PENICILLIN G SODIUM 5000000 [USP'U] Injection, Powder, For Solution
Coverage in Alabama and Tennessee (CMS PDP Region 12).
8 of 12 stand-alone Part D plans in Alabama and Tennessee cover this drug on tier 4.
No plan applies a prior authorization, step therapy or quantity limit.
175 Medicare Advantage plans in AL, TN 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. AL: 71 plans · TN: 104 plans.
Every plan that covers it
| 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% | — | $49.5292 | — | None |
| Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $32.2065 | — | None |
| Wellcare Classic (PDP)$3.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 27% | 27% | $32.2065 | — | None |
| Humana Value Rx Plan (PDP)$37.70/mo premium · $601.00 deductible | 4Non-Preferred Drug | 33% | — | $49.5292 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$63.20/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | — | $39.8688 | — | None |
| SilverScript Choice (PDP)$97.30/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $43.2000 | — | None |
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $49.5292 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$119.30/mo premium · $130.00 deductible | 4Non-Preferred Drug | 34% | — | $39.8688 | — | 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.