Preferred Brand | 16% | 16% | $61.2624 | $1,163.9919 units |
|
| BlueMedicare Premier Rx (PDP)$181.20/mo premium · $0.00 deductible | 3Preferred Brand | 20% | 20% | $57.7034 | $1,038.6618 units |
|
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 — elsewhere it depends on what is prescribed.
South Carolina — 10 plans, 9 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$4.80/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.6029 | $982.8518 units |
|
| Wellcare Classic (PDP)$9.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.6029 | $982.8518 units |
|
| Humana Basic Rx Plan (PDP)$10.10/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.3159 | $1,089.0019 units |
|
| Humana Value Rx Plan (PDP)$65.60/mo premium · $601.00 deductible | 3Preferred Brand | 19% | 14% | $57.3159 | $1,089.0019 units |
|
| HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $52.6749 | $1,000.8219 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$122.10/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $60.6519 | $1,152.3919 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible | 3Preferred Brand | 17% | 17% | $60.6519 | $1,152.3919 units |
|
| BlueCross Rx Value (PDP)$139.70/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $57.1102 | — | None |
| Humana Premier Rx Plan (PDP)$145.60/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.3159 | $1,089.0019 units |
|
| HealthSpring Assurance Rx (PDP)$152.50/mo premium · $615.00 deductible | 3Preferred Brand | 21% | 21% | $52.7179 | $1,001.6419 units |
|
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 — elsewhere it depends on what is prescribed.
Indiana and Kentucky — 10 plans, 10 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.2333 | $1,087.4319 units |
|
| Wellcare Value Script (PDP)$8.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $55.4585 | $998.2518 units |
|
| Wellcare Classic (PDP)$8.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $55.4585 | $998.2518 units |
|
| Humana Value Rx Plan (PDP)$9.90/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.2333 | $1,087.4319 units |
|
| SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible | 3Preferred Brand | 19% | 19% | $58.4424 | $1,051.9618 units |
|
| HealthSpring Extra Rx (PDP)$78.20/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $52.7436 | $1,002.1319 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$90.30/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $60.8096 | $1,155.3819 units |
|
| HealthSpring Assurance Rx (PDP)$117.80/mo premium · $615.00 deductible | 3Preferred Brand | 20% | 20% | $52.7840 | $1,002.9019 units |
|
| Humana Premier Rx Plan (PDP)$125.30/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.2333 | $1,087.4319 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$127.10/mo premium · $130.00 deductible | 3Preferred Brand | 18% | 18% | $60.8096 | $1,155.3819 units |
|
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 — elsewhere it depends on what is prescribed.
Wisconsin — 10 plans, 10 with restrictions
| 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% | $54.8599 | $987.4818 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.8599 | $987.4818 units |
|
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.0481 | $1,026.9119 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.0538 | $1,084.0219 units |
|
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.0538 | $1,084.0219 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $61.4492 | $1,167.5319 units |
|
| SilverScript Choice (PDP)$26.70/mo premium · $615.00 deductible | 3Preferred Brand | 19% | 19% | $58.4839 | $1,052.7118 units |
|
| HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $54.0171 | $1,026.3219 units |
|
| Humana Premier Rx Plan (PDP)$110.60/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.0538 | $1,084.0219 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$113.90/mo premium · $130.00 deductible | 3Preferred Brand | 15% | 15% | $61.4492 | $1,167.5319 units |
|
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 — elsewhere it depends on what is prescribed.
Louisiana — 10 plans, 10 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.0891 | $1,084.6919 units |
|
| Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.5561 | $982.0118 units |
|
| Wellcare Classic (PDP)$6.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.5561 | $982.0118 units |
|
| Humana Value Rx Plan (PDP)$19.30/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.0891 | $1,084.6919 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$37.00/mo premium · $615.00 deductible | 3Preferred Brand | 16% | 16% | $61.1482 | $1,161.8219 units |
|
| SilverScript Choice (PDP)$44.70/mo premium · $615.00 deductible | 3Preferred Brand | 19% | 19% | $58.4425 | $1,051.9718 units |
|
| HealthSpring Assurance Rx (PDP)$48.40/mo premium · $615.00 deductible | 3Preferred Brand | 20% | 20% | $53.1418 | $1,009.6919 units |
|
| HealthSpring Extra Rx (PDP)$60.60/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $53.1069 | $1,009.0319 units |
|
| Humana Premier Rx Plan (PDP)$113.70/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.0891 | $1,084.6919 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$139.50/mo premium · $130.00 deductible | 3Preferred Brand | 15% | 15% | $61.1482 | $1,161.8219 units |
|
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 — elsewhere it depends on what is prescribed.
Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming — 10 plans, 10 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$4.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.0853 | $1,084.6219 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$5.30/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $60.6127 | $1,151.6419 units |
|
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $55.5857 | $1,000.5418 units |
|
| Wellcare Classic (PDP)$12.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $55.5857 | $1,000.5418 units |
|
| Humana Value Rx Plan (PDP)$20.80/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.0853 | $1,084.6219 units |
|
| SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible | 3Preferred Brand | 19% | 19% | $58.5938 | $1,054.6918 units |
|
| HealthSpring Extra Rx (PDP)$66.50/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $53.1732 | $1,010.2919 units |
|
| Humana Premier Rx Plan (PDP)$103.70/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.0853 | $1,084.6219 units |
|
| HealthSpring Assurance Rx (PDP)$125.90/mo premium · $615.00 deductible | 3Preferred Brand | 21% | 21% | $53.2130 | $1,011.0519 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$140.20/mo premium · $130.00 deductible | 3Preferred Brand | 18% | 18% | $60.6127 | $1,151.6419 units |
|
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 — elsewhere it depends on what is prescribed.
Idaho and Utah — 10 plans, 10 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $56.8626 | $1,080.3919 units |
|
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $55.4023 | $997.2418 units |
|
| Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $56.8626 | $1,080.3919 units |
|
| Wellcare Classic (PDP)$23.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $55.4023 | $997.2418 units |
|
| SilverScript Choice (PDP)$27.70/mo premium · $615.00 deductible | 3Preferred Brand | 19% | 19% | $58.4539 | $1,052.1718 units |
|
| HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $52.8987 | $1,005.0819 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$56.50/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $60.8125 | $1,155.4419 units |
|
| Humana Premier Rx Plan (PDP)$115.50/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $56.8626 | $1,080.3919 units |
|
| HealthSpring Assurance Rx (PDP)$128.60/mo premium · $615.00 deductible | 3Preferred Brand | 21% | 21% | $52.9342 | $1,005.7519 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$132.60/mo premium · $130.00 deductible | 3Preferred Brand | 17% | 17% | $60.8125 | $1,155.4419 units |
|
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 — elsewhere it depends on what is prescribed.
New York — 9 plans, 9 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| HealthSpring Assurance Rx (PDP)$35.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $53.0421 | $1,007.8019 units |
|
| Wellcare Value Script (PDP)$42.40/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $53.8935 | $970.0818 units |
|
| Wellcare Classic (PDP)$45.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $53.8935 | $970.0818 units |
|
| HealthSpring Extra Rx (PDP)$91.60/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $53.0160 | $1,007.3019 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$105.80/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $60.2321 | $1,144.4119 units |
|
| Humana Basic Rx Plan (PDP)$140.90/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $56.6454 | $1,076.2619 units |
|
| Humana Value Rx Plan (PDP)$158.90/mo premium · $601.00 deductible | 3Preferred Brand | 17% | 12% | $56.6454 | $1,076.2619 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$163.70/mo premium · $130.00 deductible | 3Preferred Brand | 15% | 15% | $60.2321 | $1,144.4119 units |
|
| Humana Premier Rx Plan (PDP)$173.60/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $56.6454 | $1,076.2619 units |
|
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 — elsewhere it depends on what is prescribed.
