ENOXAPARIN SODIUM 150 mg/mL Injection
Package: 10 SYRINGE in 1 CARTON (0548-5606-00) / .8 mL in 1 SYRINGE. NDC 00548560600.
- Plans covering it
- 367
- across 39 regions checked
- Lowest tier
- 4
- lower tiers cost less
- Plans with restrictions
- 95
- prior auth, step therapy or quantity limit
Coverage by region
Covered by at least one plan in 39 of 39 CMS regions.
| Region | Plans covering | Tiers | Lowest 30-day cost | Restrictions |
|---|---|---|---|---|
| New Jersey | 12 of 12 | 4 | — | 4 of 12 plans |
| Pennsylvania and West Virginia | 12 of 12 | 4 | — | 2 of 12 plans |
| North Carolina | 12 of 12 | 4 | — | 4 of 12 plans |
| Alabama and Tennessee | 12 of 12 | 4 | — | 4 of 12 plans |
| Michigan | 12 of 12 | 4 | — | 2 of 12 plans |
| Illinois | 12 of 12 | 4 | — | 4 of 12 plans |
| Arkansas | 12 of 12 | 4 | — | 2 of 12 plans |
| Texas | 12 of 12 | 4 | — | 4 of 12 plans |
| Kansas | 12 of 12 | 4 | — | 5 of 12 plans |
| California | 12 of 12 | 4 | — | 4 of 12 plans |
| Connecticut, Massachusetts, Rhode Island and Vermont | 11 of 11 | 4 | — | 2 of 11 plans |
| South Carolina | 11 of 11 | 4 | — | 2 of 11 plans |
| Oklahoma | 11 of 11 | 4 | — | 4 of 11 plans |
| Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming | 11 of 11 | 4 | — | 3 of 11 plans |
| New Mexico | 11 of 11 | 4 | — | 4 of 11 plans |
| New York | 10 of 10 | 4 | — | 2 of 10 plans |
| Delaware, DC and Maryland | 10 of 10 | 4 | — | 2 of 10 plans |
| Georgia | 10 of 10 | 4 | — | 2 of 10 plans |
| Florida | 10 of 10 | 4 | — | 4 of 10 plans |
| Ohio | 10 of 10 | 4 | — | 2 of 10 plans |
| Indiana and Kentucky | 10 of 10 | 4 | — | 2 of 10 plans |
| Wisconsin | 10 of 10 | 4 | — | 2 of 10 plans |
| Missouri | 10 of 10 | 4 | — | 2 of 10 plans |
| Mississippi | 10 of 10 | 4 | — | 2 of 10 plans |
| Louisiana | 10 of 10 | 4 | — | 2 of 10 plans |
| Colorado | 10 of 10 | 4 | — | 2 of 10 plans |
| Arizona | 10 of 10 | 4 | — | 2 of 10 plans |
| Nevada | 10 of 10 | 4 | — | 2 of 10 plans |
| Oregon and Washington | 10 of 10 | 4 | — | 2 of 10 plans |
| Idaho and Utah | 10 of 10 | 4 | — | 2 of 10 plans |
| Maine and New Hampshire | 9 of 9 | 4 | — | 2 of 9 plans |
| Virginia | 9 of 9 | 4 | — | 2 of 9 plans |
| Alaska | 9 of 9 | 4 | — | 2 of 9 plans |
| Hawaii | 8 of 8 | 4 | — | 2 of 8 plans |
| Puerto Rico | 3 of 3 | 4 | — | 1 of 3 plans |
| American Samoa | 1 of 1 | 4 | — | 1 of 1 plans |
| Guam | 1 of 1 | 4 | — | 1 of 1 plans |
| Northern Mariana Islands | 1 of 1 | 4 | — | 1 of 1 plans |
| U.S. Virgin Islands | 1 of 1 | 4 | — | 1 of 1 plans |
Plan-by-plan detail
Open a region to see every plan that covers this drug, with tier, cost-sharing and restrictions.
New Jersey — 12 plans, 4 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$4.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | — | $19.7495 | — | None |
| Wellcare Value Script (PDP)$22.80/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $16.9400 | — | None |
| Wellcare Classic (PDP)$28.20/mo premium · $615.00 deductible | 4Non-Preferred Drug | 29% | 29% | $16.9400 | — | None |
| Humana Value Rx Plan (PDP)$35.60/mo premium · $601.00 deductible | 4Non-Preferred Drug | 32% | — | $19.8312 | — | None |
| HealthSpring Extra Rx (PDP)$59.90/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $13.5663 | — | None |
| Horizon Medicare Blue Rx Standard (PDP)$72.30/mo premium · $615.00 deductible | 4Non-Preferred Drug | 45% | 45% | $19.8404 | $158.728 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$77.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 36% | — | $15.7601 | $756.4848 units |
|
| SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $11.0255 | — | None |
| HealthSpring Assurance Rx (PDP)$109.30/mo premium · $615.00 deductible | 4Non-Preferred Drug | 27% | 27% | $16.7928 | — | None |
| Humana Premier Rx Plan (PDP)$111.90/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $19.7035 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$118.90/mo premium · $130.00 deductible | 4Non-Preferred Drug | 33% | — | $14.9119 | $715.7748 units |
|
| Horizon Medicare Blue Rx Enhanced (PDP)$139.10/mo premium · $200.00 deductible | 4Non-Preferred Drug | 45% | 45% | $19.8404 | $158.728 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 — elsewhere it depends on what is prescribed.
