MedicarePartD.guide

A non-government resource built from CMS public data

ACARBOSE 100 mg Tablet

Package: 100 TABLET in 1 BOTTLE (0054-0142-25). NDC 00054014225.

Plans covering it
367
across 39 regions checked
Lowest tier
1
lower tiers cost less
Plans with restrictions
256
prior auth, step therapy or quantity limit

Coverage by region

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

RegionPlans coveringTiersLowest 30-day costRestrictions
New Jersey12 of 121–3$0.009 of 12 plans
Pennsylvania and West Virginia12 of 121–3$0.009 of 12 plans
North Carolina12 of 121–3$0.009 of 12 plans
Alabama and Tennessee12 of 121–3$0.009 of 12 plans
Michigan12 of 121–3$0.007 of 12 plans
Illinois12 of 121–3$0.009 of 12 plans
Arkansas12 of 121–3$0.007 of 12 plans
Texas12 of 121–3$0.009 of 12 plans
Kansas12 of 121–3$0.009 of 12 plans
California12 of 121–3$0.007 of 12 plans
Connecticut, Massachusetts, Rhode Island and Vermont11 of 111–3$0.006 of 11 plans
South Carolina11 of 111–3$0.007 of 11 plans
Oklahoma11 of 111–3$0.008 of 11 plans
Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming11 of 111–3$0.008 of 11 plans
New Mexico11 of 111–3$0.008 of 11 plans
New York10 of 101–3$0.007 of 10 plans
Delaware, DC and Maryland10 of 101–3$0.007 of 10 plans
Georgia10 of 101–3$0.007 of 10 plans
Florida10 of 101–3$0.007 of 10 plans
Ohio10 of 101–3$0.007 of 10 plans
Indiana and Kentucky10 of 101–3$0.007 of 10 plans
Wisconsin10 of 101–3$0.007 of 10 plans
Missouri10 of 101–3$0.007 of 10 plans
Mississippi10 of 101–3$0.007 of 10 plans
Louisiana10 of 101–3$0.007 of 10 plans
Colorado10 of 101–3$0.007 of 10 plans
Arizona10 of 101–3$0.007 of 10 plans
Nevada10 of 101–3$0.007 of 10 plans
Oregon and Washington10 of 101–3$0.007 of 10 plans
Idaho and Utah10 of 101–3$0.007 of 10 plans
Maine and New Hampshire9 of 91–3$0.006 of 9 plans
Virginia9 of 91–3$0.006 of 9 plans
Alaska9 of 91–3$0.006 of 9 plans
Hawaii8 of 81–3$0.005 of 8 plans
Puerto Rico3 of 31–3$0.003 of 3 plans
American Samoa1 of 13—1 of 1 plans
Guam1 of 13—1 of 1 plans
Northern Mariana Islands1 of 13—1 of 1 plans
U.S. Virgin Islands1 of 13—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.

New Jersey — 12 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$35.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.6371—None
HealthSpring Extra Rx (PDP)$59.90/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3128$2.829 units
  • Quantity limit 9 per 30 days
HealthSpring Assurance Rx (PDP)$109.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.5368$4.839 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$111.90/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.6275—None
Wellcare Value Script (PDP)$22.80/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1938$1.749 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1366$1.239 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$4.40/mo premium · $615.00 deductible3Preferred Brand25%20%$0.6275—None
Wellcare Classic (PDP)$28.20/mo premium · $615.00 deductible3Preferred Brand25%25%$0.5221$4.709 units
  • Quantity limit 9 per 30 days
Horizon Medicare Blue Rx Standard (PDP)$72.30/mo premium · $615.00 deductible3Preferred Brand18%18%$0.3428$3.099 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$77.40/mo premium · $615.00 deductible3Preferred Brand17%17%$0.3401$3.069 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$118.90/mo premium · $130.00 deductible3Preferred Brand15%15%$0.3248$2.929 units
  • Quantity limit 9 per 30 days
Horizon Medicare Blue Rx Enhanced (PDP)$139.10/mo premium · $200.00 deductible3Preferred Brand20%20%$0.3428$3.099 units
  • Quantity limit 9 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 — 12 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.6533—None
HealthSpring Extra Rx (PDP)$62.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3396$3.069 units
  • Quantity limit 9 per 30 days
HealthSpring Assurance Rx (PDP)$74.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.6202$5.589 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$123.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.6372—None
Blue Rx PDP Complete (PDP)$164.80/mo premium · $200.00 deductible1Preferred Generic$0.00$0.00$0.2709$24.3890 units
  • Quantity limit 93 per 31 days
Blue Rx PDP Plus (PDP)$193.20/mo premium · $615.00 deductible1Preferred Generic25%25%$0.2709$24.3890 units
  • Quantity limit 93 per 31 days
Wellcare Value Script (PDP)$8.20/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1667$1.509 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$22.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.1371$1.239 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$6.60/mo premium · $615.00 deductible3Preferred Brand25%20%$0.6372—None
Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible3Preferred Brand25%25%$0.5753$5.189 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$43.50/mo premium · $615.00 deductible3Preferred Brand16%16%$0.3245$2.929 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$121.90/mo premium · $130.00 deductible3Preferred Brand16%16%$0.3240$2.929 units
  • Quantity limit 9 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.

