OLMESARTAN MEDOXOMIL 40 mg Tablet, Film Coated
Coverage in Virginia (CMS PDP Region 07).
9 of 9 stand-alone Part D plans in Virginia cover this drug on tier 1–2.
Lowest 30-day cost $0.00 at a preferred pharmacy. 8 of 9 plans apply a prior authorization, step therapy or quantity limit.
122 Medicare Advantage plans in VA 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. VA: 122 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)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1066 | $0.323 units |
|
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3765 | $1.133 units |
|
| Humana Premier Rx Plan (PDP)$87.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3682 | $1.103 units |
|
| HealthSpring Assurance Rx (PDP)$133.80/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2782 | — | None |
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3721 | $1.123 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3682 | $1.103 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$39.60/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.3416 | $1.023 units |
|
| SilverScript Choice (PDP)$78.20/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2691 | $0.813 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$100.80/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.5261 | $1.583 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.