Pennsylvania and West Virginia — 12 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$6.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | — | $18.4924 | — | None |
| Wellcare Value Script (PDP)$8.20/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $18.0639 | — | None |
| Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 28% | 28% | $18.0639 | — | None |
| Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible | 4Non-Preferred Drug | 33% | — | $18.6598 | — | None |
| SilverScript Choice (PDP)$22.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | 35% | $13.1997 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$43.50/mo premium · $615.00 deductible | 4Non-Preferred Drug | 41% | — | $14.8873 | $714.5948 units |
|
| HealthSpring Extra Rx (PDP)$62.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $13.9231 | — | None |
| HealthSpring Assurance Rx (PDP)$74.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $18.0140 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$121.90/mo premium · $130.00 deductible | 4Non-Preferred Drug | 33% | — | $14.6173 | $701.6348 units |
|
| Humana Premier Rx Plan (PDP)$123.60/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $18.3982 | — | None |
| Blue Rx PDP Complete (PDP)$164.80/mo premium · $200.00 deductible | 4Non-Preferred Drug | 25% | 25% | $16.4431 | — | None |
| Blue Rx PDP Plus (PDP)$193.20/mo premium · $615.00 deductible | 4Non-Preferred Drug | 25% | 25% | $16.4609 | — | None |
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 — elsewhere it depends on what is prescribed.
North Carolina — 12 plans, 4 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $17.6705 | — | None |
| Wellcare Classic (PDP)$4.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 27% | 27% | $17.6705 | — | None |
| Humana Basic Rx Plan (PDP)$6.80/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | — | $19.4308 | — | None |
| Humana Value Rx Plan (PDP)$32.00/mo premium · $601.00 deductible | 4Non-Preferred Drug | 34% | — | $19.7097 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$56.90/mo premium · $615.00 deductible | 4Non-Preferred Drug | 34% | — | $14.6627 | $703.8148 units |
|
| HealthSpring Extra Rx (PDP)$78.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $14.0932 | — | None |
| Blue Medicare Rx Standard (PDP)$83.90/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | 32% | $19.4654 | $155.728 units |
|
| SilverScript Choice (PDP)$90.20/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $11.5555 | — | None |
| HealthSpring Assurance Rx (PDP)$110.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | 32% | $17.6207 | — | None |
| Humana Premier Rx Plan (PDP)$110.90/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $19.2739 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$119.80/mo premium · $130.00 deductible | 4Non-Preferred Drug | 33% | — | $13.7979 | $662.3048 units |
|
| Blue Medicare Rx Enhanced (PDP)$163.20/mo premium · $0.00 deductible | 4Non-Preferred Drug | 40% | 40% | $19.4654 | $155.728 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 — elsewhere it depends on what is prescribed.
Alabama and Tennessee — 12 plans, 4 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 34% | — | $20.1655 | — | None |
| Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $17.3717 | — | None |
| Wellcare Classic (PDP)$3.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 27% | 27% | $17.3717 | — | None |
| Humana Value Rx Plan (PDP)$37.70/mo premium · $601.00 deductible | 4Non-Preferred Drug | 33% | — | $20.4000 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$63.20/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | — | $14.4620 | $694.1848 units |
|
| BlueRx Essential (PDP)$76.20/mo premium · $615.00 deductible | 4Non-Preferred Drug | 41% | 41% | $19.0372 | $152.308 units |
|
| HealthSpring Extra Rx (PDP)$77.50/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $14.4896 | — | None |
| HealthSpring Assurance Rx (PDP)$87.20/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | 32% | $17.8705 | — | None |
| SilverScript Choice (PDP)$97.30/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $10.8513 | — | None |
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $20.0336 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$119.30/mo premium · $130.00 deductible | 4Non-Preferred Drug | 34% | — | $13.1001 | $628.8048 units |
|
| BlueRx Enhanced Plus (PDP)$129.50/mo premium · $150.00 deductible | 4Non-Preferred Drug | 42% | 42% | $19.0372 | $152.308 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 — elsewhere it depends on what is prescribed.
