PAXLOVID Kit

Also known as Nirmatrelvir And Ritonavir. Coverage in Ohio (CMS PDP Region 14).

10 of 10 stand-alone Part D plans in Ohio cover this drug on tier 2–5.

Lowest 30-day cost $7.00 at a preferred pharmacy. 10 of 10 plans apply a prior authorization, step therapy or quantity limit.

193 Medicare Advantage plans in OH 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. OH: 193 plans.

Every plan that covers it

Plan	Tier	30-day preferred	90-day mail	Unit cost	Est. 30-day fill	Restrictions
SilverScript Choice (PDP)$90.30/mo premium · $615.00 deductible	2Generic	$7.00	$21.00	$75.8233	$50.800.67 units	Quantity limit 4 per 180 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible	3Preferred Brand	25%	20%	$74.4635	$893.5612 units	Quantity limit 4 per 10 days
Wellcare Value Script (PDP)$7.60/mo premium · $615.00 deductible	3Preferred Brand	25%	25%	$72.0035	$48.240.67 units	Quantity limit 2 per 90 days
Wellcare Classic (PDP)$7.70/mo premium · $615.00 deductible	3Preferred Brand	25%	25%	$72.0035	$48.240.67 units	Quantity limit 2 per 90 days
Humana Value Rx Plan (PDP)$23.70/mo premium · $601.00 deductible	3Preferred Brand	20%	15%	$74.4635	$893.5612 units	Quantity limit 4 per 10 days
Humana Premier Rx Plan (PDP)$117.60/mo premium · $0.00 deductible	3Preferred Brand	$45.00	$125.00	$74.4635	$893.5612 units	Quantity limit 4 per 10 days
HealthSpring Extra Rx (PDP)$65.70/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$73.6138	$49.320.67 units	Quantity limit 2 per 90 days
AARP Medicare Rx Saver from UHC (PDP)$73.70/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$78.5657	$942.7912 units	Quantity limit 2 per 5 days
HealthSpring Assurance Rx (PDP)$109.50/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$73.8373	$49.470.67 units	Quantity limit 2 per 90 days
AARP Medicare Rx Preferred from UHC (PDP)$123.40/mo premium · $130.00 deductible	5Specialty Tier	31%	—	$78.5657	$942.7912 units	Quantity limit 2 per 5 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 →