MedicarePartD.guide

A non-government resource built from CMS public data

HYDROMORPHONE HYDROCHLORIDE 1 mg/mL Solution

Coverage in Alabama and Tennessee (CMS PDP Region 12).

5 of 12 stand-alone Part D plans in Alabama and Tennessee cover this drug on tier 4.

5 of 5 plans apply a prior authorization, step therapy or quantity limit.

116 Medicare Advantage plans in AL, TN do cover it

Medicare Advantage plans carry their own formularies, separate from stand-alone Part D. A patient on an MA-PD plan may have coverage even where no PDP lists the drug. AL: 57 plans · TN: 59 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.3613$2.176 units
  • Quantity limit 6 per 30 days
BlueRx Essential (PDP)$76.20/mo premium · $615.00 deductible4Non-Preferred Drug41%41%$0.2724$39.23144 units
  • Quantity limit 144 per 30 days
HealthSpring Extra Rx (PDP)$77.50/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$0.3523$8.4624 units
  • Quantity limit 24 per 30 days
HealthSpring Assurance Rx (PDP)$87.20/mo premium · $615.00 deductible4Non-Preferred Drug32%32%$0.3530$8.4724 units
  • Quantity limit 24 per 30 days
BlueRx Enhanced Plus (PDP)$129.50/mo premium · $150.00 deductible4Non-Preferred Drug42%42%$0.2724$39.23144 units
  • Quantity limit 144 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.

See coverage in all 39 regions →