Michigan — 12 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 28% | 28% | $15.7633 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $15.7633 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $16.2271 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | — | $19.5179 | — | None |
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 4Non-Preferred Drug | 33% | — | $19.6507 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$14.10/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | — | $14.3184 | $687.2848 units |
|
| HealthSpring Extra Rx (PDP)$50.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | 32% | $13.6655 | — | None |
| SilverScript Choice (PDP)$78.30/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $10.5406 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$78.30/mo premium · $130.00 deductible | 4Non-Preferred Drug | 32% | — | $13.2630 | $636.6248 units |
|
| Prescription Blue Select (PDP)$78.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 25% | 25% | $13.6016 | — | None |
| Humana Premier Rx Plan (PDP)$98.10/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $19.4432 | — | None |
| Prescription Blue Premium (PDP)$106.70/mo premium · $0.00 deductible | 4Non-Preferred Drug | 27% | 27% | $13.6016 | — | None |
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 — elsewhere it depends on what is prescribed.
Illinois — 12 plans, 4 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $19.5296 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $19.5296 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 34% | — | $21.5362 | — | None |
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 4Non-Preferred Drug | 35% | — | $21.6631 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$40.20/mo premium · $615.00 deductible | 4Non-Preferred Drug | 39% | — | $15.2647 | $732.7148 units |
|
| HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $15.2774 | — | None |
| Blue Cross MedicareRx Basic (PDP)$89.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 43% | 43% | $21.3497 | $170.808 units |
|
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $11.1185 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$103.90/mo premium · $130.00 deductible | 4Non-Preferred Drug | 38% | — | $13.0722 | $627.4748 units |
|
| HealthSpring Assurance Rx (PDP)$104.20/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | 32% | $19.1765 | — | None |
| Humana Premier Rx Plan (PDP)$119.40/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $21.4649 | — | None |
| Blue Cross MedicareRx Value (PDP)$119.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | 32% | $20.1584 | $161.278 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 — elsewhere it depends on what is prescribed.
Arkansas — 12 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 26% | 26% | $16.5698 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $16.5698 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 29% | 29% | $16.9592 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 34% | — | $19.0333 | — | None |
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 4Non-Preferred Drug | 33% | — | $19.6771 | — | None |
| BlueMedicare Value Rx (PDP)$52.50/mo premium · $615.00 deductible | 4Non-Preferred Drug | 34% | 34% | $10.4525 | — | None |
| HealthSpring Extra Rx (PDP)$54.50/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $14.3491 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$65.10/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | — | $14.4926 | $695.6448 units |
|
| SilverScript Choice (PDP)$73.50/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $11.1749 | — | None |
| Humana Premier Rx Plan (PDP)$92.40/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $18.6711 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$114.90/mo premium · $130.00 deductible | 4Non-Preferred Drug | 29% | — | $13.6251 | $654.0048 units |
|
| BlueMedicare Premier Rx (PDP)$181.20/mo premium · $0.00 deductible | 4Non-Preferred Drug | 34% | 34% | $10.4525 | — | None |
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 — elsewhere it depends on what is prescribed.
Texas — 12 plans, 4 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 29% | 29% | $17.2323 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $17.2323 | — | None |
| Humana Value Rx Plan (PDP)$22.90/mo premium · $601.00 deductible | 4Non-Preferred Drug | 34% | — | $19.7874 | — | None |
| Humana Basic Rx Plan (PDP)$41.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 34% | — | $19.4724 | — | None |
| HealthSpring Extra Rx (PDP)$70.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $14.4063 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$89.20/mo premium · $615.00 deductible | 4Non-Preferred Drug | 38% | — | $14.5937 | $700.5048 units |
|
| SilverScript Choice (PDP)$94.80/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $11.4924 | — | None |
| Blue Cross MedicareRx Basic (PDP)$104.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 42% | 42% | $21.0719 | $168.588 units |
|
| HealthSpring Assurance Rx (PDP)$111.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $17.7357 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $130.00 deductible | 4Non-Preferred Drug | 35% | — | $13.6167 | $653.6048 units |
|
| Humana Premier Rx Plan (PDP)$118.20/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $19.2952 | — | None |
| Blue Cross MedicareRx Value (PDP)$167.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | 32% | $21.0901 | $168.728 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 — elsewhere it depends on what is prescribed.