New Jersey — 9 plans, 9 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$4.40/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $56.8936 | $1,080.9819 units |
|
| Wellcare Value Script (PDP)$22.80/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $53.9652 | $971.3718 units |
|
| Wellcare Classic (PDP)$28.20/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $53.9652 | $971.3718 units |
|
| Humana Value Rx Plan (PDP)$35.60/mo premium · $601.00 deductible | 3Preferred Brand | 19% | 14% | $56.8936 | $1,080.9819 units |
|
| HealthSpring Extra Rx (PDP)$59.90/mo premium · $615.00 deductible | 3Preferred Brand | 16% | 16% | $53.2163 | $1,011.1119 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$77.40/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $60.4210 | $1,148.0019 units |
|
| HealthSpring Assurance Rx (PDP)$109.30/mo premium · $615.00 deductible | 3Preferred Brand | 20% | 20% | $53.2424 | $1,011.6119 units |
|
| Humana Premier Rx Plan (PDP)$111.90/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $56.8936 | $1,080.9819 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$118.90/mo premium · $130.00 deductible | 3Preferred Brand | 15% | 15% | $60.4210 | $1,148.0019 units |
|
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 — elsewhere it depends on what is prescribed.
Delaware, DC and Maryland — 9 plans, 9 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.0218 | $1,083.4119 units |
|
| Humana Value Rx Plan (PDP)$4.30/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.0218 | $1,083.4119 units |
|
| Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.3855 | $978.9418 units |
|
| Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.3855 | $978.9418 units |
|
| HealthSpring Assurance Rx (PDP)$32.60/mo premium · $615.00 deductible | 3Preferred Brand | 22% | 22% | $53.2418 | $1,011.5919 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$37.80/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $60.6836 | $1,152.9919 units |
|
| HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $53.2069 | $1,010.9319 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible | 3Preferred Brand | 17% | 17% | $60.6836 | $1,152.9919 units |
|
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.0218 | $1,083.4119 units |
|
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 — elsewhere it depends on what is prescribed.
North Carolina — 9 plans, 9 with restrictions
| 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% | $54.7698 | $985.8618 units |
|
| Wellcare Classic (PDP)$4.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.7698 | $985.8618 units |
|
| Humana Basic Rx Plan (PDP)$6.80/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.1496 | $1,085.8419 units |
|
| Humana Value Rx Plan (PDP)$32.00/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.1496 | $1,085.8419 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$56.90/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $60.9498 | $1,158.0519 units |
|
| HealthSpring Extra Rx (PDP)$78.00/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $53.1763 | $1,010.3519 units |
|
| HealthSpring Assurance Rx (PDP)$110.40/mo premium · $615.00 deductible | 3Preferred Brand | 22% | 22% | $53.2129 | $1,011.0519 units |
|
| Humana Premier Rx Plan (PDP)$110.90/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.1496 | $1,085.8419 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$119.80/mo premium · $130.00 deductible | 3Preferred Brand | 17% | 17% | $60.9498 | $1,158.0519 units |
|
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 — elsewhere it depends on what is prescribed.
Georgia — 9 plans, 9 with restrictions
| 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% | $55.0279 | $990.5018 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $55.0279 | $990.5018 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.2182 | $1,087.1519 units |
|
| Humana Value Rx Plan (PDP)$36.40/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.2182 | $1,087.1519 units |
|
| HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $52.6881 | $1,001.0719 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$98.00/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $60.6438 | $1,152.2319 units |
|
| Humana Premier Rx Plan (PDP)$129.50/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.2182 | $1,087.1519 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$139.80/mo premium · $130.00 deductible | 3Preferred Brand | 16% | 16% | $60.6438 | $1,152.2319 units |
|
| HealthSpring Assurance Rx (PDP)$149.30/mo premium · $615.00 deductible | 3Preferred Brand | 21% | 21% | $52.7284 | $1,001.8419 units |
|
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 — elsewhere it depends on what is prescribed.
Alabama and Tennessee — 9 plans, 9 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.0867 | $1,084.6519 units |
|
| Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $55.0270 | $990.4918 units |
|
| Wellcare Classic (PDP)$3.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $55.0270 | $990.4918 units |
|
| Humana Value Rx Plan (PDP)$37.70/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.0867 | $1,084.6519 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$63.20/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $61.0517 | $1,159.9819 units |
|
| HealthSpring Extra Rx (PDP)$77.50/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $53.3550 | $1,013.7419 units |
|
| HealthSpring Assurance Rx (PDP)$87.20/mo premium · $615.00 deductible | 3Preferred Brand | 22% | 22% | $53.3902 | $1,014.4119 units |
|
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.0867 | $1,084.6519 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$119.30/mo premium · $130.00 deductible | 3Preferred Brand | 17% | 17% | $61.0517 | $1,159.9819 units |
|
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 — elsewhere it depends on what is prescribed.
