MedicarePartD.guide

A non-government resource built from CMS public data

MEGESTROL ACETATE 125 mg/mL Suspension

Coverage in Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming (CMS PDP Region 25).

3 of 11 stand-alone Part D plans in Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming cover this drug on tier 4.

1 of 3 plans apply a prior authorization, step therapy or quantity limit.

206 Medicare Advantage plans in IA, MN, MT, NE, ND, SD, WY 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. IA: 52 plans · MN: 46 plans · MT: 20 plans · NE: 39 plans · ND: 22 plans · SD: 19 plans · WY: 8 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$3.2256—
  • Prior authorization
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible4Non-Preferred Drug35%35%$3.6364—None
AARP Medicare Rx Preferred from UHC (PDP)$140.20/mo premium · $130.00 deductible4Non-Preferred Drug34%—$1.7763—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.

See coverage in all 39 regions →