Kansas — 12 plans, 5 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Blue MedicareRx Essentials (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $21.3322 | $170.668 units |
|
| Blue MedicareRx Value (PDP)$0.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $21.5163 | $172.138 units |
|
| HealthSpring Assurance Rx (PDP)$6.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $17.2451 | — | None |
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $14.0413 | — | None |
| Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 26% | 26% | $14.0292 | — | None |
| Humana Basic Rx Plan (PDP)$15.50/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | — | $18.1015 | — | None |
| Humana Value Rx Plan (PDP)$55.60/mo premium · $601.00 deductible | 4Non-Preferred Drug | 32% | — | $18.3323 | — | None |
| Blue MedicareRx Plus (PDP)$67.40/mo premium · $0.00 deductible | 4Non-Preferred Drug | 40% | 40% | $21.5163 | $172.138 units |
|
| SilverScript Choice (PDP)$88.30/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $10.9661 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$105.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 38% | — | $12.5342 | $601.6448 units |
|
| Humana Premier Rx Plan (PDP)$116.30/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $17.9716 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$147.00/mo premium · $130.00 deductible | 4Non-Preferred Drug | 38% | — | $12.1504 | $583.2248 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 — elsewhere it depends on what is prescribed.
California — 12 plans, 4 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 29% | 29% | $18.4066 | — | None |
| Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $18.4286 | — | None |
| Wellcare Classic (PDP)$6.20/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $18.4286 | — | None |
| HealthSpring Extra Rx (PDP)$70.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $14.0494 | — | None |
| SilverScript Choice (PDP)$103.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $12.7443 | — | None |
| Humana Value Rx Plan (PDP)$104.60/mo premium · $601.00 deductible | 4Non-Preferred Drug | 32% | — | $19.3349 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$109.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 38% | — | $15.2818 | $733.5348 units |
|
| Humana Basic Rx Plan (PDP)$132.20/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | — | $19.2209 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$165.40/mo premium · $130.00 deductible | 4Non-Preferred Drug | 31% | — | $14.7871 | $709.7848 units |
|
| Humana Premier Rx Plan (PDP)$172.90/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $19.1568 | — | None |
| Blue Shield Rx Plus (PDP)$199.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 49% | 49% | $24.6090 | $1,181.2348 units |
|
| Blue Shield Rx Enhanced (PDP)$227.80/mo premium · $0.00 deductible | 4Non-Preferred Drug | 37% | 37% | $24.6090 | $1,181.2348 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 — elsewhere it depends on what is prescribed.
Connecticut, Massachusetts, Rhode Island and Vermont — 11 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$8.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | — | $19.8127 | — | None |
| Wellcare Value Script (PDP)$16.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $18.9871 | — | None |
| Blue MedicareRx Value Plus (PDP)$20.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | 32% | $8.6628 | — | None |
| Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 29% | 29% | $18.9876 | — | None |
| SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | 35% | $12.9278 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | — | $15.4614 | $742.1548 units |
|
| Humana Value Rx Plan (PDP)$73.60/mo premium · $601.00 deductible | 4Non-Preferred Drug | 31% | — | $19.9053 | — | None |
| Humana Premier Rx Plan (PDP)$138.60/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $19.7607 | — | None |
| HealthSpring Assurance Rx (PDP)$139.30/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $18.9142 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible | 4Non-Preferred Drug | 30% | — | $14.6655 | $703.9448 units |
|
| Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible | 4Non-Preferred Drug | 35% | 35% | $8.6628 | — | None |
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 — elsewhere it depends on what is prescribed.
South Carolina — 11 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$4.80/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $17.8396 | — | None |
| Wellcare Classic (PDP)$9.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 27% | 27% | $17.8396 | — | None |
| Humana Basic Rx Plan (PDP)$10.10/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | — | $19.3764 | — | None |
| Humana Value Rx Plan (PDP)$65.60/mo premium · $601.00 deductible | 4Non-Preferred Drug | 34% | — | $19.6873 | — | None |
| HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $14.1996 | — | None |
| SilverScript Choice (PDP)$98.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $12.1928 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$122.10/mo premium · $615.00 deductible | 4Non-Preferred Drug | 36% | — | $14.7729 | $709.1048 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible | 4Non-Preferred Drug | 35% | — | $14.0016 | $672.0848 units |
|
| BlueCross Rx Value (PDP)$139.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 50% | 50% | $15.0013 | — | None |
| Humana Premier Rx Plan (PDP)$145.60/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $19.2015 | — | None |
| HealthSpring Assurance Rx (PDP)$152.50/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $18.0686 | — | None |
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 — elsewhere it depends on what is prescribed.
Oklahoma — 11 plans, 4 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Blue Cross MedicareRx Basic (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $21.7977 | $174.388 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 29% | — | $19.0144 | — | None |
| Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $17.2221 | — | None |
| Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 26% | 26% | $17.2221 | — | None |
| Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible | 4Non-Preferred Drug | 35% | — | $19.4602 | — | None |
| HealthSpring Extra Rx (PDP)$65.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $14.9114 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 41% | — | $14.4757 | $694.8348 units |
|
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $18.7637 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$121.00/mo premium · $130.00 deductible | 4Non-Preferred Drug | 40% | — | $13.7228 | $658.6948 units |
|
| HealthSpring Assurance Rx (PDP)$126.50/mo premium · $615.00 deductible | 4Non-Preferred Drug | 29% | 29% | $17.1974 | — | None |
| Blue Cross MedicareRx Value (PDP)$167.30/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | 32% | $21.5918 | $172.738 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 — elsewhere it depends on what is prescribed.
Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming — 11 plans, 3 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$4.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 34% | — | $18.7535 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$5.30/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | — | $14.4913 | $695.5848 units |
|
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $17.3962 | — | None |
| Wellcare Classic (PDP)$12.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 27% | 27% | $17.3908 | — | None |
| Humana Value Rx Plan (PDP)$20.80/mo premium · $601.00 deductible | 4Non-Preferred Drug | 34% | — | $19.0550 | — | None |
| SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | 35% | $12.0626 | — | None |
| HealthSpring Extra Rx (PDP)$66.50/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $13.9230 | — | None |
| MedicareBlue Rx Standard (PDP)$101.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 42% | 42% | $23.5790 | $188.638 units |
|
| Humana Premier Rx Plan (PDP)$103.70/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $18.5839 | — | None |
| HealthSpring Assurance Rx (PDP)$125.90/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $16.1152 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$140.20/mo premium · $130.00 deductible | 4Non-Preferred Drug | 34% | — | $13.6992 | $657.5648 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 — elsewhere it depends on what is prescribed.
New Mexico — 11 plans, 4 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $18.3095 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $18.3095 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 29% | 29% | $18.4749 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | — | $20.3027 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 43% | — | $15.1654 | $727.9448 units |
|
| Humana Value Rx Plan (PDP)$69.60/mo premium · $601.00 deductible | 4Non-Preferred Drug | 30% | — | $20.7842 | — | None |
| Humana Premier Rx Plan (PDP)$75.60/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $20.0318 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible | 4Non-Preferred Drug | 35% | — | $13.7364 | $659.3548 units |
|
| SilverScript Choice (PDP)$104.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $11.4874 | — | None |
| Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $20.8189 | $166.558 units |
|
| Blue Cross MedicareRx Basic (PDP)$145.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $20.9920 | $167.948 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 — elsewhere it depends on what is prescribed.
New York — 10 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| HealthSpring Assurance Rx (PDP)$35.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 29% | 29% | $16.6163 | — | None |
| Wellcare Value Script (PDP)$42.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $17.0571 | — | None |
| Wellcare Classic (PDP)$45.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 28% | 28% | $17.0626 | — | None |
| HealthSpring Extra Rx (PDP)$91.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 29% | 29% | $13.7235 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$105.80/mo premium · $615.00 deductible | 4Non-Preferred Drug | 38% | — | $14.8736 | $713.9348 units |
|
| SilverScript Choice (PDP)$116.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $11.2131 | — | None |
| Humana Basic Rx Plan (PDP)$140.90/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | — | $19.5997 | — | None |
| Humana Value Rx Plan (PDP)$158.90/mo premium · $601.00 deductible | 4Non-Preferred Drug | 31% | — | $19.7049 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$163.70/mo premium · $130.00 deductible | 4Non-Preferred Drug | 28% | — | $13.9428 | $669.2548 units |
|
| Humana Premier Rx Plan (PDP)$173.60/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $19.5406 | — | None |
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 — elsewhere it depends on what is prescribed.
Delaware, DC and Maryland — 10 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | — | $20.4068 | — | None |
| Humana Value Rx Plan (PDP)$4.30/mo premium · $601.00 deductible | 4Non-Preferred Drug | 33% | — | $20.6800 | — | None |
| Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $18.8834 | — | None |
| Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $18.8834 | — | None |
| HealthSpring Assurance Rx (PDP)$32.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $18.6201 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$37.80/mo premium · $615.00 deductible | 4Non-Preferred Drug | 36% | — | $15.2000 | $729.6048 units |
|
| HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | 32% | $14.5572 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible | 4Non-Preferred Drug | 34% | — | $13.8814 | $666.3148 units |
|
| SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $12.0346 | — | None |
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $20.2531 | — | None |
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 — elsewhere it depends on what is prescribed.
Georgia — 10 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 28% | 28% | $16.1195 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $16.1195 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 34% | — | $19.2409 | — | None |
| Humana Value Rx Plan (PDP)$36.40/mo premium · $601.00 deductible | 4Non-Preferred Drug | 34% | — | $19.4789 | — | None |
| HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $14.1179 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$98.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | — | $14.0638 | $675.0648 units |
|
| SilverScript Choice (PDP)$100.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $10.9226 | — | None |
| Humana Premier Rx Plan (PDP)$129.50/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $19.1069 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$139.80/mo premium · $130.00 deductible | 4Non-Preferred Drug | 36% | — | $13.1607 | $631.7148 units |
|
| HealthSpring Assurance Rx (PDP)$149.30/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $17.0260 | — | None |
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 — elsewhere it depends on what is prescribed.