Ohio — 9 plans, 9 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.2712 | $1,088.1519 units |
|
| Wellcare Value Script (PDP)$7.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $55.4092 | $997.3718 units |
|
| Wellcare Classic (PDP)$7.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $55.4092 | $997.3718 units |
|
| Humana Value Rx Plan (PDP)$23.70/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.2712 | $1,088.1519 units |
|
| HealthSpring Extra Rx (PDP)$65.70/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $52.5743 | $998.9119 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$73.70/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $59.8693 | $1,137.5219 units |
|
| HealthSpring Assurance Rx (PDP)$109.50/mo premium · $615.00 deductible | 3Preferred Brand | 21% | 21% | $52.6211 | $999.8019 units |
|
| Humana Premier Rx Plan (PDP)$117.60/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.2712 | $1,088.1519 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$123.40/mo premium · $130.00 deductible | 3Preferred Brand | 17% | 17% | $59.8693 | $1,137.5219 units |
|
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 — elsewhere it depends on what is prescribed.
Illinois — 9 plans, 9 with restrictions
| 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% | $54.9009 | $988.2218 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.9009 | $988.2218 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.4970 | $1,092.4419 units |
|
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.4970 | $1,092.4419 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$40.20/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $61.1867 | $1,162.5519 units |
|
| HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $53.8045 | $1,022.2919 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$103.90/mo premium · $130.00 deductible | 3Preferred Brand | 17% | 17% | $61.1867 | $1,162.5519 units |
|
| HealthSpring Assurance Rx (PDP)$104.20/mo premium · $615.00 deductible | 3Preferred Brand | 21% | 21% | $53.8396 | $1,022.9519 units |
|
| Humana Premier Rx Plan (PDP)$119.40/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.4970 | $1,092.4419 units |
|
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 — elsewhere it depends on what is prescribed.
Missouri — 9 plans, 9 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.9840 | $989.7118 units |
|
| Wellcare Classic (PDP)$10.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.9840 | $989.7118 units |
|
| Humana Basic Rx Plan (PDP)$16.50/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.1929 | $1,086.6719 units |
|
| Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.1929 | $1,086.6719 units |
|
| HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $53.1011 | $1,008.9219 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$71.90/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $61.2862 | $1,164.4419 units |
|
| HealthSpring Assurance Rx (PDP)$74.30/mo premium · $615.00 deductible | 3Preferred Brand | 20% | 20% | $53.1407 | $1,009.6719 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$125.40/mo premium · $130.00 deductible | 3Preferred Brand | 17% | 17% | $61.2862 | $1,164.4419 units |
|
| Humana Premier Rx Plan (PDP)$126.40/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.1929 | $1,086.6719 units |
|
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 — elsewhere it depends on what is prescribed.
Mississippi — 9 plans, 9 with restrictions
| 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% | $55.2180 | $993.9218 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $55.2180 | $993.9218 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.0833 | $1,084.5819 units |
|
| Humana Value Rx Plan (PDP)$37.60/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.0833 | $1,084.5819 units |
|
| HealthSpring Assurance Rx (PDP)$59.70/mo premium · $615.00 deductible | 3Preferred Brand | 21% | 21% | $53.1591 | $1,010.0219 units |
|
| HealthSpring Extra Rx (PDP)$77.10/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $53.1242 | $1,009.3619 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$84.70/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $61.0440 | $1,159.8419 units |
|
| Humana Premier Rx Plan (PDP)$89.90/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.0833 | $1,084.5819 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$140.60/mo premium · $130.00 deductible | 3Preferred Brand | 16% | 16% | $61.0440 | $1,159.8419 units |
|
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 — elsewhere it depends on what is prescribed.
