MedicarePartD.guide

A non-government resource built from CMS public data

DIGOXIN .05 mg/mL Solution

Package: 60 mL in 1 BOTTLE (0054-0057-46). NDC 00054005746.

Plans covering it
263
across 39 regions checked
Lowest tier
2
lower tiers cost less
Plans with restrictions
22
prior auth, step therapy or quantity limit

Medicare Advantage plans in your county

Medicare Advantage drug plans in 50 states list this drug on their own formularies. Enter a ZIP code or choose a state to see every plan in a county, with its tier, cost-sharing and restrictions.

Coverage by region

Covered by at least one plan in 39 of 39 CMS regions.

RegionPlans coveringTiersLowest 30-day costRestrictions
New Jersey9 of 122–4$7.002 of 9 plans
Pennsylvania and West Virginia9 of 123–4—2 of 9 plans
North Carolina9 of 122–4$7.002 of 9 plans
Alabama and Tennessee9 of 122–4$7.002 of 9 plans
Michigan9 of 122–4$7.00none
Illinois9 of 122–4$7.002 of 9 plans
Arkansas9 of 122–4$7.00none
Texas9 of 122–4$7.002 of 9 plans
Kansas9 of 122–4$7.003 of 9 plans
Connecticut, Massachusetts, Rhode Island and Vermont8 of 113–4—none
South Carolina8 of 112–4$7.00none
Oklahoma8 of 113–4—2 of 8 plans
Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming8 of 113–4—1 of 8 plans
New Mexico8 of 112–4$7.002 of 8 plans
New York7 of 102–4$6.00none
Delaware, DC and Maryland7 of 102–4$7.00none
Georgia7 of 102–4$7.00none
Florida7 of 102–4$7.002 of 7 plans
Ohio7 of 102–4$7.00none
Indiana and Kentucky7 of 103–4—none
Wisconsin7 of 103–4—none
Missouri7 of 102–4$7.00none
Mississippi7 of 102–4$7.00none
Louisiana7 of 103–4—none
Colorado7 of 102–4$7.00none
Arizona7 of 102–4$7.00none
Nevada7 of 102–4$7.00none
Oregon and Washington7 of 102–4$7.00none
Idaho and Utah7 of 103–4—none
California7 of 122–4$7.00none
Maine and New Hampshire6 of 92–4$7.00none
Virginia6 of 92–4$7.00none
Alaska6 of 92–4$7.00none
Hawaii5 of 83–4—none
Puerto Rico3 of 33–4—none
American Samoa1 of 14—none
Guam1 of 14—none
Northern Mariana Islands1 of 14—none
U.S. Virgin Islands1 of 14—none

Plan-by-plan detail

Open a region to see every plan that covers this drug, with tier, cost-sharing and restrictions.

New Jersey — 9 plans, 2 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 9 of 9 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$22.80/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$2.1383—None
Wellcare Classic (PDP)$28.20/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug29%29%$2.1472—None
HealthSpring Extra Rx (PDP)$59.90/mo premium · $615.00 deductible3Preferred Brand16%16%$1.5389—None
Horizon Medicare Blue Rx Standard (PDP)$72.30/mo premium · $615.00 deductible4Non-Preferred Drug45%45%$2.5429$38.1415 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$77.40/mo premium · $615.00 deductible4Non-Preferred Drug36%—$1.8350—None
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible2Generic$7.00$21.00$0.9993—None
HealthSpring Assurance Rx (PDP)$109.30/mo premium · $615.00 deductible4Non-Preferred Drug27%27%$1.2633—None
AARP Medicare Rx Preferred from UHC (PDP)$118.90/mo premium · $130.00 deductible4Non-Preferred Drug33%—$1.8907—None
Horizon Medicare Blue Rx Enhanced (PDP)$139.10/mo premium · $200.00 deductible4Non-Preferred Drug45%45%$2.5429$38.1415 units
  • Quantity limit 15 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 — elsewhere it depends on what is prescribed.

