RALDESY TM 10 mg/mL Solution
Also known as Trazodone Hydrochloride Oral. Coverage in Texas (CMS PDP Region 22).
12 of 12 stand-alone Part D plans in Texas cover this drug on tier 4–5.
5 of 12 plans apply a prior authorization, step therapy or quantity limit.
389 Medicare Advantage plans in TX 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. TX: 389 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Blue Cross MedicareRx Basic (PDP)$104.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 42% | 42% | $2.6901 | $32.2812 units |
|
| Blue Cross MedicareRx Value (PDP)$167.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | 32% | $2.6635 | $31.9612 units |
|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $1.5565 | — |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $1.5565 | — |
|
| Humana Value Rx Plan (PDP)$22.90/mo premium · $601.00 deductible | 5Specialty Tier | 26% | — | $1.6212 | — | None |
| Humana Basic Rx Plan (PDP)$41.70/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $1.6212 | — | None |
| HealthSpring Extra Rx (PDP)$70.00/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $1.5535 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$89.20/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $2.6775 | — | None |
| SilverScript Choice (PDP)$94.80/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $1.6852 | $30.3318 units |
|
| HealthSpring Assurance Rx (PDP)$111.40/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $1.5537 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $130.00 deductible | 5Specialty Tier | 31% | — | $2.6775 | — | None |
| Humana Premier Rx Plan (PDP)$118.20/mo premium · $0.00 deductible | 5Specialty Tier | 33% | — | $1.6212 | — | 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.