Texas — 9 plans, 9 with restrictions
| 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% | $54.8171 | $986.7118 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.8171 | $986.7118 units |
|
| Humana Value Rx Plan (PDP)$22.90/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.0120 | $1,083.2319 units |
|
| Humana Basic Rx Plan (PDP)$41.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.0120 | $1,083.2319 units |
|
| HealthSpring Extra Rx (PDP)$70.00/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $52.8858 | $1,004.8319 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$89.20/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $60.9662 | $1,158.3619 units |
|
| HealthSpring Assurance Rx (PDP)$111.40/mo premium · $615.00 deductible | 3Preferred Brand | 21% | 21% | $52.9294 | $1,005.6619 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $130.00 deductible | 3Preferred Brand | 18% | 18% | $60.9662 | $1,158.3619 units |
|
| Humana Premier Rx Plan (PDP)$118.20/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.0120 | $1,083.2319 units |
|
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 — elsewhere it depends on what is prescribed.
Oklahoma — 9 plans, 9 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.0774 | $1,084.4719 units |
|
| Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.9985 | $989.9718 units |
|
| Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.9985 | $989.9718 units |
|
| Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.0774 | $1,084.4719 units |
|
| HealthSpring Extra Rx (PDP)$65.40/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $53.3815 | $1,014.2519 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $61.5456 | $1,169.3719 units |
|
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.0774 | $1,084.4719 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$121.00/mo premium · $130.00 deductible | 3Preferred Brand | 16% | 16% | $61.5456 | $1,169.3719 units |
|
| HealthSpring Assurance Rx (PDP)$126.50/mo premium · $615.00 deductible | 3Preferred Brand | 20% | 20% | $53.4189 | $1,014.9619 units |
|
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 — elsewhere it depends on what is prescribed.
Colorado — 9 plans, 9 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $56.1509 | $1,010.7218 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.3155 | $1,088.9919 units |
|
| Wellcare Classic (PDP)$2.20/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $56.1509 | $1,010.7218 units |
|
| Humana Value Rx Plan (PDP)$48.50/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.3155 | $1,088.9919 units |
|
| HealthSpring Assurance Rx (PDP)$61.70/mo premium · $615.00 deductible | 3Preferred Brand | 20% | 20% | $52.7481 | $1,002.2119 units |
|
| HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $52.7015 | $1,001.3319 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$125.00/mo premium · $615.00 deductible | 3Preferred Brand | 19% | 19% | $61.1341 | $1,161.5519 units |
|
| Humana Premier Rx Plan (PDP)$137.10/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.3155 | $1,088.9919 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$151.90/mo premium · $130.00 deductible | 3Preferred Brand | 17% | 17% | $61.1341 | $1,161.5519 units |
|
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 — elsewhere it depends on what is prescribed.
Arizona — 9 plans, 9 with restrictions
| 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% | $55.5260 | $999.4718 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $55.5260 | $999.4718 units |
|
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $53.5587 | $1,017.6219 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 23% | 18% | $57.3611 | $1,089.8619 units |
|
| Humana Value Rx Plan (PDP)$2.50/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.3611 | $1,089.8619 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $60.9896 | $1,158.8019 units |
|
| HealthSpring Extra Rx (PDP)$66.40/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $53.5193 | $1,016.8719 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$97.50/mo premium · $130.00 deductible | 3Preferred Brand | 18% | 18% | $60.9896 | $1,158.8019 units |
|
| Humana Premier Rx Plan (PDP)$119.20/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.3611 | $1,089.8619 units |
|
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 — elsewhere it depends on what is prescribed.
Nevada — 9 plans, 9 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.3154 | $1,088.9919 units |
|
| Wellcare Classic (PDP)$2.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $55.3134 | $995.6418 units |
|
| Wellcare Value Script (PDP)$2.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $55.3134 | $995.6418 units |
|
| Humana Value Rx Plan (PDP)$43.70/mo premium · $601.00 deductible | 3Preferred Brand | 18% | 13% | $57.3154 | $1,088.9919 units |
|
| HealthSpring Extra Rx (PDP)$52.60/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $54.0501 | $1,026.9519 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$76.70/mo premium · $615.00 deductible | 3Preferred Brand | 19% | 19% | $61.5091 | $1,168.6719 units |
|
| HealthSpring Assurance Rx (PDP)$95.60/mo premium · $615.00 deductible | 3Preferred Brand | 20% | 20% | $54.0837 | $1,027.5919 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$139.10/mo premium · $130.00 deductible | 3Preferred Brand | 18% | 18% | $61.5091 | $1,168.6719 units |
|
| Humana Premier Rx Plan (PDP)$148.70/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.3154 | $1,088.9919 units |
|
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 — elsewhere it depends on what is prescribed.