Pennsylvania and West Virginia — 9 plans, 2 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 9 of 9 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$8.20/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$1.4664—None
Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug28%28%$1.4684—None
SilverScript Choice (PDP)$22.70/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand19%19%$1.0354—None
AARP Medicare Rx Saver from UHC (PDP)$43.50/mo premium · $615.00 deductible4Non-Preferred Drug41%—$1.6317—None
HealthSpring Extra Rx (PDP)$62.60/mo premium · $615.00 deductible3Preferred Brand17%17%$1.2611—None
HealthSpring Assurance Rx (PDP)$74.00/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$1.1998—None
AARP Medicare Rx Preferred from UHC (PDP)$121.90/mo premium · $130.00 deductible4Non-Preferred Drug33%—$1.6466—None
Blue Rx PDP Complete (PDP)$164.80/mo premium · $200.00 deductible3Preferred Brand25%25%$1.3537$203.05150 units
  • Quantity limit 155 per 31 days
Blue Rx PDP Plus (PDP)$193.20/mo premium · $615.00 deductible3Preferred Brand25%25%$1.3573$203.59150 units
  • Quantity limit 155 per 31 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 — elsewhere it depends on what is prescribed.

North Carolina — 9 plans, 2 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 9 of 9 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$2.2400—None
Wellcare Classic (PDP)$4.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug27%27%$2.2400—None
AARP Medicare Rx Saver from UHC (PDP)$56.90/mo premium · $615.00 deductible4Non-Preferred Drug34%—$1.4072—None
HealthSpring Extra Rx (PDP)$78.00/mo premium · $615.00 deductible3Preferred Brand17%17%$2.1700—None
Blue Medicare Rx Standard (PDP)$83.90/mo premium · $615.00 deductible4Non-Preferred Drug32%32%$2.4911$37.3715 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$90.20/mo premium · $615.00 deductible2Generic$7.00$21.00$1.0970—None
HealthSpring Assurance Rx (PDP)$110.40/mo premium · $615.00 deductible4Non-Preferred Drug32%32%$2.1700—None
AARP Medicare Rx Preferred from UHC (PDP)$119.80/mo premium · $130.00 deductible4Non-Preferred Drug33%—$1.7590—None
Blue Medicare Rx Enhanced (PDP)$163.20/mo premium · $0.00 deductible4Non-Preferred Drug40%40%$2.4911$37.3715 units
  • Quantity limit 15 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 — elsewhere it depends on what is prescribed.

Alabama and Tennessee — 9 plans, 2 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 9 of 9 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$2.0891—None
Wellcare Classic (PDP)$3.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug27%27%$2.0942—None
AARP Medicare Rx Saver from UHC (PDP)$63.20/mo premium · $615.00 deductible4Non-Preferred Drug35%—$1.5690—None
BlueRx Essential (PDP)$76.20/mo premium · $615.00 deductible4Non-Preferred Drug41%41%$2.4649$36.9715 units
  • Quantity limit 15 per 30 days
HealthSpring Extra Rx (PDP)$77.50/mo premium · $615.00 deductible3Preferred Brand17%17%$1.7305—None
HealthSpring Assurance Rx (PDP)$87.20/mo premium · $615.00 deductible4Non-Preferred Drug32%32%$1.5711—None
SilverScript Choice (PDP)$97.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.5948—None
AARP Medicare Rx Preferred from UHC (PDP)$119.30/mo premium · $130.00 deductible4Non-Preferred Drug34%—$1.6798—None
BlueRx Enhanced Plus (PDP)$129.50/mo premium · $150.00 deductible4Non-Preferred Drug42%42%$2.4649$36.9715 units
  • Quantity limit 15 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 — elsewhere it depends on what is prescribed.

Michigan — 9 plans
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 9 of 9 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug28%28%$1.6791—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$1.6785—None
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug30%30%$1.5131—None
AARP Medicare Rx Saver from UHC (PDP)$14.10/mo premium · $615.00 deductible4Non-Preferred Drug33%—$1.4297—None
HealthSpring Extra Rx (PDP)$50.40/mo premium · $615.00 deductible3Preferred Brand17%17%$1.5571—None
SilverScript Choice (PDP)$78.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.7168—None
AARP Medicare Rx Preferred from UHC (PDP)$78.30/mo premium · $130.00 deductible4Non-Preferred Drug32%—$1.6541—None
Prescription Blue Select (PDP)$78.40/mo premium · $615.00 deductible3Preferred Brand20%20%$1.9142—None
Prescription Blue Premium (PDP)$106.70/mo premium · $0.00 deductible3Preferred Brand24%24%$1.9142—None

