FENTANYL 75 ug/h Patch
Coverage in Louisiana (CMS PDP Region 21).
10 of 10 stand-alone Part D plans in Louisiana cover this drug on tier 3–4.
10 of 10 plans apply a prior authorization, step therapy or quantity limit.
103 Medicare Advantage plans in LA 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. LA: 103 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP)$139.50/mo premium · $130.00 deductible | 3Preferred Brand | 15% | 15% | $14.6039 | $219.0615 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | — | $19.7069 | $39.412 units |
|
| Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $21.2181 | $21.221 unit |
|
| Wellcare Classic (PDP)$6.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 28% | 28% | $21.2181 | $21.221 unit |
|
| Humana Value Rx Plan (PDP)$19.30/mo premium · $601.00 deductible | 4Non-Preferred Drug | 35% | — | $19.7459 | $39.492 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$37.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | — | $14.6460 | $219.6915 units |
|
| SilverScript Choice (PDP)$44.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | 35% | $11.1933 | $11.191 unit |
|
| HealthSpring Assurance Rx (PDP)$48.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $19.5925 | $19.591 unit |
|
| HealthSpring Extra Rx (PDP)$60.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $20.1719 | $20.171 unit |
|
| Humana Premier Rx Plan (PDP)$113.70/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $19.6850 | $39.372 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.