AMLODIPINE AND VALSARTAN 10/160 mg Tablet, Film Coated
Coverage in Arizona (CMS PDP Region 28).
9 of 10 stand-alone Part D plans in Arizona cover this drug on tier 1–3.
Lowest 30-day cost $0.00 at a preferred pharmacy. 7 of 9 plans apply a prior authorization, step therapy or quantity limit.
125 Medicare Advantage plans in AZ 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. AZ: 125 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1271 | $0.383 units |
|
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | 5% | 5% | $1.6830 | — | None |
| HealthSpring Extra Rx (PDP)$66.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.5856 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $3.00 | $0.00 | $1.4979 | $4.493 units |
|
| Humana Value Rx Plan (PDP)$2.50/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $1.5234 | $4.573 units |
|
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.3683 | $1.103 units |
|
| Humana Premier Rx Plan (PDP)$119.20/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $1.4979 | $4.493 units |
|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $2.1457 | $6.443 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$97.50/mo premium · $130.00 deductible | 3Preferred Brand | 18% | 18% | $0.6397 | $1.923 units |
|
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.