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, 2 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 9 of 9 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug31%31%$2.1911—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$2.1893—None
AARP Medicare Rx Saver from UHC (PDP)$40.20/mo premium · $615.00 deductible4Non-Preferred Drug39%—$1.6646—None
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible3Preferred Brand17%17%$2.0214—None
Blue Cross MedicareRx Basic (PDP)$89.70/mo premium · $615.00 deductible4Non-Preferred Drug43%43%$2.5172$37.7615 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible2Generic$7.00$21.00$0.4699—None
AARP Medicare Rx Preferred from UHC (PDP)$103.90/mo premium · $130.00 deductible4Non-Preferred Drug38%—$1.7948—None
HealthSpring Assurance Rx (PDP)$104.20/mo premium · $615.00 deductible4Non-Preferred Drug32%32%$1.9564—None
Blue Cross MedicareRx Value (PDP)$119.70/mo premium · $615.00 deductible4Non-Preferred Drug32%32%$2.5071$37.6115 units
  • Quantity limit 15 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 — elsewhere it depends on what is prescribed.

Arkansas — 9 plans
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 9 of 9 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug26%26%$2.2400—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$2.2400—None
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug29%29%$2.1700—None
BlueMedicare Value Rx (PDP)$52.50/mo premium · $615.00 deductible4Non-Preferred Drug34%34%$0.9610—None
HealthSpring Extra Rx (PDP)$54.50/mo premium · $615.00 deductible3Preferred Brand17%17%$2.1700—None
AARP Medicare Rx Saver from UHC (PDP)$65.10/mo premium · $615.00 deductible4Non-Preferred Drug32%—$1.4072—None
SilverScript Choice (PDP)$73.50/mo premium · $615.00 deductible2Generic$7.00$21.00$1.0148—None
AARP Medicare Rx Preferred from UHC (PDP)$114.90/mo premium · $130.00 deductible4Non-Preferred Drug29%—$1.7590—None
BlueMedicare Premier Rx (PDP)$181.20/mo premium · $0.00 deductible4Non-Preferred Drug34%34%$0.9610—None

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, 2 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 9 of 9 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug29%29%$1.5775—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$1.5773—None
HealthSpring Extra Rx (PDP)$70.00/mo premium · $615.00 deductible3Preferred Brand17%17%$1.5166—None
AARP Medicare Rx Saver from UHC (PDP)$89.20/mo premium · $615.00 deductible4Non-Preferred Drug38%—$1.5433—None
SilverScript Choice (PDP)$94.80/mo premium · $615.00 deductible2Generic$7.00$21.00$0.6591—None
Blue Cross MedicareRx Basic (PDP)$104.70/mo premium · $615.00 deductible4Non-Preferred Drug42%42%$2.3913$35.8715 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$111.40/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$1.4763—None
AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $130.00 deductible4Non-Preferred Drug35%—$1.5853—None
Blue Cross MedicareRx Value (PDP)$167.40/mo premium · $615.00 deductible4Non-Preferred Drug32%32%$2.3819$35.7315 units
  • Quantity limit 15 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 — elsewhere it depends on what is prescribed.

Kansas — 9 plans, 3 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 9 of 9 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Blue MedicareRx Essentials (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug30%30%$2.4069$36.1015 units
  • Quantity limit 15 per 30 days
Blue MedicareRx Value (PDP)$0.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$2.3679$35.5215 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$6.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug31%31%$1.0000—None
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$1.2100—None
Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug26%26%$1.2100—None
Blue MedicareRx Plus (PDP)$67.40/mo premium · $0.00 deductible4Non-Preferred Drug40%40%$2.3679$35.5215 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$88.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.8941—None
AARP Medicare Rx Saver from UHC (PDP)$105.40/mo premium · $615.00 deductible4Non-Preferred Drug38%—$1.4419—None
AARP Medicare Rx Preferred from UHC (PDP)$147.00/mo premium · $130.00 deductible4Non-Preferred Drug38%—$1.6015—None

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 — 8 plans
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 8 of 8 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$16.40/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$1.9361—None
Blue MedicareRx Value Plus (PDP)$20.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug32%32%$1.1709—None
Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug29%29%$1.9374—None
SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand19%19%$1.2010—None
AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible4Non-Preferred Drug35%—$1.6362—None
HealthSpring Assurance Rx (PDP)$139.30/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$1.7581—None
AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible4Non-Preferred Drug30%—$1.7650—None
Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible4Non-Preferred Drug35%35%$1.1709—None

