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

Also known as Insulin Glargine And Lixisenatide. Coverage in Idaho and Utah (CMS PDP Region 31).

10 of 10 stand-alone Part D plans in Idaho and Utah cover this drug on tier 3.

Lowest 30-day cost $45.00 at a preferred pharmacy. 10 of 10 plans apply a prior authorization, step therapy or quantity limit.

86 Medicare Advantage plans in ID, UT 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. ID: 39 plans · UT: 47 plans.

Every plan that covers it

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	Quantity limit 15 per 24 days
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible	3Preferred Brand	25%	25%	$55.4023	$997.2418 units	Quantity limit 15 per 25 days
Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible	3Preferred Brand	20%	15%	$56.8626	$1,080.3919 units	Quantity limit 15 per 24 days
Wellcare Classic (PDP)$23.70/mo premium · $615.00 deductible	3Preferred Brand	25%	25%	$55.4023	$997.2418 units	Quantity limit 15 per 25 days
SilverScript Choice (PDP)$27.70/mo premium · $615.00 deductible	3Preferred Brand	19%	19%	$58.4539	$1,052.1718 units	Quantity limit 15 per 25 days
HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible	3Preferred Brand	17%	17%	$52.8987	$1,005.0819 units	Quantity limit 15 per 24 days
AARP Medicare Rx Saver from UHC (PDP)$56.50/mo premium · $615.00 deductible	3Preferred Brand	17%	17%	$60.8125	$1,155.4419 units	Quantity limit 15 per 24 days
Humana Premier Rx Plan (PDP)$115.50/mo premium · $0.00 deductible	3Preferred Brand	$45.00	$125.00	$56.8626	$1,080.3919 units	Quantity limit 15 per 24 days
HealthSpring Assurance Rx (PDP)$128.60/mo premium · $615.00 deductible	3Preferred Brand	21%	21%	$52.9342	$1,005.7519 units	Quantity limit 15 per 24 days
AARP Medicare Rx Preferred from UHC (PDP)$132.60/mo premium · $130.00 deductible	3Preferred Brand	17%	17%	$60.8125	$1,155.4419 units	Quantity limit 15 per 24 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.

See coverage in all 39 regions →