MedicarePartD.guide

A non-government resource built from CMS public data

METHADONE HYDROCHLORIDE 10 mg/5mL Solution

Coverage in New Mexico (CMS PDP Region 26).

7 of 11 stand-alone Part D plans in New Mexico cover this drug on tier 3–4.

Lowest 30-day cost $45.00 at a preferred pharmacy. 7 of 7 plans apply a prior authorization, step therapy or quantity limit.

50 Medicare Advantage plans in NM 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. NM: 50 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Premier Rx Plan (PDP)$75.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$0.1439$2.5918 units
  • Quantity limit 18 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible3Preferred Brand16%16%$0.1064$1.9218 units
  • Quantity limit 18 per 30 days
SilverScript Choice (PDP)$104.00/mo premium · $615.00 deductible3Preferred Brand18%18%$0.1409$6.3445 units
  • Prior authorization
  • Quantity limit 45 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.0848$3.8245 units
  • Prior authorization
  • Quantity limit 45 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug29%29%$0.0818$0.496 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug32%—$0.1440$2.5918 units
  • Quantity limit 18 per 30 days
Humana Value Rx Plan (PDP)$69.60/mo premium · $601.00 deductible4Non-Preferred Drug30%—$0.1444$2.6018 units
  • Quantity limit 18 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.

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