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 — 8 plans
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 8 of 8 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$4.80/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$2.1908—None
Wellcare Classic (PDP)$9.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug27%27%$2.1992—None
HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible3Preferred Brand17%17%$1.6267—None
SilverScript Choice (PDP)$98.40/mo premium · $615.00 deductible2Generic$7.00$21.00$0.3544—None
AARP Medicare Rx Saver from UHC (PDP)$122.10/mo premium · $615.00 deductible4Non-Preferred Drug36%—$1.7004—None
AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible4Non-Preferred Drug35%—$1.7590—None
BlueCross Rx Value (PDP)$139.70/mo premium · $615.00 deductible4Non-Preferred Drug50%50%$1.5102—None
HealthSpring Assurance Rx (PDP)$152.50/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$1.3458—None

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 — 8 plans, 2 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 8 of 8 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Blue Cross MedicareRx Basic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$2.6040$39.0615 units
  • Quantity limit 15 per 30 days
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$1.5340—None
Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug26%26%$1.5340—None
HealthSpring Extra Rx (PDP)$65.40/mo premium · $615.00 deductible3Preferred Brand17%17%$1.4712—None
AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible4Non-Preferred Drug41%—$1.5581—None
AARP Medicare Rx Preferred from UHC (PDP)$121.00/mo premium · $130.00 deductible4Non-Preferred Drug40%—$1.6355—None
HealthSpring Assurance Rx (PDP)$126.50/mo premium · $615.00 deductible4Non-Preferred Drug29%29%$1.4803—None
Blue Cross MedicareRx Value (PDP)$167.30/mo premium · $615.00 deductible4Non-Preferred Drug32%32%$2.6040$39.0615 units
  • Quantity limit 15 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 — elsewhere it depends on what is prescribed.

Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming — 8 plans, 1 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 8 of 8 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Saver from UHC (PDP)$5.30/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug35%—$1.7114—None
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$2.0877—None
Wellcare Classic (PDP)$12.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug27%27%$2.0944—None
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand19%19%$0.8736—None
HealthSpring Extra Rx (PDP)$66.50/mo premium · $615.00 deductible3Preferred Brand17%17%$1.4182—None
MedicareBlue Rx Standard (PDP)$101.00/mo premium · $615.00 deductible4Non-Preferred Drug42%42%$2.3621$35.4315 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$125.90/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$1.2007—None
AARP Medicare Rx Preferred from UHC (PDP)$140.20/mo premium · $130.00 deductible4Non-Preferred Drug34%—$1.6683—None

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, 2 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 8 of 8 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug31%31%$1.5340—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$1.5340—None
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug29%29%$1.4803—None
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug43%—$1.5581—None
AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible4Non-Preferred Drug35%—$1.6355—None
SilverScript Choice (PDP)$104.00/mo premium · $615.00 deductible2Generic$7.00$21.00$1.4004—None
Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible4Non-Preferred Drug33%33%$2.4126$36.1915 units
  • Quantity limit 15 per 30 days
Blue Cross MedicareRx Basic (PDP)$145.40/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$2.4372$36.5615 units
  • Quantity limit 15 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 — elsewhere it depends on what is prescribed.

New York — 7 plans
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 7 of 7 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$35.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug29%29%$1.4945—None
Wellcare Value Script (PDP)$42.40/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$1.9168—None
Wellcare Classic (PDP)$45.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug28%28%$1.9209—None
HealthSpring Extra Rx (PDP)$91.60/mo premium · $615.00 deductible3Preferred Brand17%17%$1.6210—None
AARP Medicare Rx Saver from UHC (PDP)$105.80/mo premium · $615.00 deductible4Non-Preferred Drug38%—$1.6484—None
SilverScript Choice (PDP)$116.00/mo premium · $615.00 deductible2Generic$6.00$18.00$0.8132—None
AARP Medicare Rx Preferred from UHC (PDP)$163.70/mo premium · $130.00 deductible4Non-Preferred Drug28%—$1.7786—None

