MedicarePartD.guide

A non-government resource built from CMS public data

FENTANYL 75 ug/h Patch

Coverage in Michigan (CMS PDP Region 13).

12 of 12 stand-alone Part D plans in Michigan cover this drug on tier 3–4.

12 of 12 plans apply a prior authorization, step therapy or quantity limit.

177 Medicare Advantage plans in MI 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. MI: 177 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$78.30/mo premium · $130.00 deductible3Preferred Brand18%18%$14.6421$219.6315 units
  • Quantity limit 15 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug28%28%$22.6319$22.631 unit
  • Prior authorization
  • Quantity limit 1 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$22.6319$22.631 unit
  • Prior authorization
  • Quantity limit 1 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$20.8200$20.821 unit
  • Quantity limit 1 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug33%—$19.4649$38.932 units
  • Quantity limit 2 per 30 days
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible4Non-Preferred Drug33%—$19.5318$39.062 units
  • Quantity limit 2 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$14.10/mo premium · $615.00 deductible4Non-Preferred Drug33%—$14.6818$220.2315 units
  • Quantity limit 15 per 30 days
HealthSpring Extra Rx (PDP)$50.40/mo premium · $615.00 deductible4Non-Preferred Drug32%32%$21.2360$21.241 unit
  • Quantity limit 1 per 30 days
SilverScript Choice (PDP)$78.30/mo premium · $615.00 deductible4Non-Preferred Drug33%33%$10.6406$10.641 unit
  • Prior authorization
  • Quantity limit 1 per 30 days
Prescription Blue Select (PDP)$78.40/mo premium · $615.00 deductible4Non-Preferred Drug25%25%$14.0001$210.0015 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$98.10/mo premium · $0.00 deductible4Non-Preferred Drug50%50%$19.4273$38.852 units
  • Quantity limit 2 per 30 days
Prescription Blue Premium (PDP)$106.70/mo premium · $0.00 deductible4Non-Preferred Drug27%27%$14.0001$210.0015 units
  • Quantity limit 15 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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