MedicarePartD.guide

A non-government resource built from CMS public data

RISPERIDONE 3 mg Tablet

Package: 60 TABLET in 1 BOTTLE (43547-343-06). NDC 43547034306.

Plans covering it
367
across 39 regions checked
Lowest tier
1
lower tiers cost less
Plans with restrictions
220
prior auth, step therapy or quantity limit

Coverage by region

Covered by at least one plan in 39 of 39 CMS regions.

RegionPlans coveringTiersLowest 30-day costRestrictions
New Jersey12 of 121–3$0.008 of 12 plans
Pennsylvania and West Virginia12 of 121–2$0.008 of 12 plans
North Carolina12 of 121–3$0.008 of 12 plans
Alabama and Tennessee12 of 121–3$0.008 of 12 plans
Michigan12 of 121–3$0.008 of 12 plans
Illinois12 of 121–3$0.008 of 12 plans
Arkansas12 of 121–3$0.006 of 12 plans
Texas12 of 121–3$0.008 of 12 plans
Kansas12 of 121–3$0.008 of 12 plans
California12 of 121–3$0.006 of 12 plans
Connecticut, Massachusetts, Rhode Island and Vermont11 of 111–2$0.005 of 11 plans
South Carolina11 of 111–3$0.007 of 11 plans
Oklahoma11 of 111–2$0.007 of 11 plans
Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming11 of 111–2$0.007 of 11 plans
New Mexico11 of 111–3$0.007 of 11 plans
New York10 of 101–3$0.006 of 10 plans
Delaware, DC and Maryland10 of 101–3$0.006 of 10 plans
Georgia10 of 101–3$0.006 of 10 plans
Florida10 of 101–3$0.006 of 10 plans
Ohio10 of 101–3$0.006 of 10 plans
Indiana and Kentucky10 of 101–2$0.006 of 10 plans
Wisconsin10 of 101–2$0.006 of 10 plans
Missouri10 of 101–3$0.006 of 10 plans
Mississippi10 of 101–3$0.006 of 10 plans
Louisiana10 of 101–2$0.006 of 10 plans
Colorado10 of 101–3$0.006 of 10 plans
Arizona10 of 101–3$0.006 of 10 plans
Nevada10 of 101–3$0.006 of 10 plans
Oregon and Washington10 of 101–3$0.006 of 10 plans
Idaho and Utah10 of 101–2$0.006 of 10 plans
Maine and New Hampshire9 of 91–3$0.005 of 9 plans
Virginia9 of 91–3$0.005 of 9 plans
Alaska9 of 91–3$0.005 of 9 plans
Hawaii8 of 81–2$0.004 of 8 plans
Puerto Rico3 of 32$2.002 of 3 plans
American Samoa1 of 12—none
Guam1 of 12—none
Northern Mariana Islands1 of 12—none
U.S. Virgin Islands1 of 12—none

Plan-by-plan detail

Open a region to see every plan that covers this drug, with tier, cost-sharing and restrictions.

New Jersey — 12 plans, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$4.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1828$1.106 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$35.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1841$1.106 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$111.90/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1828$1.106 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$22.80/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1089—None
Wellcare Classic (PDP)$28.20/mo premium · $615.00 deductible2Generic$10.00$30.00$0.1903—None
HealthSpring Extra Rx (PDP)$59.90/mo premium · $615.00 deductible2Generic$5.00$3.00$0.2641$1.586 units
  • Quantity limit 6 per 30 days
Horizon Medicare Blue Rx Standard (PDP)$72.30/mo premium · $615.00 deductible2Generic$3.00$4.50$0.3051$1.836 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$77.40/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2354—None
HealthSpring Assurance Rx (PDP)$109.30/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1332$0.806 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$118.90/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4470—None
Horizon Medicare Blue Rx Enhanced (PDP)$139.10/mo premium · $200.00 deductible2Generic$6.00$9.00$0.3051$1.836 units
  • Quantity limit 6 per 30 days
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0654$0.599 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