North Carolina — 12 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$32.00/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.6684—None
HealthSpring Extra Rx (PDP)$78.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3978$3.589 units
  • Quantity limit 9 per 30 days
HealthSpring Assurance Rx (PDP)$110.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.6571$5.919 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$110.90/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.6454—None
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1694$1.529 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$90.20/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1333$1.209 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$4.70/mo premium · $615.00 deductible3Preferred Brand25%25%$0.6119$5.519 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$6.80/mo premium · $615.00 deductible3Preferred Brand25%20%$0.6454—None
AARP Medicare Rx Saver from UHC (PDP)$56.90/mo premium · $615.00 deductible3Preferred Brand18%18%$0.3231$2.919 units
  • Quantity limit 9 per 30 days
Blue Medicare Rx Standard (PDP)$83.90/mo premium · $615.00 deductible3Preferred Brand20%20%$0.4874$4.399 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$119.80/mo premium · $130.00 deductible3Preferred Brand17%17%$0.3231$2.919 units
  • Quantity limit 9 per 30 days
Blue Medicare Rx Enhanced (PDP)$163.20/mo premium · $0.00 deductible3Preferred Brand$45.00$135.00$0.4874$4.399 units
  • Quantity limit 9 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 — 12 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$37.70/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.6815—None
HealthSpring Extra Rx (PDP)$77.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.4310$3.889 units
  • Quantity limit 9 per 30 days
HealthSpring Assurance Rx (PDP)$87.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.6544$5.899 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.6530—None
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1813$1.639 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$97.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1724$1.559 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$0.6530—None
Wellcare Classic (PDP)$3.70/mo premium · $615.00 deductible3Preferred Brand25%25%$0.6191$5.579 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$63.20/mo premium · $615.00 deductible3Preferred Brand17%17%$0.3230$2.919 units
  • Quantity limit 9 per 30 days
BlueRx Essential (PDP)$76.20/mo premium · $615.00 deductible3Preferred Brand19%19%$0.4790$4.319 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$119.30/mo premium · $130.00 deductible3Preferred Brand17%17%$0.3230$2.919 units
  • Quantity limit 9 per 30 days
BlueRx Enhanced Plus (PDP)$129.50/mo premium · $150.00 deductible3Preferred Brand$47.00$94.00$0.4790$4.319 units
  • Quantity limit 9 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 — 12 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.5323$4.799 units
  • Quantity limit 9 per 30 days
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.6287—None
HealthSpring Extra Rx (PDP)$50.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3090$2.789 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$98.10/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.6187—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1760$1.589 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$78.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1376$1.249 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%25%$0.5490$4.949 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$0.6187—None
AARP Medicare Rx Saver from UHC (PDP)$14.10/mo premium · $615.00 deductible3Preferred Brand17%17%$0.3251$2.939 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$78.30/mo premium · $130.00 deductible3Preferred Brand18%18%$0.3251$2.939 units
  • Quantity limit 9 per 30 days
Prescription Blue Select (PDP)$78.40/mo premium · $615.00 deductible3Preferred Brand20%20%$0.6030—None
Prescription Blue Premium (PDP)$106.70/mo premium · $0.00 deductible3Preferred Brand24%24%$0.6030—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 — 12 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.6713—None
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3571$3.219 units
  • Quantity limit 9 per 30 days
HealthSpring Assurance Rx (PDP)$104.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.7691$6.929 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$119.40/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.6574—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1227$1.109 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1283$1.159 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%25%$0.7411$6.679 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$0.6574—None
AARP Medicare Rx Saver from UHC (PDP)$40.20/mo premium · $615.00 deductible3Preferred Brand17%17%$0.3253$2.939 units
  • Quantity limit 9 per 30 days
Blue Cross MedicareRx Basic (PDP)$89.70/mo premium · $615.00 deductible3Preferred Brand20%20%$0.4090$3.689 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$103.90/mo premium · $130.00 deductible3Preferred Brand17%17%$0.3222$2.909 units
  • Quantity limit 9 per 30 days
Blue Cross MedicareRx Value (PDP)$119.70/mo premium · $615.00 deductible3Preferred Brand18%18%$0.4321$3.899 units
  • Quantity limit 9 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 — 12 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.6279$5.659 units
  • Quantity limit 9 per 30 days
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.6086—None
HealthSpring Extra Rx (PDP)$54.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.5172$4.659 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$92.40/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.5654—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.2225$2.009 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$73.50/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1554$1.409 units
  • Quantity limit 9 per 30 days
BlueMedicare Premier Rx (PDP)$181.20/mo premium · $0.00 deductible2Generic$5.00$15.00$0.5311—None
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%25%$0.5906$5.329 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$0.5654—None
BlueMedicare Value Rx (PDP)$52.50/mo premium · $615.00 deductible3Preferred Brand19%19%$0.5311—None
AARP Medicare Rx Saver from UHC (PDP)$65.10/mo premium · $615.00 deductible3Preferred Brand18%18%$0.3238$2.919 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$114.90/mo premium · $130.00 deductible3Preferred Brand16%16%$0.3238$2.919 units
  • Quantity limit 9 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.

