MedicarePartD.guide

A non-government resource built from CMS public data

METHADONE HYDROCHLORIDE 5 mg Tablet

Coverage in Colorado (CMS PDP Region 27).

10 of 10 stand-alone Part D plans in Colorado cover this drug on tier 2–4.

Lowest 30-day cost $3.00 at a preferred pharmacy. 10 of 10 plans apply a prior authorization, step therapy or quantity limit.

96 Medicare Advantage plans in CO 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. CO: 96 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1147$1.039 units
  • Prior authorization
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$2.20/mo premium · $615.00 deductible2Generic$10.00$30.00$0.1605$1.449 units
  • Prior authorization
  • Quantity limit 9 per 30 days
HealthSpring Assurance Rx (PDP)$61.70/mo premium · $615.00 deductible3Preferred Brand20%20%$0.2824$6.7824 units
  • Quantity limit 24 per 30 days
HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible3Preferred Brand17%17%$0.2776$6.6624 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$105.10/mo premium · $615.00 deductible3Preferred Brand18%18%$0.2175$1.969 units
  • Prior authorization
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$125.00/mo premium · $615.00 deductible3Preferred Brand19%19%$0.2200$5.2824 units
  • Quantity limit 24 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$151.90/mo premium · $130.00 deductible3Preferred Brand17%17%$0.2288$5.4924 units
  • Quantity limit 24 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug31%—$0.2838$13.6248 units
  • Quantity limit 48 per 30 days
Humana Value Rx Plan (PDP)$48.50/mo premium · $601.00 deductible4Non-Preferred Drug34%—$0.2883$13.8448 units
  • Quantity limit 48 per 30 days
Humana Premier Rx Plan (PDP)$137.10/mo premium · $0.00 deductible4Non-Preferred Drug50%50%$0.2813$13.5048 units
  • Quantity limit 48 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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