Pennsylvania and West Virginia — 12 plans, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$6.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1749$1.056 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1770$1.066 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$123.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1749$1.056 units
  • Quantity limit 6 per 30 days
Blue Rx PDP Complete (PDP)$164.80/mo premium · $200.00 deductible1Preferred Generic$0.00$0.00$0.1138$10.2490 units
  • Quantity limit 93 per 31 days
Blue Rx PDP Plus (PDP)$193.20/mo premium · $615.00 deductible1Preferred Generic25%25%$0.1138$10.2490 units
  • Quantity limit 93 per 31 days
Wellcare Value Script (PDP)$8.20/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1275—None
Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2064—None
SilverScript Choice (PDP)$22.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.1394$1.259 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$43.50/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2384—None
HealthSpring Extra Rx (PDP)$62.60/mo premium · $615.00 deductible2Generic$5.00$3.00$0.2608$1.566 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$74.00/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1431$0.866 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$121.90/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4128—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 — elsewhere it depends on what is prescribed.

North Carolina — 12 plans, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$6.80/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1915$1.156 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$32.00/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1945$1.176 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$110.90/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1915$1.156 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1591—None
Wellcare Classic (PDP)$4.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2406—None
AARP Medicare Rx Saver from UHC (PDP)$56.90/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2272—None
HealthSpring Extra Rx (PDP)$78.00/mo premium · $615.00 deductible2Generic$5.00$3.00$0.3365$2.026 units
  • Quantity limit 6 per 30 days
Blue Medicare Rx Standard (PDP)$83.90/mo premium · $615.00 deductible2Generic$10.00$30.00$0.3734$2.246 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$110.40/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1956$1.176 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$119.80/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3670—None
Blue Medicare Rx Enhanced (PDP)$163.20/mo premium · $0.00 deductible2Generic$6.00$18.00$0.3734$2.246 units
  • Quantity limit 6 per 30 days
SilverScript Choice (PDP)$90.20/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0627$0.569 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

Alabama and Tennessee — 12 plans, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1789$1.076 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$37.70/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1828$1.106 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1789$1.076 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1384—None
Wellcare Classic (PDP)$3.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2084—None
AARP Medicare Rx Saver from UHC (PDP)$63.20/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2304—None
BlueRx Essential (PDP)$76.20/mo premium · $615.00 deductible2Generic$10.00$20.00$0.3368$2.026 units
  • Quantity limit 6 per 30 days
HealthSpring Extra Rx (PDP)$77.50/mo premium · $615.00 deductible2Generic$5.00$3.00$0.3270$1.966 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$87.20/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1694$1.026 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$119.30/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3663—None
BlueRx Enhanced Plus (PDP)$129.50/mo premium · $150.00 deductible2Generic$12.00$24.00$0.3368$2.026 units
  • Quantity limit 6 per 30 days
SilverScript Choice (PDP)$97.30/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0650$0.589 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

Michigan — 12 plans, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1691$1.016 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1707$1.026 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$98.10/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1691$1.016 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.1897—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1234—None
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible2Generic10%10%$0.1400$0.846 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$14.10/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2383—None
HealthSpring Extra Rx (PDP)$50.40/mo premium · $615.00 deductible2Generic$5.00$3.00$0.2639$1.586 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$78.30/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3872—None
Prescription Blue Select (PDP)$78.40/mo premium · $615.00 deductible2Generic$5.00$15.00$0.0820$0.496 units
  • Quantity limit 18 per 90 days
Prescription Blue Premium (PDP)$106.70/mo premium · $0.00 deductible2Generic$5.00$10.00$0.0820$0.496 units
  • Quantity limit 18 per 90 days
SilverScript Choice (PDP)$78.30/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0656$0.599 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

Illinois — 12 plans, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1879$1.136 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1899$1.146 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$119.40/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1879$1.136 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2250—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1117—None
AARP Medicare Rx Saver from UHC (PDP)$40.20/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2201—None
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible2Generic$5.00$3.00$0.3064$1.846 units
  • Quantity limit 6 per 30 days
Blue Cross MedicareRx Basic (PDP)$89.70/mo premium · $615.00 deductible2Generic$5.00$15.00$0.3686$2.216 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$103.90/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3514—None
HealthSpring Assurance Rx (PDP)$104.20/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1585$0.956 units
  • Quantity limit 6 per 30 days
Blue Cross MedicareRx Value (PDP)$119.70/mo premium · $615.00 deductible2Generic$1.00$3.00$0.3653$2.196 units
  • Quantity limit 6 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0656$0.599 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