Florida — 10 plans, 4 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 28% | 28% | $18.0108 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $18.0130 | — | None |
| Humana Value Rx Plan (PDP)$25.90/mo premium · $601.00 deductible | 4Non-Preferred Drug | 33% | — | $21.1776 | — | None |
| Humana Basic Rx Plan (PDP)$92.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 36% | — | $21.0326 | — | None |
| SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $11.1627 | — | None |
| BlueMedicare Premier Rx (PDP)$98.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $18.4614 | $147.698 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$98.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | — | $15.0707 | $723.3948 units |
|
| Humana Premier Rx Plan (PDP)$115.90/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $20.9511 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$119.10/mo premium · $130.00 deductible | 4Non-Preferred Drug | 34% | — | $13.3039 | $638.5948 units |
|
| BlueMedicare Complete Rx (PDP)$217.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 29% | 29% | $18.4614 | $147.698 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 — elsewhere it depends on what is prescribed.
Ohio — 10 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | — | $18.9479 | — | None |
| Wellcare Value Script (PDP)$7.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $16.3017 | — | None |
| Wellcare Classic (PDP)$7.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 27% | 27% | $16.3017 | — | None |
| Humana Value Rx Plan (PDP)$23.70/mo premium · $601.00 deductible | 4Non-Preferred Drug | 34% | — | $19.2191 | — | None |
| HealthSpring Extra Rx (PDP)$65.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $14.5187 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$73.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | — | $13.6362 | $654.5448 units |
|
| SilverScript Choice (PDP)$90.30/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $10.9252 | — | None |
| HealthSpring Assurance Rx (PDP)$109.50/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $18.1592 | — | None |
| Humana Premier Rx Plan (PDP)$117.60/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $18.7953 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$123.40/mo premium · $130.00 deductible | 4Non-Preferred Drug | 36% | — | $12.9746 | $622.7848 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 — elsewhere it depends on what is prescribed.
Indiana and Kentucky — 10 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | — | $18.5955 | — | None |
| Wellcare Value Script (PDP)$8.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $16.2303 | — | None |
| Wellcare Classic (PDP)$8.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 27% | 27% | $16.1803 | — | None |
| Humana Value Rx Plan (PDP)$9.90/mo premium · $601.00 deductible | 4Non-Preferred Drug | 34% | — | $18.7815 | — | None |
| SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | 35% | $12.6476 | — | None |
| HealthSpring Extra Rx (PDP)$78.20/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $14.6999 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$90.30/mo premium · $615.00 deductible | 4Non-Preferred Drug | 42% | — | $13.8419 | $664.4148 units |
|
| HealthSpring Assurance Rx (PDP)$117.80/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $18.5756 | — | None |
| Humana Premier Rx Plan (PDP)$125.30/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $18.4908 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$127.10/mo premium · $130.00 deductible | 4Non-Preferred Drug | 34% | — | $13.3057 | $638.6748 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 — elsewhere it depends on what is prescribed.
Wisconsin — 10 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 26% | 26% | $17.2687 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $17.2687 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $17.5486 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | — | $21.0197 | — | None |
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 4Non-Preferred Drug | 35% | — | $21.2592 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | — | $14.5105 | $696.5048 units |
|
| SilverScript Choice (PDP)$26.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | 35% | $11.0157 | — | None |
| HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $14.6305 | — | None |
| Humana Premier Rx Plan (PDP)$110.60/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $20.8849 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$113.90/mo premium · $130.00 deductible | 4Non-Preferred Drug | 36% | — | $12.6333 | $606.4048 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 — elsewhere it depends on what is prescribed.
Missouri — 10 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $17.9107 | — | None |
| Wellcare Classic (PDP)$10.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 26% | 26% | $17.9107 | — | None |
| Humana Basic Rx Plan (PDP)$16.50/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | — | $20.0517 | — | None |
| Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible | 4Non-Preferred Drug | 34% | — | $20.3248 | — | None |
| HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $14.1796 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$71.90/mo premium · $615.00 deductible | 4Non-Preferred Drug | 39% | — | $14.7764 | $709.2748 units |
|
| HealthSpring Assurance Rx (PDP)$74.30/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $17.1775 | — | None |
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $11.4797 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$125.40/mo premium · $130.00 deductible | 4Non-Preferred Drug | 35% | — | $13.5142 | $648.6848 units |
|
| Humana Premier Rx Plan (PDP)$126.40/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $19.8981 | — | None |
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 — elsewhere it depends on what is prescribed.