Texas — 12 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$22.90/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.7033—None
HealthSpring Extra Rx (PDP)$70.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.4248$3.829 units
  • Quantity limit 9 per 30 days
HealthSpring Assurance Rx (PDP)$111.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.7024$6.329 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$118.20/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.6728—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1461$1.319 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$94.80/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1297$1.179 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%25%$0.6833$6.159 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$41.70/mo premium · $615.00 deductible3Preferred Brand25%20%$0.6728—None
AARP Medicare Rx Saver from UHC (PDP)$89.20/mo premium · $615.00 deductible3Preferred Brand18%18%$0.3220$2.909 units
  • Quantity limit 9 per 30 days
Blue Cross MedicareRx Basic (PDP)$104.70/mo premium · $615.00 deductible3Preferred Brand19%19%$0.4456$4.019 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $130.00 deductible3Preferred Brand18%18%$0.3220$2.909 units
  • Quantity limit 9 per 30 days
Blue Cross MedicareRx Value (PDP)$167.40/mo premium · $615.00 deductible3Preferred Brand18%18%$0.5388$4.859 units
  • Quantity limit 9 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 — 12 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$6.70/mo premium · $615.00 deductible1Preferred Generic5%5%$0.6905$6.219 units
  • Quantity limit 9 per 30 days
Humana Value Rx Plan (PDP)$55.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.6516—None
Humana Premier Rx Plan (PDP)$116.30/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.6209—None
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1702$1.539 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$88.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1399$1.269 units
  • Quantity limit 9 per 30 days
Blue MedicareRx Essentials (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand20%20%$0.5300$4.779 units
  • Quantity limit 9 per 30 days
Blue MedicareRx Value (PDP)$0.70/mo premium · $615.00 deductible3Preferred Brand18%18%$0.5558$5.009 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible3Preferred Brand25%25%$0.6077$5.479 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$15.50/mo premium · $615.00 deductible3Preferred Brand25%20%$0.6209—None
Blue MedicareRx Plus (PDP)$67.40/mo premium · $0.00 deductible3Preferred Brand20%20%$0.5558$5.009 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$105.40/mo premium · $615.00 deductible3Preferred Brand17%17%$0.3214$2.899 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$147.00/mo premium · $130.00 deductible3Preferred Brand15%15%$0.3214$2.899 units
  • Quantity limit 9 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.