Arkansas — 12 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1623$0.976 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1691$1.016 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$92.40/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1623$0.976 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2045—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1640—None
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible2Generic10%10%$0.1765$1.066 units
  • Quantity limit 6 per 30 days
BlueMedicare Value Rx (PDP)$52.50/mo premium · $615.00 deductible2Generic$5.00$15.00$0.1779—None
HealthSpring Extra Rx (PDP)$54.50/mo premium · $615.00 deductible2Generic$5.00$3.00$0.3682$2.216 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$65.10/mo premium · $615.00 deductible2Generic$7.00$27.00$0.2366—None
AARP Medicare Rx Preferred from UHC (PDP)$114.90/mo premium · $130.00 deductible2Generic$10.00$54.00$0.3652—None
BlueMedicare Premier Rx (PDP)$181.20/mo premium · $0.00 deductible2Generic$5.00$15.00$0.1779—None
SilverScript Choice (PDP)$73.50/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0662$0.609 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

Texas — 12 plans, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$22.90/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1873$1.126 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$41.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1831$1.106 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$118.20/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1831$1.106 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2227—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1305—None
HealthSpring Extra Rx (PDP)$70.00/mo premium · $615.00 deductible2Generic$5.00$3.00$0.3008$1.806 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$89.20/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2244—None
Blue Cross MedicareRx Basic (PDP)$104.70/mo premium · $615.00 deductible2Generic$5.00$15.00$0.3210$1.936 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$111.40/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1549$0.936 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3384—None
Blue Cross MedicareRx Value (PDP)$167.40/mo premium · $615.00 deductible2Generic$1.00$3.00$0.3401$2.046 units
  • Quantity limit 6 per 30 days
SilverScript Choice (PDP)$94.80/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0655$0.599 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

Kansas — 12 plans, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$15.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1690$1.016 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$55.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1758$1.056 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$116.30/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1690$1.016 units
  • Quantity limit 6 per 30 days
Blue MedicareRx Essentials (PDP)$0.00/mo premium · $615.00 deductible2Generic$0.00$0.00$0.4081$2.456 units
  • Quantity limit 6 per 30 days
Blue MedicareRx Value (PDP)$0.70/mo premium · $615.00 deductible2Generic$2.00$6.00$0.4203$2.526 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$6.70/mo premium · $615.00 deductible2Generic10%10%$0.1737$1.046 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1813—None
Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible2Generic$9.00$27.00$0.2327—None
Blue MedicareRx Plus (PDP)$67.40/mo premium · $0.00 deductible2Generic$0.00$0.00$0.4203$2.526 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$105.40/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2227—None
AARP Medicare Rx Preferred from UHC (PDP)$147.00/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3590—None
SilverScript Choice (PDP)$88.30/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0728$0.669 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

California — 12 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$104.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1816$1.096 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$132.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1799$1.086 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$172.90/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1799$1.086 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible2Generic10%10%$0.1455$0.876 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1224—None
Wellcare Classic (PDP)$6.20/mo premium · $615.00 deductible2Generic$10.00$30.00$0.1971—None
HealthSpring Extra Rx (PDP)$70.60/mo premium · $615.00 deductible2Generic$5.00$3.00$0.2696$1.626 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$109.40/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2323—None
AARP Medicare Rx Preferred from UHC (PDP)$165.40/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4063—None
Blue Shield Rx Plus (PDP)$199.70/mo premium · $615.00 deductible2Generic$7.00$17.50$0.0937—None
Blue Shield Rx Enhanced (PDP)$227.80/mo premium · $0.00 deductible2Generic$7.00$14.00$0.0937—None
SilverScript Choice (PDP)$103.60/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0648$0.589 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

Connecticut, Massachusetts, Rhode Island and Vermont — 11 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$8.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1919$1.156 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$73.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1927$1.166 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$138.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1919$1.156 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$16.40/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1137—None
Blue MedicareRx Value Plus (PDP)$20.70/mo premium · $615.00 deductible2Generic$3.00$6.00$0.1891—None
Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2067—None
SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.1652$1.499 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2576—None
HealthSpring Assurance Rx (PDP)$139.30/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1427$0.866 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4235—None
Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible2Generic$7.00$14.00$0.1891—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 — elsewhere it depends on what is prescribed.