Mississippi — 10 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 29% | 29% | $15.7985 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $15.7985 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | — | $18.7842 | — | None |
| Humana Value Rx Plan (PDP)$37.60/mo premium · $601.00 deductible | 4Non-Preferred Drug | 35% | — | $19.2145 | — | None |
| HealthSpring Assurance Rx (PDP)$59.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $16.2574 | — | None |
| HealthSpring Extra Rx (PDP)$77.10/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $13.7419 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$84.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 37% | — | $14.5137 | $696.6648 units |
|
| Humana Premier Rx Plan (PDP)$89.90/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $18.5421 | — | None |
| SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $11.2683 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$140.60/mo premium · $130.00 deductible | 4Non-Preferred Drug | 34% | — | $13.8616 | $665.3648 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 — elsewhere it depends on what is prescribed.
Louisiana — 10 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | — | $20.7183 | — | None |
| Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $17.2295 | — | None |
| Wellcare Classic (PDP)$6.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 28% | 28% | $17.2295 | — | None |
| Humana Value Rx Plan (PDP)$19.30/mo premium · $601.00 deductible | 4Non-Preferred Drug | 35% | — | $20.9374 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$37.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | — | $14.9302 | $716.6548 units |
|
| SilverScript Choice (PDP)$44.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | 35% | $10.8322 | — | None |
| HealthSpring Assurance Rx (PDP)$48.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $16.6356 | — | None |
| HealthSpring Extra Rx (PDP)$60.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $13.7227 | — | None |
| Humana Premier Rx Plan (PDP)$113.70/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $20.5950 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$139.50/mo premium · $130.00 deductible | 4Non-Preferred Drug | 36% | — | $13.3304 | $639.8648 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 — elsewhere it depends on what is prescribed.
Colorado — 10 plans, 2 with restrictions
| 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 | 4Non-Preferred Drug | 40% | 40% | $15.7769 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | — | $18.6312 | — | None |
| Wellcare Classic (PDP)$2.20/mo premium · $615.00 deductible | 4Non-Preferred Drug | 29% | 29% | $15.7769 | — | None |
| Humana Value Rx Plan (PDP)$48.50/mo premium · $601.00 deductible | 4Non-Preferred Drug | 34% | — | $19.0938 | — | None |
| HealthSpring Assurance Rx (PDP)$61.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $18.0011 | — | None |
| HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $15.0857 | — | None |
| SilverScript Choice (PDP)$105.10/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $10.8407 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$125.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | — | $13.5279 | $649.3448 units |
|
| Humana Premier Rx Plan (PDP)$137.10/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $18.3710 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$151.90/mo premium · $130.00 deductible | 4Non-Preferred Drug | 37% | — | $12.8203 | $615.3748 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 — elsewhere it depends on what is prescribed.
Arizona — 10 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | 32% | $17.8703 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $17.9748 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 29% | 29% | $19.3980 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | — | $20.2645 | — | None |
| Humana Value Rx Plan (PDP)$2.50/mo premium · $601.00 deductible | 4Non-Preferred Drug | 34% | — | $20.6199 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 36% | — | $14.0473 | $674.2748 units |
|
| HealthSpring Extra Rx (PDP)$66.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $15.4425 | — | None |
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $11.3917 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$97.50/mo premium · $130.00 deductible | 4Non-Preferred Drug | 35% | — | $13.0432 | $626.0748 units |
|
| Humana Premier Rx Plan (PDP)$119.20/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $20.0646 | — | None |
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 — elsewhere it depends on what is prescribed.
Nevada — 10 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | — | $21.4929 | — | None |
| Wellcare Classic (PDP)$2.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $18.4570 | — | None |
| Wellcare Value Script (PDP)$2.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $18.4570 | — | None |
| Humana Value Rx Plan (PDP)$43.70/mo premium · $601.00 deductible | 4Non-Preferred Drug | 34% | — | $21.6378 | — | None |
| HealthSpring Extra Rx (PDP)$52.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $15.3228 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$76.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 34% | — | $14.6046 | $701.0248 units |
|
| HealthSpring Assurance Rx (PDP)$95.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $19.6494 | — | None |
| SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $11.5422 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$139.10/mo premium · $130.00 deductible | 4Non-Preferred Drug | 36% | — | $12.6832 | $608.7948 units |
|
| Humana Premier Rx Plan (PDP)$148.70/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $21.4114 | — | None |
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 — elsewhere it depends on what is prescribed.
Oregon and Washington — 10 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 28% | 28% | $15.5433 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $15.5447 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $17.1319 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | — | $18.8816 | — | None |
| Humana Value Rx Plan (PDP)$22.10/mo premium · $601.00 deductible | 4Non-Preferred Drug | 33% | — | $19.0879 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$38.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 36% | — | $13.5837 | $652.0248 units |
|
| HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $14.4888 | — | None |
| SilverScript Choice (PDP)$85.90/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $10.5373 | — | None |
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $18.7656 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$110.00/mo premium · $130.00 deductible | 4Non-Preferred Drug | 37% | — | $12.7946 | $614.1448 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 — elsewhere it depends on what is prescribed.
