MedicarePartD.guide

A non-government resource built from CMS public data

PAXLOVID Kit

Also known as Nirmatrelvir And Ritonavir. Coverage in Georgia (CMS PDP Region 10).

10 of 10 stand-alone Part D plans in Georgia 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.

142 Medicare Advantage plans in GA 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. GA: 142 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
SilverScript Choice (PDP)$100.70/mo premium · $615.00 deductible2Generic$7.00$21.00$145.7271$582.914 units
  • Quantity limit 22 per 180 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%25%$133.7733$535.094 units
  • Quantity limit 11 per 90 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%25%$133.7733$535.094 units
  • Quantity limit 11 per 90 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$140.1925$9,252.7066 units
  • Quantity limit 22 per 10 days
Humana Value Rx Plan (PDP)$36.40/mo premium · $601.00 deductible3Preferred Brand20%15%$140.1925$9,252.7066 units
  • Quantity limit 22 per 10 days
Humana Premier Rx Plan (PDP)$129.50/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$140.1925$9,252.7066 units
  • Quantity limit 22 per 10 days
HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible5Specialty Tier25%—$133.5077$534.034 units
  • Quantity limit 11 per 90 days
AARP Medicare Rx Saver from UHC (PDP)$98.00/mo premium · $615.00 deductible5Specialty Tier25%—$145.7516$9,619.6166 units
  • Quantity limit 11 per 5 days
AARP Medicare Rx Preferred from UHC (PDP)$139.80/mo premium · $130.00 deductible5Specialty Tier31%—$145.7516$9,619.6166 units
  • Quantity limit 11 per 5 days
HealthSpring Assurance Rx (PDP)$149.30/mo premium · $615.00 deductible5Specialty Tier25%—$133.5259$534.104 units
  • Quantity limit 11 per 90 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 →