California — 12 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.5406$4.879 units
  • Quantity limit 9 per 30 days
HealthSpring Extra Rx (PDP)$70.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2944$2.659 units
  • Quantity limit 9 per 30 days
Humana Value Rx Plan (PDP)$104.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.6376—None
Humana Premier Rx Plan (PDP)$172.90/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.6304—None
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1863$1.689 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$103.60/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1371$1.239 units
  • Quantity limit 9 per 30 days
Blue Shield Rx Enhanced (PDP)$227.80/mo premium · $0.00 deductible2Generic$7.00$14.00$0.6261—None
Wellcare Classic (PDP)$6.20/mo premium · $615.00 deductible3Preferred Brand25%25%$0.5053$4.559 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$109.40/mo premium · $615.00 deductible3Preferred Brand17%17%$0.3282$2.959 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$132.20/mo premium · $615.00 deductible3Preferred Brand25%20%$0.6304—None
AARP Medicare Rx Preferred from UHC (PDP)$165.40/mo premium · $130.00 deductible3Preferred Brand15%15%$0.3252$2.939 units
  • Quantity limit 9 per 30 days
Blue Shield Rx Plus (PDP)$199.70/mo premium · $615.00 deductible3Preferred Brand19%19%$0.6261—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 — 11 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$73.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.7451—None
Humana Premier Rx Plan (PDP)$138.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.7377—None
HealthSpring Assurance Rx (PDP)$139.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.6782$6.109 units
  • Quantity limit 9 per 30 days
Wellcare Value Script (PDP)$16.40/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1193$1.079 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.1252$1.139 units
  • Quantity limit 9 per 30 days
Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible2Generic$7.00$14.00$0.3610—None
Humana Basic Rx Plan (PDP)$8.40/mo premium · $615.00 deductible3Preferred Brand25%20%$0.7377—None
Blue MedicareRx Value Plus (PDP)$20.70/mo premium · $615.00 deductible3Preferred Brand17%17%$0.3610—None
Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible3Preferred Brand25%25%$0.6009$5.419 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible3Preferred Brand17%17%$0.3510$3.169 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible3Preferred Brand15%15%$0.3409$3.079 units
  • Quantity limit 9 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.

South Carolina — 11 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$65.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.7217—None
HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3470$3.129 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$145.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.7038—None
HealthSpring Assurance Rx (PDP)$152.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.6994$6.299 units
  • Quantity limit 9 per 30 days
Wellcare Value Script (PDP)$4.80/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1273$1.159 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$98.40/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1488$1.349 units
  • Quantity limit 9 per 30 days
BlueCross Rx Value (PDP)$139.70/mo premium · $615.00 deductible2Generic$17.00$42.50$0.4715—None
Wellcare Classic (PDP)$9.70/mo premium · $615.00 deductible3Preferred Brand25%25%$0.6541$5.899 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$10.10/mo premium · $615.00 deductible3Preferred Brand25%20%$0.7038—None
AARP Medicare Rx Saver from UHC (PDP)$122.10/mo premium · $615.00 deductible3Preferred Brand18%18%$0.3217$2.909 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible3Preferred Brand17%17%$0.3217$2.909 units
  • Quantity limit 9 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.