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 — 7 plans
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 7 of 7 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$2.0484—None
Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug31%31%$2.0567—None
HealthSpring Assurance Rx (PDP)$32.60/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$1.2335—None
AARP Medicare Rx Saver from UHC (PDP)$37.80/mo premium · $615.00 deductible4Non-Preferred Drug36%—$1.7120—None
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible3Preferred Brand17%17%$1.4913—None
AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible4Non-Preferred Drug34%—$1.6852—None
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible2Generic$7.00$21.00$0.4845—None

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 — 7 plans
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 7 of 7 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug28%28%$2.0921—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$2.0914—None
HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible3Preferred Brand17%17%$2.1064—None
AARP Medicare Rx Saver from UHC (PDP)$98.00/mo premium · $615.00 deductible4Non-Preferred Drug35%—$1.4323—None
SilverScript Choice (PDP)$100.70/mo premium · $615.00 deductible2Generic$7.00$21.00$0.9127—None
AARP Medicare Rx Preferred from UHC (PDP)$139.80/mo premium · $130.00 deductible4Non-Preferred Drug36%—$1.6797—None
HealthSpring Assurance Rx (PDP)$149.30/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$2.0650—None

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, 2 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 7 of 7 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug28%28%$1.6109—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$1.6094—None
SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.7906—None
BlueMedicare Premier Rx (PDP)$98.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$2.4944$37.4215 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$98.70/mo premium · $615.00 deductible4Non-Preferred Drug35%—$1.6471—None
AARP Medicare Rx Preferred from UHC (PDP)$119.10/mo premium · $130.00 deductible4Non-Preferred Drug34%—$1.5768—None
BlueMedicare Complete Rx (PDP)$217.00/mo premium · $615.00 deductible4Non-Preferred Drug29%29%$2.4944$37.4215 units
  • Quantity limit 15 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 — elsewhere it depends on what is prescribed.

Ohio — 7 plans
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 7 of 7 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$7.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$1.5177—None
Wellcare Classic (PDP)$7.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug27%27%$1.5177—None
HealthSpring Extra Rx (PDP)$65.70/mo premium · $615.00 deductible3Preferred Brand17%17%$1.3963—None
AARP Medicare Rx Saver from UHC (PDP)$73.70/mo premium · $615.00 deductible4Non-Preferred Drug32%—$1.4182—None
SilverScript Choice (PDP)$90.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.6109—None
HealthSpring Assurance Rx (PDP)$109.50/mo premium · $615.00 deductible4Non-Preferred Drug33%33%$1.3830—None
AARP Medicare Rx Preferred from UHC (PDP)$123.40/mo premium · $130.00 deductible4Non-Preferred Drug36%—$1.5869—None

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 — 7 plans
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 7 of 7 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$8.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$1.8249—None
Wellcare Classic (PDP)$8.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug27%27%$1.8251—None
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand19%19%$1.0688—None
HealthSpring Extra Rx (PDP)$78.20/mo premium · $615.00 deductible3Preferred Brand17%17%$1.8162—None
AARP Medicare Rx Saver from UHC (PDP)$90.30/mo premium · $615.00 deductible4Non-Preferred Drug42%—$1.4148—None
HealthSpring Assurance Rx (PDP)$117.80/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$1.6893—None
AARP Medicare Rx Preferred from UHC (PDP)$127.10/mo premium · $130.00 deductible4Non-Preferred Drug34%—$1.6371—None

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 — 7 plans
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 7 of 7 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug26%26%$1.6553—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$1.6553—None
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug30%30%$1.6241—None
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug33%—$1.4950—None
SilverScript Choice (PDP)$26.70/mo premium · $615.00 deductible3Preferred Brand19%19%$1.1379—None
HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible3Preferred Brand17%17%$1.6241—None
AARP Medicare Rx Preferred from UHC (PDP)$113.90/mo premium · $130.00 deductible4Non-Preferred Drug36%—$1.6931—None

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 — 7 plans
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 7 of 7 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$1.9500—None
Wellcare Classic (PDP)$10.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug26%26%$1.9500—None
HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible3Preferred Brand17%17%$2.0500—None
AARP Medicare Rx Saver from UHC (PDP)$71.90/mo premium · $615.00 deductible4Non-Preferred Drug39%—$1.4072—None
HealthSpring Assurance Rx (PDP)$74.30/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$2.0500—None
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible2Generic$7.00$21.00$0.8985—None
AARP Medicare Rx Preferred from UHC (PDP)$125.40/mo premium · $130.00 deductible4Non-Preferred Drug35%—$1.5800—None

