AMOXICILLIN AND CLAVULANATE POTASSIUM 562.5/437.5/62.5 mg Tablet, Multilayer, Extended Release
Coverage in Nevada (CMS PDP Region 29).
6 of 10 stand-alone Part D plans in Nevada cover this drug on tier 4.
No plan applies a prior authorization, step therapy or quantity limit.
58 Medicare Advantage plans in NV 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. NV: 58 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$2.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $5.3588 | — | None |
| HealthSpring Extra Rx (PDP)$52.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $5.7245 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$76.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 34% | — | $5.6305 | — | None |
| HealthSpring Assurance Rx (PDP)$95.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $6.0669 | — | None |
| SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $6.3293 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$139.10/mo premium · $130.00 deductible | 4Non-Preferred Drug | 36% | — | $5.6205 | — | 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.