Oklahoma — 11 plans, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.7015—None
HealthSpring Extra Rx (PDP)$65.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.4812$4.339 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.6643—None
HealthSpring Assurance Rx (PDP)$126.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.7030$6.339 units
  • Quantity limit 9 per 30 days
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1817$1.649 units
  • Quantity limit 9 per 30 days
Blue Cross MedicareRx Basic (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand16%16%$0.4403$3.969 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$0.6643—None
Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible3Preferred Brand25%25%$0.6593$5.939 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible3Preferred Brand17%17%$0.3224$2.909 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$121.00/mo premium · $130.00 deductible3Preferred Brand16%16%$0.3224$2.909 units
  • Quantity limit 9 per 30 days
Blue Cross MedicareRx Value (PDP)$167.30/mo premium · $615.00 deductible3Preferred Brand18%18%$0.5633$5.079 units
  • Quantity limit 9 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 — 11 plans, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$20.80/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.6238—None
HealthSpring Extra Rx (PDP)$66.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3838$3.459 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$103.70/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.6020—None
HealthSpring Assurance Rx (PDP)$125.90/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.5891$5.309 units
  • Quantity limit 9 per 30 days
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1973$1.789 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.1604$1.449 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$4.70/mo premium · $615.00 deductible3Preferred Brand25%20%$0.6020—None
AARP Medicare Rx Saver from UHC (PDP)$5.30/mo premium · $615.00 deductible3Preferred Brand17%17%$0.3282$2.959 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$12.70/mo premium · $615.00 deductible3Preferred Brand25%25%$0.7382$6.649 units
  • Quantity limit 9 per 30 days
MedicareBlue Rx Standard (PDP)$101.00/mo premium · $615.00 deductible3Preferred Brand22%22%$0.5132$4.629 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$140.20/mo premium · $130.00 deductible3Preferred Brand18%18%$0.3282$2.959 units
  • Quantity limit 9 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 Mexico — 11 plans, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.7783$7.009 units
  • Quantity limit 9 per 30 days
Humana Value Rx Plan (PDP)$69.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.7076—None
Humana Premier Rx Plan (PDP)$75.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.6564—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.2175$1.969 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$104.00/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1531$1.389 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%25%$0.7507$6.769 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$0.6564—None
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand16%16%$0.3352$3.029 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible3Preferred Brand16%16%$0.3352$3.029 units
  • Quantity limit 9 per 30 days
Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible3Preferred Brand14%14%$0.5543$4.999 units
  • Quantity limit 9 per 30 days
Blue Cross MedicareRx Basic (PDP)$145.40/mo premium · $615.00 deductible3Preferred Brand18%18%$0.4771$4.299 units
  • Quantity limit 9 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 — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$35.70/mo premium · $615.00 deductible1Preferred Generic5%5%$0.3673$3.319 units
  • Quantity limit 9 per 30 days
HealthSpring Extra Rx (PDP)$91.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2759$2.489 units
  • Quantity limit 9 per 30 days
Humana Value Rx Plan (PDP)$158.90/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.5460—None
Humana Premier Rx Plan (PDP)$173.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.5451—None
Wellcare Value Script (PDP)$42.40/mo premium · $615.00 deductible2Generic$3.00$9.00$0.2530$2.289 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$116.00/mo premium · $615.00 deductible2Generic$6.00$18.00$0.1532$1.389 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$45.70/mo premium · $615.00 deductible3Preferred Brand25%25%$0.3605$3.249 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$105.80/mo premium · $615.00 deductible3Preferred Brand17%17%$0.3321$2.999 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$140.90/mo premium · $615.00 deductible3Preferred Brand25%20%$0.5451—None
AARP Medicare Rx Preferred from UHC (PDP)$163.70/mo premium · $130.00 deductible3Preferred Brand15%15%$0.3295$2.979 units
  • Quantity limit 9 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.

Delaware, DC and Maryland — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$4.30/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.7132—None
HealthSpring Assurance Rx (PDP)$32.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.6742$6.079 units
  • Quantity limit 9 per 30 days
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3005$2.709 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.7022—None
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1275$1.159 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1260$1.139 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$0.7022—None
Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible3Preferred Brand25%25%$0.6295$5.679 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$37.80/mo premium · $615.00 deductible3Preferred Brand17%17%$0.3221$2.909 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible3Preferred Brand17%17%$0.3221$2.909 units
  • Quantity limit 9 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.