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 — 7 plans
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 7 of 7 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug29%29%$1.5842—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$1.5813—None
HealthSpring Assurance Rx (PDP)$59.70/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$1.2037—None
HealthSpring Extra Rx (PDP)$77.10/mo premium · $615.00 deductible3Preferred Brand17%17%$1.2947—None
AARP Medicare Rx Saver from UHC (PDP)$84.70/mo premium · $615.00 deductible4Non-Preferred Drug37%—$1.4894—None
SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.9307—None
AARP Medicare Rx Preferred from UHC (PDP)$140.60/mo premium · $130.00 deductible4Non-Preferred Drug34%—$1.6279—None

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 — 7 plans
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 7 of 7 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$2.1900—None
Wellcare Classic (PDP)$6.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug28%28%$2.1900—None
AARP Medicare Rx Saver from UHC (PDP)$37.00/mo premium · $615.00 deductible4Non-Preferred Drug40%—$1.4072—None
SilverScript Choice (PDP)$44.70/mo premium · $615.00 deductible3Preferred Brand19%19%$0.8698—None
HealthSpring Assurance Rx (PDP)$48.40/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$2.2400—None
HealthSpring Extra Rx (PDP)$60.60/mo premium · $615.00 deductible3Preferred Brand17%17%$2.2400—None
AARP Medicare Rx Preferred from UHC (PDP)$139.50/mo premium · $130.00 deductible4Non-Preferred Drug36%—$1.4072—None

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 — 7 plans
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 7 of 7 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$2.0768—None
Wellcare Classic (PDP)$2.20/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug29%29%$2.0768—None
HealthSpring Assurance Rx (PDP)$61.70/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$1.8843—None
HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible3Preferred Brand17%17%$2.0853—None
SilverScript Choice (PDP)$105.10/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2556—None
AARP Medicare Rx Saver from UHC (PDP)$125.00/mo premium · $615.00 deductible4Non-Preferred Drug33%—$1.4072—None
AARP Medicare Rx Preferred from UHC (PDP)$151.90/mo premium · $130.00 deductible4Non-Preferred Drug37%—$1.6834—None

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 — 7 plans
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 7 of 7 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug32%32%$1.5340—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$1.5340—None
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug29%29%$1.4803—None
AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible4Non-Preferred Drug36%—$1.5581—None
HealthSpring Extra Rx (PDP)$66.40/mo premium · $615.00 deductible3Preferred Brand17%17%$1.4712—None
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible2Generic$7.00$21.00$1.4004—None
AARP Medicare Rx Preferred from UHC (PDP)$97.50/mo premium · $130.00 deductible4Non-Preferred Drug35%—$1.6355—None

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 — 7 plans
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 7 of 7 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$2.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug31%31%$1.5000—None
Wellcare Value Script (PDP)$2.70/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$1.5000—None
HealthSpring Extra Rx (PDP)$52.60/mo premium · $615.00 deductible3Preferred Brand17%17%$1.5000—None
AARP Medicare Rx Saver from UHC (PDP)$76.70/mo premium · $615.00 deductible4Non-Preferred Drug34%—$1.8293—None
HealthSpring Assurance Rx (PDP)$95.60/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$1.5000—None
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible2Generic$7.00$21.00$0.6712—None
AARP Medicare Rx Preferred from UHC (PDP)$139.10/mo premium · $130.00 deductible4Non-Preferred Drug36%—$1.4072—None

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 — 7 plans
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 7 of 7 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug28%28%$2.1500—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$2.1500—None
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug30%30%$1.8800—None
AARP Medicare Rx Saver from UHC (PDP)$38.40/mo premium · $615.00 deductible4Non-Preferred Drug36%—$1.7300—None
HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible3Preferred Brand16%16%$2.1500—None
SilverScript Choice (PDP)$85.90/mo premium · $615.00 deductible2Generic$7.00$21.00$1.2036—None
AARP Medicare Rx Preferred from UHC (PDP)$110.00/mo premium · $130.00 deductible4Non-Preferred Drug37%—$1.8607—None