South Carolina — 11 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$10.10/mo premium · $615.00 deductible1Preferred Generic$1.00$0.00$0.1988$1.196 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$65.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.2032$1.226 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$145.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1988$1.196 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$4.80/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1261—None
Wellcare Classic (PDP)$9.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2237—None
HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible2Generic$5.00$3.00$0.2931$1.766 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$122.10/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2375—None
AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3819—None
BlueCross Rx Value (PDP)$139.70/mo premium · $615.00 deductible2Generic$17.00$42.50$0.2630$1.586 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$152.50/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1501$0.906 units
  • Quantity limit 6 per 30 days
SilverScript Choice (PDP)$98.40/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0654$0.599 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

Oklahoma — 11 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$1.00$0.00$0.1700$1.026 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1772$1.066 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1700$1.026 units
  • Quantity limit 6 per 30 days
Blue Cross MedicareRx Basic (PDP)$0.00/mo premium · $615.00 deductible2Generic$5.00$15.00$0.4198$2.526 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.2069—None
Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2441—None
HealthSpring Extra Rx (PDP)$65.40/mo premium · $615.00 deductible2Generic$5.00$3.00$0.3740$2.246 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2166—None
AARP Medicare Rx Preferred from UHC (PDP)$121.00/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3620—None
HealthSpring Assurance Rx (PDP)$126.50/mo premium · $615.00 deductible2Generic$2.00$2.00$0.2066$1.246 units
  • Quantity limit 6 per 30 days
Blue Cross MedicareRx Value (PDP)$167.30/mo premium · $615.00 deductible2Generic$1.00$3.00$0.4526$2.726 units
  • Quantity limit 6 per 30 days

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 — elsewhere it depends on what is prescribed.

Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming — 11 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$4.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1622$0.976 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$20.80/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1649$0.996 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$103.70/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1622$0.976 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$5.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2102—None
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1406—None
Wellcare Classic (PDP)$12.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2136—None
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.1488$1.349 units
  • Quantity limit 9 per 30 days
HealthSpring Extra Rx (PDP)$66.50/mo premium · $615.00 deductible2Generic$5.00$3.00$0.2802$1.686 units
  • Quantity limit 6 per 30 days
MedicareBlue Rx Standard (PDP)$101.00/mo premium · $615.00 deductible2Generic$1.00$3.00$0.3537$2.126 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$125.90/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1489$0.896 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$140.20/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3213—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 — elsewhere it depends on what is prescribed.

New Mexico — 11 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1765$1.066 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$69.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1828$1.106 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$75.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1765$1.066 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2541—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1765—None
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible2Generic10%10%$0.2081$1.256 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible2Generic$6.00$18.00$0.2172—None
AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3759—None
Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible2Generic$4.00$12.00$0.3529$2.126 units
  • Quantity limit 6 per 30 days
Blue Cross MedicareRx Basic (PDP)$145.40/mo premium · $615.00 deductible2Generic$5.00$15.00$0.3313$1.996 units
  • Quantity limit 6 per 30 days
SilverScript Choice (PDP)$104.00/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0673$0.619 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

New York — 10 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$140.90/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1702$1.026 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$158.90/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1710$1.036 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$173.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1702$1.026 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$35.70/mo premium · $615.00 deductible2Generic10%10%$0.1379$0.836 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$42.40/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1176—None
Wellcare Classic (PDP)$45.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.1805—None
HealthSpring Extra Rx (PDP)$91.60/mo premium · $615.00 deductible2Generic$5.00$3.00$0.2516$1.516 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$105.80/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2317—None
AARP Medicare Rx Preferred from UHC (PDP)$163.70/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4106—None
SilverScript Choice (PDP)$116.00/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0647$0.589 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