Georgia — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$36.40/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.6921—None
HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.4618$4.169 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$129.50/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.6554—None
HealthSpring Assurance Rx (PDP)$149.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.6996$6.309 units
  • Quantity limit 9 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1634$1.479 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$100.70/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1370$1.239 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%25%$0.6391$5.759 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$0.6554—None
AARP Medicare Rx Saver from UHC (PDP)$98.00/mo premium · $615.00 deductible3Preferred Brand18%18%$0.3218$2.909 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.80/mo premium · $130.00 deductible3Preferred Brand16%16%$0.3218$2.909 units
  • Quantity limit 9 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.

Florida — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$25.90/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.7331—None
Humana Premier Rx Plan (PDP)$115.90/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.7185—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1475$1.339 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1246$1.129 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%25%$0.6363$5.739 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$92.70/mo premium · $615.00 deductible3Preferred Brand25%20%$0.7185—None
BlueMedicare Premier Rx (PDP)$98.60/mo premium · $615.00 deductible3Preferred Brand20%20%$0.3768$3.399 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$98.70/mo premium · $615.00 deductible3Preferred Brand18%18%$0.3233$2.919 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$119.10/mo premium · $130.00 deductible3Preferred Brand17%17%$0.3233$2.919 units
  • Quantity limit 9 per 30 days
BlueMedicare Complete Rx (PDP)$217.00/mo premium · $615.00 deductible3Preferred Brand18%18%$0.3768$3.399 units
  • Quantity limit 9 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 — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$23.70/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.6585—None
HealthSpring Extra Rx (PDP)$65.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3235$2.919 units
  • Quantity limit 9 per 30 days
HealthSpring Assurance Rx (PDP)$109.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.7112$6.409 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$117.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.6430—None
Wellcare Value Script (PDP)$7.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1276$1.159 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$90.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1325$1.199 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$0.6430—None
Wellcare Classic (PDP)$7.70/mo premium · $615.00 deductible3Preferred Brand25%25%$0.6238$5.619 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$73.70/mo premium · $615.00 deductible3Preferred Brand18%18%$0.3305$2.979 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$123.40/mo premium · $130.00 deductible3Preferred Brand17%17%$0.3281$2.959 units
  • Quantity limit 9 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.

Indiana and Kentucky — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$9.90/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.6420—None
HealthSpring Extra Rx (PDP)$78.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3528$3.189 units
  • Quantity limit 9 per 30 days
HealthSpring Assurance Rx (PDP)$117.80/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.6326$5.699 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$125.30/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.6250—None
Wellcare Value Script (PDP)$8.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1841$1.669 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.1502$1.359 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$0.6250—None
Wellcare Classic (PDP)$8.70/mo premium · $615.00 deductible3Preferred Brand25%25%$0.5733$5.169 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$90.30/mo premium · $615.00 deductible3Preferred Brand17%17%$0.3272$2.949 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$127.10/mo premium · $130.00 deductible3Preferred Brand18%18%$0.3272$2.949 units
  • Quantity limit 9 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.

Wisconsin — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.7328$6.609 units
  • Quantity limit 9 per 30 days
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.7164—None
HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3476$3.139 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$110.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.7002—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1367$1.239 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$26.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.1548$1.399 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%25%$0.6694$6.029 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$0.7002—None
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand17%17%$0.3305$2.979 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$113.90/mo premium · $130.00 deductible3Preferred Brand15%15%$0.3305$2.979 units
  • Quantity limit 9 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.

Missouri — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.7017—None
HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.4622$4.169 units
  • Quantity limit 9 per 30 days
HealthSpring Assurance Rx (PDP)$74.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.6939$6.259 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$126.40/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.6669—None
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1815$1.639 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1537$1.389 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$10.70/mo premium · $615.00 deductible3Preferred Brand25%25%$0.6691$6.029 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$16.50/mo premium · $615.00 deductible3Preferred Brand25%20%$0.6669—None
AARP Medicare Rx Saver from UHC (PDP)$71.90/mo premium · $615.00 deductible3Preferred Brand17%17%$0.3316$2.989 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$125.40/mo premium · $130.00 deductible3Preferred Brand17%17%$0.3221$2.909 units
  • Quantity limit 9 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.

