METOCLOPRAMIDE HYDROCHLORIDE 5 mg Tablet, Orally Disintegrating
Coverage in Kansas (CMS PDP Region 24).
1 of 12 stand-alone Part D plans in Kansas cover this drug on tier 2.
Lowest 30-day cost $7.00 at a preferred pharmacy. No plan applies a prior authorization, step therapy or quantity limit.
21 Medicare Advantage plans in KS 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. KS: 21 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| SilverScript Choice (PDP)$88.30/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $7.4278 | — | 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.