Delaware, DC and Maryland — 10 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1812$1.096 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$4.30/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1829$1.106 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1812$1.096 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1089—None
Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2020—None
HealthSpring Assurance Rx (PDP)$32.60/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1380$0.836 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$37.80/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2273—None
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible2Generic$5.00$3.00$0.2559$1.546 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3861—None
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0650$0.589 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

Georgia — 10 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1778$1.076 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$36.40/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1806$1.086 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$129.50/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1778$1.076 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2125—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1361—None
HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible2Generic$5.00$3.00$0.3068$1.846 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$98.00/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2314—None
AARP Medicare Rx Preferred from UHC (PDP)$139.80/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3714—None
HealthSpring Assurance Rx (PDP)$149.30/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1613$0.976 units
  • Quantity limit 6 per 30 days
SilverScript Choice (PDP)$100.70/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0655$0.599 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

Florida — 10 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$25.90/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1962$1.186 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$92.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1937$1.166 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$115.90/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1937$1.166 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2105—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1187—None
BlueMedicare Premier Rx (PDP)$98.60/mo premium · $615.00 deductible2Generic$14.00$42.00$0.2905$1.746 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$98.70/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2241—None
AARP Medicare Rx Preferred from UHC (PDP)$119.10/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3572—None
BlueMedicare Complete Rx (PDP)$217.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.2905$1.746 units
  • Quantity limit 6 per 30 days
SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0651$0.599 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

Ohio — 10 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1737$1.046 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$23.70/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1763$1.066 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$117.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1737$1.046 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$7.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1238—None
Wellcare Classic (PDP)$7.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2176—None
HealthSpring Extra Rx (PDP)$65.70/mo premium · $615.00 deductible2Generic$5.00$3.00$0.2914$1.756 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$73.70/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2337—None
HealthSpring Assurance Rx (PDP)$109.50/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1500$0.906 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$123.40/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3861—None
SilverScript Choice (PDP)$90.30/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0644$0.589 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

Indiana and Kentucky — 10 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1738$1.046 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$9.90/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1774$1.066 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$125.30/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1738$1.046 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$8.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1442—None
Wellcare Classic (PDP)$8.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2153—None
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.1438$1.299 units
  • Quantity limit 9 per 30 days
HealthSpring Extra Rx (PDP)$78.20/mo premium · $615.00 deductible2Generic$5.00$3.00$0.3183$1.916 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$90.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2402—None
HealthSpring Assurance Rx (PDP)$117.80/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1644$0.996 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$127.10/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3613—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 — elsewhere it depends on what is prescribed.

Wisconsin — 10 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1846$1.116 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1880$1.136 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$110.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1846$1.116 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2123—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1378—None
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible2Generic10%10%$0.1654$0.996 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2133—None
SilverScript Choice (PDP)$26.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.1350$1.229 units
  • Quantity limit 9 per 30 days
HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible2Generic$5.00$3.00$0.3399$2.046 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$113.90/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3324—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 — elsewhere it depends on what is prescribed.

Missouri — 10 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$16.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1810$1.096 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1862$1.126 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$126.40/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1810$1.096 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1608—None
Wellcare Classic (PDP)$10.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2283—None
HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible2Generic$5.00$3.00$0.3337$2.006 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$71.90/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2252—None
HealthSpring Assurance Rx (PDP)$74.30/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1687$1.016 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$125.40/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3909—None
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0674$0.619 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

Mississippi — 10 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1672$1.006 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$37.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1717$1.036 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$89.90/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1672$1.006 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.1997—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1501—None
HealthSpring Assurance Rx (PDP)$59.70/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1639$0.986 units
  • Quantity limit 6 per 30 days
HealthSpring Extra Rx (PDP)$77.10/mo premium · $615.00 deductible2Generic$5.00$3.00$0.3403$2.046 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$84.70/mo premium · $615.00 deductible2Generic$6.00$18.00$0.2248—None
AARP Medicare Rx Preferred from UHC (PDP)$140.60/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3579—None
SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0672$0.609 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

