MedicarePartD.guide

A non-government resource built from CMS public data

HYDROMORPHONE HYDROCHLORIDE 1 mg/mL Solution

Coverage in Oregon and Washington (CMS PDP Region 30).

3 of 10 stand-alone Part D plans in Oregon and Washington cover this drug on tier 4.

3 of 3 plans apply a prior authorization, step therapy or quantity limit.

109 Medicare Advantage plans in OR, WA 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. OR: 50 plans · WA: 59 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.3541$2.126 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$0.3425$8.2224 units
  • Quantity limit 24 per 30 days
HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$0.3485$8.3624 units
  • Quantity limit 24 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 →