SOLIQUA 100/33 100/33 U/mL/ug/mL Injection, Solution

Also known as Insulin Glargine And Lixisenatide. Coverage in Arkansas (CMS PDP Region 19).

11 of 12 stand-alone Part D plans in Arkansas cover this drug on tier 3.

Lowest 30-day cost $45.00 at a preferred pharmacy. 11 of 11 plans apply a prior authorization, step therapy or quantity limit.

77 Medicare Advantage plans in AR 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. AR: 77 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%	$54.7813	$986.0618 units	Quantity limit 15 per 25 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible	3Preferred Brand	25%	25%	$54.7813	$986.0618 units	Quantity limit 15 per 25 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible	3Preferred Brand	25%	25%	$53.0169	$1,007.3219 units	Quantity limit 15 per 24 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible	3Preferred Brand	25%	20%	$56.8367	$1,079.9019 units	Quantity limit 15 per 24 days
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible	3Preferred Brand	20%	15%	$56.8367	$1,079.9019 units	Quantity limit 15 per 24 days
BlueMedicare Value Rx (PDP)$52.50/mo premium · $615.00 deductible	3Preferred Brand	19%	19%	$57.7034	$1,038.6618 units	Quantity limit 15 per 25 days
HealthSpring Extra Rx (PDP)$54.50/mo premium · $615.00 deductible	3Preferred Brand	17%	17%	$52.9828	$1,006.6719 units	Quantity limit 15 per 24 days
AARP Medicare Rx Saver from UHC (PDP)$65.10/mo premium · $615.00 deductible	3Preferred Brand	18%	18%	$61.2624	$1,163.9919 units	Quantity limit 15 per 24 days
Humana Premier Rx Plan (PDP)$92.40/mo premium · $0.00 deductible	3Preferred Brand	$45.00	$125.00	$56.8367	$1,079.9019 units	Quantity limit 15 per 24 days
AARP Medicare Rx Preferred from UHC (PDP)$114.90/mo premium · $130.00 deductible	3Preferred Brand	16%	16%	$61.2624	$1,163.9919 units	Quantity limit 15 per 24 days
BlueMedicare Premier Rx (PDP)$181.20/mo premium · $0.00 deductible	3Preferred Brand	20%	20%	$57.7034	$1,038.6618 units	Quantity limit 15 per 25 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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