Oregon and Washington — 9 plans, 9 with restrictions
| 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% | $55.4912 | $998.8418 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $55.4912 | $998.8418 units |
|
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 24% | 24% | $52.9403 | $1,005.8719 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.1181 | $1,085.2419 units |
|
| Humana Value Rx Plan (PDP)$22.10/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.1181 | $1,085.2419 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$38.40/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $61.0133 | $1,159.2519 units |
|
| HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible | 3Preferred Brand | 16% | 16% | $52.8961 | $1,005.0319 units |
|
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.1181 | $1,085.2419 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$110.00/mo premium · $130.00 deductible | 3Preferred Brand | 16% | 16% | $61.0133 | $1,159.2519 units |
|
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 — elsewhere it depends on what is prescribed.
California — 9 plans, 9 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $52.8782 | $1,004.6919 units |
|
| Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.2182 | $975.9318 units |
|
| Wellcare Classic (PDP)$6.20/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.2182 | $975.9318 units |
|
| HealthSpring Extra Rx (PDP)$70.60/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $52.8425 | $1,004.0119 units |
|
| Humana Value Rx Plan (PDP)$104.60/mo premium · $601.00 deductible | 3Preferred Brand | 18% | 13% | $57.0529 | $1,084.0119 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$109.40/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $60.3494 | $1,146.6419 units |
|
| Humana Basic Rx Plan (PDP)$132.20/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.0529 | $1,084.0119 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$165.40/mo premium · $130.00 deductible | 3Preferred Brand | 15% | 15% | $60.3494 | $1,146.6419 units |
|
| Humana Premier Rx Plan (PDP)$172.90/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.0529 | $1,084.0119 units |
|
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 — elsewhere it depends on what is prescribed.
Maine and New Hampshire — 8 plans, 8 with restrictions
| 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% | $55.0301 | $990.5418 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $55.0301 | $990.5418 units |
|
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $52.8543 | $1,004.2319 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.1452 | $1,085.7619 units |
|
| Humana Value Rx Plan (PDP)$54.40/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.1452 | $1,085.7619 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $60.8521 | $1,156.1919 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$104.30/mo premium · $130.00 deductible | 3Preferred Brand | 15% | 15% | $60.8521 | $1,156.1919 units |
|
| Humana Premier Rx Plan (PDP)$150.20/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.1452 | $1,085.7619 units |
|
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 — elsewhere it depends on what is prescribed.
Virginia — 8 plans, 8 with restrictions
| 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% | $54.8232 | $986.8218 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.8232 | $986.8218 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.2979 | $1,088.6619 units |
|
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.2979 | $1,088.6619 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$39.60/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $60.8381 | $1,155.9219 units |
|
| Humana Premier Rx Plan (PDP)$87.60/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.2979 | $1,088.6619 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$100.80/mo premium · $130.00 deductible | 3Preferred Brand | 17% | 17% | $60.8381 | $1,155.9219 units |
|
| HealthSpring Assurance Rx (PDP)$133.80/mo premium · $615.00 deductible | 3Preferred Brand | 22% | 22% | $52.6580 | $1,000.5019 units |
|
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 — elsewhere it depends on what is prescribed.
Kansas — 8 plans, 8 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| HealthSpring Assurance Rx (PDP)$6.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $52.9057 | $1,005.2119 units |
|
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $56.6050 | $1,018.8918 units |
|
| Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $56.6050 | $1,018.8918 units |
|
| Humana Basic Rx Plan (PDP)$15.50/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.2842 | $1,088.4019 units |
|
| Humana Value Rx Plan (PDP)$55.60/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.2842 | $1,088.4019 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$105.40/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $61.0405 | $1,159.7719 units |
|
| Humana Premier Rx Plan (PDP)$116.30/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.2842 | $1,088.4019 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$147.00/mo premium · $130.00 deductible | 3Preferred Brand | 15% | 15% | $61.0405 | $1,159.7719 units |
|
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 — elsewhere it depends on what is prescribed.
