KETODAN 20 mg/g Aerosol, Foam
Also known as Ketoconazole. Coverage in Connecticut, Massachusetts, Rhode Island and Vermont (CMS PDP Region 02).
2 of 11 stand-alone Part D plans in Connecticut, Massachusetts, Rhode Island and Vermont cover this drug on tier 4.
2 of 2 plans apply a prior authorization, step therapy or quantity limit.
Every plan that covers it
Showing 2 of 2 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible · $0 with full Extra Help | 4Non-Preferred Drug | 35% | 35% | $5.4593 | $5.461 unit |
|
| AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible | 4Non-Preferred Drug | 30% | — | $5.1818 | $5.181 unit |
|
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.
Medicare Advantage plans
Medicare Advantage plans carry their own formularies, separate from stand-alone Part D, and are sold county by county. Pick a county to see every Medicare Advantage drug plan there that covers this drug.
17 Medicare Advantage plans in CT, MA, RI do cover it
A patient on an MA-PD plan may have coverage even where no PDP lists the drug. CT: 8 plans · MA: 6 plans · RI: 3 plans.