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 — 7 plans
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 7 of 7 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$2.1900—None
Wellcare Classic (PDP)$23.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug27%27%$2.1900—None
SilverScript Choice (PDP)$27.70/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand19%19%$0.8919—None
HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible3Preferred Brand17%17%$2.2400—None
AARP Medicare Rx Saver from UHC (PDP)$56.50/mo premium · $615.00 deductible4Non-Preferred Drug35%—$1.7779—None
HealthSpring Assurance Rx (PDP)$128.60/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$2.2400—None
AARP Medicare Rx Preferred from UHC (PDP)$132.60/mo premium · $130.00 deductible4Non-Preferred Drug36%—$1.5135—None

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 — 7 plans
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 7 of 7 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug29%29%$1.2687—None
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$1.9204—None
Wellcare Classic (PDP)$6.20/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug31%31%$1.9268—None
HealthSpring Extra Rx (PDP)$70.60/mo premium · $615.00 deductible3Preferred Brand17%17%$1.4681—None
SilverScript Choice (PDP)$103.60/mo premium · $615.00 deductible2Generic$7.00$21.00$0.9255—None
AARP Medicare Rx Saver from UHC (PDP)$109.40/mo premium · $615.00 deductible4Non-Preferred Drug38%—$1.7027—None
AARP Medicare Rx Preferred from UHC (PDP)$165.40/mo premium · $130.00 deductible4Non-Preferred Drug31%—$1.7779—None

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 — 6 plans
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 6 of 6 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug27%27%$1.3700—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$1.3700—None
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug30%30%$1.3700—None
AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible4Non-Preferred Drug36%—$1.8293—None
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1990—None
AARP Medicare Rx Preferred from UHC (PDP)$104.30/mo premium · $130.00 deductible4Non-Preferred Drug30%—$1.4072—None

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 — 6 plans
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 6 of 6 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug31%31%$1.6400—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$1.6380—None
AARP Medicare Rx Saver from UHC (PDP)$39.60/mo premium · $615.00 deductible4Non-Preferred Drug34%—$1.8152—None
SilverScript Choice (PDP)$78.20/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1990—None
AARP Medicare Rx Preferred from UHC (PDP)$100.80/mo premium · $130.00 deductible4Non-Preferred Drug35%—$1.4776—None
HealthSpring Assurance Rx (PDP)$133.80/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$1.4420—None

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 — 6 plans
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 6 of 6 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug28%28%$1.5340—None
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug29%29%$1.4803—None
Wellcare Value Script (PDP)$19.70/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$1.5340—None
AARP Medicare Rx Saver from UHC (PDP)$53.20/mo premium · $615.00 deductible4Non-Preferred Drug33%—$1.5581—None
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible2Generic$7.00$21.00$1.4004—None
AARP Medicare Rx Preferred from UHC (PDP)$100.20/mo premium · $130.00 deductible4Non-Preferred Drug35%—$1.6355—None

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 — 5 plans
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 5 of 5 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug38%—$1.4072—None
SilverScript Choice (PDP)$14.70/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand19%19%$1.6156—None
Wellcare Value Script (PDP)$21.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$2.0600—None
Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug35%35%$2.0600—None
AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible4Non-Preferred Drug34%—$1.5739—None

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
Prior authorization
Step therapy
Quantity limit
Tier

Showing 3 of 3 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible3Preferred Brand17%17%$1.4712—None
HealthSpring Assurance Rx (PDP)$65.70/mo premium · $615.00 deductible4Non-Preferred Drug34%34%$1.4803—None
AARP Medicare Rx Preferred from UHC (PDP)$145.10/mo premium · $615.00 deductible4Non-Preferred Drug25%25%$1.6596—None

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
Prior authorization
Step therapy
Quantity limit
Extra Help (LIS)

Showing 1 of 1 plan

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug25%25%$1.6596—None

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
Prior authorization
Step therapy
Quantity limit
Extra Help (LIS)

Showing 1 of 1 plan

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug25%25%$1.6596—None

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
Prior authorization
Step therapy
Quantity limit

Showing 1 of 1 plan

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$32.10/mo premium · $615.00 deductible4Non-Preferred Drug25%25%$1.6596—None

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
Prior authorization
Step therapy
Quantity limit

Showing 1 of 1 plan

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $615.00 deductible4Non-Preferred Drug25%25%$1.6596—None

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.