CICLOPIROX 7.7 mg/g Gel
Coverage in Idaho and Utah (CMS PDP Region 31).
6 of 10 stand-alone Part D plans in Idaho and Utah cover this drug on tier 2–4.
Lowest 30-day cost $10.00 at a preferred pharmacy. 4 of 6 plans apply a prior authorization, step therapy or quantity limit.
73 Medicare Advantage plans in ID, UT 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. ID: 32 plans · UT: 41 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| SilverScript Choice (PDP)$27.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.4734 | $0.471 unit |
|
| AARP Medicare Rx Saver from UHC (PDP)$56.50/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $1.1900 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$132.60/mo premium · $130.00 deductible | 3Preferred Brand | 17% | 17% | $1.1961 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | — | $1.5147 | $1.511 unit |
|
| Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible | 4Non-Preferred Drug | 32% | — | $1.5354 | $1.541 unit |
|
| Humana Premier Rx Plan (PDP)$115.50/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $1.5031 | $1.501 unit |
|
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.