Mississippi — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$37.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.6549—None
HealthSpring Assurance Rx (PDP)$59.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.6205$5.589 units
  • Quantity limit 9 per 30 days
HealthSpring Extra Rx (PDP)$77.10/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.4181$3.769 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$89.90/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.6295—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1942$1.759 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1394$1.259 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%25%$0.5679$5.119 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$0.6295—None
AARP Medicare Rx Saver from UHC (PDP)$84.70/mo premium · $615.00 deductible3Preferred Brand17%17%$0.3240$2.929 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$140.60/mo premium · $130.00 deductible3Preferred Brand16%16%$0.3240$2.929 units
  • Quantity limit 9 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.

Louisiana — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$19.30/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.6845—None
HealthSpring Assurance Rx (PDP)$48.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.6488$5.849 units
  • Quantity limit 9 per 30 days
HealthSpring Extra Rx (PDP)$60.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.4302$3.879 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$113.70/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.6555—None
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1859$1.679 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$44.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.1440$1.309 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$0.6555—None
Wellcare Classic (PDP)$6.70/mo premium · $615.00 deductible3Preferred Brand25%25%$0.6042$5.449 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$37.00/mo premium · $615.00 deductible3Preferred Brand16%16%$0.3271$2.949 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.50/mo premium · $130.00 deductible3Preferred Brand15%15%$0.3262$2.949 units
  • Quantity limit 9 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.

Colorado — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$48.50/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.6233—None
HealthSpring Assurance Rx (PDP)$61.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.7655$6.899 units
  • Quantity limit 9 per 30 days
HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3390$3.059 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$137.10/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.6057—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1096$0.999 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$105.10/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1352$1.229 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$0.6057—None
Wellcare Classic (PDP)$2.20/mo premium · $615.00 deductible3Preferred Brand25%25%$0.6332$5.709 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$125.00/mo premium · $615.00 deductible3Preferred Brand19%19%$0.3210$2.899 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$151.90/mo premium · $130.00 deductible3Preferred Brand17%17%$0.3210$2.899 units
  • Quantity limit 9 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.

Arizona — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.8329$7.509 units
  • Quantity limit 9 per 30 days
Humana Value Rx Plan (PDP)$2.50/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.6965—None
HealthSpring Extra Rx (PDP)$66.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.4692$4.229 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$119.20/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.6627—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1470$1.329 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1333$1.209 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%25%$0.7416$6.679 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand23%18%$0.6627—None
AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible3Preferred Brand18%18%$0.3270$2.949 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$97.50/mo premium · $130.00 deductible3Preferred Brand18%18%$0.3270$2.949 units
  • Quantity limit 9 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.

Nevada — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$43.70/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.7480—None
HealthSpring Extra Rx (PDP)$52.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.4010$3.619 units
  • Quantity limit 9 per 30 days
HealthSpring Assurance Rx (PDP)$95.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.8043$7.249 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$148.70/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.7190—None
Wellcare Value Script (PDP)$2.70/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1115$1.009 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1213$1.099 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$0.7190—None
Wellcare Classic (PDP)$2.70/mo premium · $615.00 deductible3Preferred Brand25%25%$0.7244$6.529 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$76.70/mo premium · $615.00 deductible3Preferred Brand19%19%$0.3224$2.909 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.10/mo premium · $130.00 deductible3Preferred Brand18%18%$0.3199$2.889 units
  • Quantity limit 9 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.

Oregon and Washington — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.6770$6.099 units
  • Quantity limit 9 per 30 days
Humana Value Rx Plan (PDP)$22.10/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.6146—None
HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3452$3.119 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.5963—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1573$1.429 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$85.90/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1363$1.239 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%25%$0.6026$5.429 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$0.5963—None
AARP Medicare Rx Saver from UHC (PDP)$38.40/mo premium · $615.00 deductible3Preferred Brand17%17%$0.3236$2.919 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$110.00/mo premium · $130.00 deductible3Preferred Brand16%16%$0.3231$2.919 units
  • Quantity limit 9 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.