New Mexico — 8 plans, 8 with restrictions
| 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% | $55.0653 | $991.1818 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $55.0653 | $991.1818 units |
|
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $53.2894 | $1,012.5019 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.2165 | $1,087.1119 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 16% | 16% | $61.4656 | $1,167.8519 units |
|
| Humana Value Rx Plan (PDP)$69.60/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.2165 | $1,087.1119 units |
|
| Humana Premier Rx Plan (PDP)$75.60/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.2165 | $1,087.1119 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible | 3Preferred Brand | 16% | 16% | $61.4656 | $1,167.8519 units |
|
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 — elsewhere it depends on what is prescribed.
Hawaii — 8 plans, 8 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 16% | 16% | $60.1274 | $1,142.4219 units |
|
| Humana Basic Rx Plan (PDP)$0.40/mo premium · $615.00 deductible | 3Preferred Brand | 23% | 18% | $57.3237 | $1,089.1519 units |
|
| SilverScript Choice (PDP)$14.70/mo premium · $615.00 deductible | 3Preferred Brand | 19% | 19% | $58.4362 | $1,051.8518 units |
|
| Wellcare Value Script (PDP)$21.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.0749 | $973.3518 units |
|
| Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.0749 | $973.3518 units |
|
| Humana Value Rx Plan (PDP)$51.60/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.3237 | $1,089.1519 units |
|
| Humana Premier Rx Plan (PDP)$90.20/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.3237 | $1,089.1519 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible | 3Preferred Brand | 17% | 17% | $60.1274 | $1,142.4219 units |
|
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 — elsewhere it depends on what is prescribed.
Alaska — 8 plans, 8 with restrictions
| 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% | $56.0432 | $1,008.7818 units |
|
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $52.2103 | $992.0019 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 24% | 19% | $57.2315 | $1,087.4019 units |
|
| Humana Value Rx Plan (PDP)$10.60/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.2315 | $1,087.4019 units |
|
| Wellcare Value Script (PDP)$19.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $56.0432 | $1,008.7818 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$53.20/mo premium · $615.00 deductible | 3Preferred Brand | 19% | 19% | $60.8191 | $1,155.5619 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$100.20/mo premium · $130.00 deductible | 3Preferred Brand | 18% | 18% | $60.8191 | $1,155.5619 units |
|
| Humana Premier Rx Plan (PDP)$112.40/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.2315 | $1,087.4019 units |
|
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 — elsewhere it depends on what is prescribed.
Florida — 7 plans, 7 with restrictions
| 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% | $54.4794 | $980.6318 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $54.4794 | $980.6318 units |
|
| Humana Value Rx Plan (PDP)$25.90/mo premium · $601.00 deductible | 3Preferred Brand | 20% | 15% | $57.2427 | $1,087.6119 units |
|
| Humana Basic Rx Plan (PDP)$92.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 20% | $57.2427 | $1,087.6119 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$98.70/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $60.7361 | $1,153.9919 units |
|
| Humana Premier Rx Plan (PDP)$115.90/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $57.2427 | $1,087.6119 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$119.10/mo premium · $130.00 deductible | 3Preferred Brand | 17% | 17% | $60.7361 | $1,153.9919 units |
|
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 — elsewhere it depends on what is prescribed.
Puerto Rico — 3 plans, 3 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $54.5193 | $1,035.8719 units |
|
| HealthSpring Assurance Rx (PDP)$65.70/mo premium · $615.00 deductible | 3Preferred Brand | 22% | 22% | $54.5277 | $1,036.0319 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$145.10/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $60.0692 | $1,141.3119 units |
|
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 — elsewhere it depends on what is prescribed.
American Samoa — 1 plan, 1 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $62.0261 | $1,178.5019 units |
|
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 — elsewhere it depends on what is prescribed.
Guam — 1 plan, 1 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $62.0261 | $1,178.5019 units |
|
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 — elsewhere it depends on what is prescribed.
Northern Mariana Islands — 1 plan, 1 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP)$32.10/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $62.0261 | $1,178.5019 units |
|
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 — elsewhere it depends on what is prescribed.
U.S. Virgin Islands — 1 plan, 1 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $71.9103 | $1,366.3019 units |
|
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 — elsewhere it depends on what is prescribed.