MedicarePartD.guide

A non-government resource built from CMS public data

METHADONE HYDROCHLORIDE 5 mg/5mL Solution

Coverage in Texas (CMS PDP Region 22).

8 of 12 stand-alone Part D plans in Texas 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.

344 Medicare Advantage plans in TX 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. TX: 344 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$70.00/mo premium · $615.00 deductible3Preferred Brand17%17%$0.0500$0.6012 units
  • Quantity limit 12 per 30 days
SilverScript Choice (PDP)$94.80/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0779$3.5145 units
  • Prior authorization
  • Quantity limit 45 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $130.00 deductible3Preferred Brand18%18%$0.0752$2.7136 units
  • Quantity limit 36 per 30 days
Humana Premier Rx Plan (PDP)$118.20/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$0.0836$3.0136 units
  • Quantity limit 36 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.0521$2.3445 units
  • Prior authorization
  • Quantity limit 45 per 30 days
Humana Value Rx Plan (PDP)$22.90/mo premium · $601.00 deductible4Non-Preferred Drug34%—$0.0838$3.0236 units
  • Quantity limit 36 per 30 days
Humana Basic Rx Plan (PDP)$41.70/mo premium · $615.00 deductible4Non-Preferred Drug34%—$0.0837$3.0136 units
  • Quantity limit 36 per 30 days
HealthSpring Assurance Rx (PDP)$111.40/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$0.0521$0.6312 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 →