Idaho and Utah — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.5932—None
HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2672$2.409 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$115.50/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.5871—None
HealthSpring Assurance Rx (PDP)$128.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.6470$5.829 units
  • Quantity limit 9 per 30 days
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1379$1.249 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$27.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.1194$1.079 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$0.5871—None
Wellcare Classic (PDP)$23.70/mo premium · $615.00 deductible3Preferred Brand25%25%$0.5606$5.059 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$56.50/mo premium · $615.00 deductible3Preferred Brand17%17%$0.3234$2.919 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$132.60/mo premium · $130.00 deductible3Preferred Brand17%17%$0.3234$2.919 units
  • Quantity limit 9 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.

Maine and New Hampshire — 9 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.6324$5.699 units
  • Quantity limit 9 per 30 days
Humana Value Rx Plan (PDP)$54.40/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.6538—None
Humana Premier Rx Plan (PDP)$150.20/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.6267—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.2254$2.039 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1233$1.119 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%25%$0.6570$5.919 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$0.6267—None
AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible3Preferred Brand17%17%$0.3750$3.389 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$104.30/mo premium · $130.00 deductible3Preferred Brand15%15%$0.3750$3.389 units
  • Quantity limit 9 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.

Virginia — 9 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.7114—None
Humana Premier Rx Plan (PDP)$87.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.6757—None
HealthSpring Assurance Rx (PDP)$133.80/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.7154$6.449 units
  • Quantity limit 9 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1592$1.439 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$78.20/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1286$1.169 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%25%$0.6708$6.049 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$0.6757—None
AARP Medicare Rx Saver from UHC (PDP)$39.60/mo premium · $615.00 deductible3Preferred Brand17%17%$0.3237$2.919 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$100.80/mo premium · $130.00 deductible3Preferred Brand17%17%$0.3237$2.919 units
  • Quantity limit 9 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.

Alaska — 9 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.7700$6.939 units
  • Quantity limit 9 per 30 days
Humana Value Rx Plan (PDP)$10.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.4910—None
Humana Premier Rx Plan (PDP)$112.40/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.4910—None
Wellcare Value Script (PDP)$19.70/mo premium · $615.00 deductible2Generic$3.00$9.00$0.0400$0.369 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1424$1.289 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%25%$0.4600$4.149 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand24%19%$0.4910—None
AARP Medicare Rx Saver from UHC (PDP)$53.20/mo premium · $615.00 deductible3Preferred Brand19%19%$0.3178$2.869 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$100.20/mo premium · $130.00 deductible3Preferred Brand18%18%$0.3178$2.869 units
  • Quantity limit 9 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.

Hawaii — 8 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$51.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.7406—None
Humana Premier Rx Plan (PDP)$90.20/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.7247—None
SilverScript Choice (PDP)$14.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.1406$1.279 units
  • Quantity limit 9 per 30 days
Wellcare Value Script (PDP)$21.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1276$1.159 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand16%16%$0.3222$2.909 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$0.40/mo premium · $615.00 deductible3Preferred Brand23%18%$0.7247—None
Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible3Preferred Brand25%25%$0.6224$5.609 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible3Preferred Brand17%17%$0.3222$2.909 units
  • Quantity limit 9 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.

Puerto Rico — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3517$3.179 units
  • Quantity limit 9 per 30 days
HealthSpring Assurance Rx (PDP)$65.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.5827$5.249 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$145.10/mo premium · $615.00 deductible3Preferred Brand25%25%$0.2616$2.359 units
  • Quantity limit 9 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.

American Samoa — 1 plan, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%25%$0.3574$3.229 units
  • Quantity limit 9 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.

Guam — 1 plan, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%25%$0.3305$2.979 units
  • Quantity limit 9 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.

Northern Mariana Islands — 1 plan, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$32.10/mo premium · $615.00 deductible3Preferred Brand25%25%$0.3305$2.979 units
  • Quantity limit 9 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.

U.S. Virgin Islands — 1 plan, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $615.00 deductible3Preferred Brand25%25%$0.3178$2.869 units
  • Quantity limit 9 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.