MedicarePartD.guide

A non-government resource built from CMS public data

DRONABINOL 10 mg Capsule

Coverage in North Carolina (CMS PDP Region 08).

12 of 12 stand-alone Part D plans in North Carolina cover this drug on tier 4.

12 of 12 plans apply a prior authorization, step therapy or quantity limit.

160 Medicare Advantage plans in NC 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. NC: 160 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$13.2624$79.576 units
  • Prior authorization
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$4.70/mo premium · $615.00 deductible4Non-Preferred Drug27%27%$13.2624$79.576 units
  • Prior authorization
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$6.80/mo premium · $615.00 deductible4Non-Preferred Drug32%—$6.5976$79.1712 units
  • Prior authorization
  • Quantity limit 12 per 30 days
Humana Value Rx Plan (PDP)$32.00/mo premium · $601.00 deductible4Non-Preferred Drug34%—$6.6547$79.8612 units
  • Prior authorization
  • Quantity limit 12 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$56.90/mo premium · $615.00 deductible4Non-Preferred Drug34%—$5.1752—
  • Prior authorization
HealthSpring Extra Rx (PDP)$78.00/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$15.7784$94.676 units
  • Prior authorization
  • Quantity limit 6 per 30 days
Blue Medicare Rx Standard (PDP)$83.90/mo premium · $615.00 deductible4Non-Preferred Drug32%32%$33.2739—
  • Prior authorization
SilverScript Choice (PDP)$90.20/mo premium · $615.00 deductible4Non-Preferred Drug33%33%$4.1367$24.826 units
  • Prior authorization
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$110.40/mo premium · $615.00 deductible4Non-Preferred Drug32%32%$16.3823$98.296 units
  • Prior authorization
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$110.90/mo premium · $0.00 deductible4Non-Preferred Drug50%50%$6.5655$78.7912 units
  • Prior authorization
  • Quantity limit 12 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$119.80/mo premium · $130.00 deductible4Non-Preferred Drug33%—$5.0993—
  • Prior authorization
Blue Medicare Rx Enhanced (PDP)$163.20/mo premium · $0.00 deductible4Non-Preferred Drug40%40%$33.2739—
  • Prior authorization

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.

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