MedicarePartD.guide

A non-government resource built from CMS public data

METHADONE HYDROCHLORIDE 5 mg/5mL Solution

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

8 of 12 stand-alone Part D plans in Alabama and Tennessee cover this drug on tier 3–4.

Lowest 30-day cost $45.00 at a preferred pharmacy. 8 of 8 plans apply a prior authorization, step therapy or quantity limit.

205 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: 85 plans · TN: 120 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$77.50/mo premium · $615.00 deductible3Preferred Brand17%17%$0.0653$0.7812 units
  • Quantity limit 12 per 30 days
SilverScript Choice (PDP)$97.30/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0749$3.3745 units
  • Prior authorization
  • Quantity limit 45 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$0.0941$3.3936 units
  • Quantity limit 36 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$119.30/mo premium · $130.00 deductible3Preferred Brand17%17%$0.0721$2.6036 units
  • Quantity limit 36 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug34%—$0.0943$3.3936 units
  • Quantity limit 36 per 30 days
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.0675$3.0445 units
  • Prior authorization
  • Quantity limit 45 per 30 days
Humana Value Rx Plan (PDP)$37.70/mo premium · $601.00 deductible4Non-Preferred Drug33%—$0.0947$3.4136 units
  • Quantity limit 36 per 30 days
HealthSpring Assurance Rx (PDP)$87.20/mo premium · $615.00 deductible4Non-Preferred Drug32%32%$0.0675$0.8112 units
  • Quantity limit 12 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 →