DEXMETHYLPHENIDATE HYDROCHLORIDE 5 mg Tablet
Coverage in Mississippi (CMS PDP Region 20).
9 of 10 stand-alone Part D plans in Mississippi cover this drug on tier 3–4.
Lowest 30-day cost $45.00 at a preferred pharmacy. 7 of 9 plans apply a prior authorization, step therapy or quantity limit.
84 Medicare Advantage plans in MS 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. MS: 84 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| HealthSpring Assurance Rx (PDP)$59.70/mo premium · $615.00 deductible | 3Preferred Brand | 21% | 21% | $0.6309 | — | None |
| HealthSpring Extra Rx (PDP)$77.10/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $0.6238 | — | None |
| Humana Premier Rx Plan (PDP)$89.90/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $0.4473 | $2.686 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$140.60/mo premium · $130.00 deductible | 3Preferred Brand | 16% | 16% | $0.3565 | $2.146 units |
|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 29% | 29% | $0.7060 | $4.246 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $0.7060 | $4.246 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | — | $0.4552 | $2.736 units |
|
| Humana Value Rx Plan (PDP)$37.60/mo premium · $601.00 deductible | 4Non-Preferred Drug | 35% | — | $0.4695 | $2.826 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$84.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 37% | — | $0.3565 | $2.146 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.