Idaho and Utah — 10 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | — | $18.4750 | — | None |
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $14.8756 | — | None |
| Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible | 4Non-Preferred Drug | 32% | — | $18.6877 | — | None |
| Wellcare Classic (PDP)$23.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 27% | 27% | $14.8756 | — | None |
| SilverScript Choice (PDP)$27.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | 35% | $11.8529 | — | None |
| HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $14.0173 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$56.50/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | — | $13.5381 | $649.8348 units |
|
| Humana Premier Rx Plan (PDP)$115.50/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $18.3554 | — | None |
| HealthSpring Assurance Rx (PDP)$128.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $16.2246 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$132.60/mo premium · $130.00 deductible | 4Non-Preferred Drug | 36% | — | $12.9053 | $619.4548 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 — elsewhere it depends on what is prescribed.
Maine and New Hampshire — 9 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 27% | 27% | $16.9625 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $16.9625 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $16.7732 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | — | $19.6262 | — | None |
| Humana Value Rx Plan (PDP)$54.40/mo premium · $601.00 deductible | 4Non-Preferred Drug | 31% | — | $19.8217 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 36% | — | $14.6619 | $703.7748 units |
|
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $11.3638 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$104.30/mo premium · $130.00 deductible | 4Non-Preferred Drug | 30% | — | $13.5782 | $651.7548 units |
|
| Humana Premier Rx Plan (PDP)$150.20/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $19.5162 | — | None |
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 — elsewhere it depends on what is prescribed.
Virginia — 9 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $17.0723 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $17.0723 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | — | $19.2114 | — | None |
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 4Non-Preferred Drug | 32% | — | $19.5271 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$39.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 34% | — | $14.2705 | $684.9848 units |
|
| SilverScript Choice (PDP)$78.20/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $11.6317 | — | None |
| Humana Premier Rx Plan (PDP)$87.60/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $19.0338 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$100.80/mo premium · $130.00 deductible | 4Non-Preferred Drug | 35% | — | $13.4253 | $644.4148 units |
|
| HealthSpring Assurance Rx (PDP)$133.80/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $18.2103 | — | None |
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 — elsewhere it depends on what is prescribed.
Alaska — 9 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 28% | 28% | $11.1966 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 29% | 29% | $17.1619 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 28% | — | $17.1237 | — | None |
| Humana Value Rx Plan (PDP)$10.60/mo premium · $601.00 deductible | 4Non-Preferred Drug | 33% | — | $17.1924 | — | None |
| Wellcare Value Script (PDP)$19.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $11.1966 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$53.20/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | — | $10.8706 | $521.7948 units |
|
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $9.4813 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$100.20/mo premium · $130.00 deductible | 4Non-Preferred Drug | 35% | — | $10.8119 | $518.9748 units |
|
| Humana Premier Rx Plan (PDP)$112.40/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $17.0850 | — | None |
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 — elsewhere it depends on what is prescribed.
Hawaii — 8 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 38% | — | $14.6241 | $701.9648 units |
|
| Humana Basic Rx Plan (PDP)$0.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 28% | — | $19.5855 | — | None |
| SilverScript Choice (PDP)$14.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | 35% | $18.4084 | — | None |
| Wellcare Value Script (PDP)$21.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $16.9808 | — | None |
| Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | 35% | $16.9535 | — | None |
| Humana Value Rx Plan (PDP)$51.60/mo premium · $601.00 deductible | 4Non-Preferred Drug | 30% | — | $19.5865 | — | None |
| Humana Premier Rx Plan (PDP)$90.20/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $19.5850 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible | 4Non-Preferred Drug | 34% | — | $13.8062 | $662.7048 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 — elsewhere it depends on what is prescribed.
Puerto Rico — 3 plans, 1 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $11.6659 | — | None |
| HealthSpring Assurance Rx (PDP)$65.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 34% | 34% | $11.8641 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$145.10/mo premium · $615.00 deductible | 4Non-Preferred Drug | 25% | 25% | $13.5036 | $648.1748 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 — elsewhere it depends on what is prescribed.
American Samoa — 1 plan, 1 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 25% | 25% | $16.2464 | $779.8348 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 — elsewhere it depends on what is prescribed.
Guam — 1 plan, 1 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 25% | 25% | $16.2464 | $779.8348 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 — elsewhere it depends on what is prescribed.
Northern Mariana Islands — 1 plan, 1 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP)$32.10/mo premium · $615.00 deductible | 4Non-Preferred Drug | 25% | 25% | $16.2464 | $779.8348 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 — elsewhere it depends on what is prescribed.
U.S. Virgin Islands — 1 plan, 1 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $615.00 deductible | 4Non-Preferred Drug | 25% | 25% | $16.2464 | $779.8348 units |
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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 — elsewhere it depends on what is prescribed.