METFORMIN HYDROCHLORIDE 1000 mg Tablet, Film Coated, Extended Release
Coverage in Idaho and Utah (CMS PDP Region 31).
1 of 10 stand-alone Part D plans in Idaho and Utah cover this drug on tier 4.
1 of 1 plans apply a prior authorization, step therapy or quantity limit.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $2.3925 | $14.366 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.