Louisiana — 10 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1834$1.106 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$19.30/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1876$1.136 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$113.70/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1834$1.106 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1501—None
Wellcare Classic (PDP)$6.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2130—None
AARP Medicare Rx Saver from UHC (PDP)$37.00/mo premium · $615.00 deductible2Generic$6.00$18.00$0.2221—None
SilverScript Choice (PDP)$44.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.1496$1.359 units
  • Quantity limit 9 per 30 days
HealthSpring Assurance Rx (PDP)$48.40/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1764$1.066 units
  • Quantity limit 6 per 30 days
HealthSpring Extra Rx (PDP)$60.60/mo premium · $615.00 deductible2Generic$5.00$3.00$0.3312$1.996 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.50/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3589—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 — elsewhere it depends on what is prescribed.

Colorado — 10 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1588$0.956 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$48.50/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1628$0.986 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$137.10/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1588$0.956 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1425—None
Wellcare Classic (PDP)$2.20/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2249—None
HealthSpring Assurance Rx (PDP)$61.70/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1764$1.066 units
  • Quantity limit 6 per 30 days
HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible2Generic$5.00$3.00$0.3550$2.136 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$125.00/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2261—None
AARP Medicare Rx Preferred from UHC (PDP)$151.90/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3541—None
SilverScript Choice (PDP)$105.10/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0661$0.599 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

Arizona — 10 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$2.00$0.00$0.1744$1.056 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$2.50/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1771$1.066 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$119.20/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1744$1.056 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2552—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1667—None
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible2Generic10%10%$0.1998$1.206 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2360—None
HealthSpring Extra Rx (PDP)$66.40/mo premium · $615.00 deductible2Generic$5.00$3.00$0.3319$1.996 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$97.50/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3714—None
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0636$0.579 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

Nevada — 10 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1891$1.136 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$43.70/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1924$1.156 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$148.70/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1891$1.136 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$2.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2250—None
Wellcare Value Script (PDP)$2.70/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1412—None
HealthSpring Extra Rx (PDP)$52.60/mo premium · $615.00 deductible2Generic$5.00$3.00$0.3317$1.996 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$76.70/mo premium · $615.00 deductible2Generic$6.00$18.00$0.2232—None
HealthSpring Assurance Rx (PDP)$95.60/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1770$1.066 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.10/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3548—None
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0649$0.589 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

Oregon and Washington — 10 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1623$0.976 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$22.10/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1654$0.996 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1623$0.976 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2264—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1552—None
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible2Generic10%10%$0.1829$1.106 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$38.40/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2325—None
HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible2Generic$5.00$3.00$0.3073$1.846 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$110.00/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3659—None
SilverScript Choice (PDP)$85.90/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0672$0.609 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

Idaho and Utah — 10 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1584$0.956 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1624$0.976 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$115.50/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1584$0.956 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1373—None
Wellcare Classic (PDP)$23.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2018—None
SilverScript Choice (PDP)$27.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.1276$1.159 units
  • Quantity limit 9 per 30 days
HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible2Generic$5.00$3.00$0.3351$2.016 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$56.50/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2248—None
HealthSpring Assurance Rx (PDP)$128.60/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1652$0.996 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$132.60/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3464—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 — elsewhere it depends on what is prescribed.

Maine and New Hampshire — 9 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1824$1.096 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$54.40/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1859$1.126 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$150.20/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1824$1.096 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2422—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1533—None
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible2Generic10%10%$0.1867$1.126 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2222—None
AARP Medicare Rx Preferred from UHC (PDP)$104.30/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3032—None
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0637$0.579 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

Virginia — 9 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1910$1.156 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1963$1.186 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$87.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1910$1.156 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2531—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1668—None
AARP Medicare Rx Saver from UHC (PDP)$39.60/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2447—None
AARP Medicare Rx Preferred from UHC (PDP)$100.80/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3626—None
HealthSpring Assurance Rx (PDP)$133.80/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1987$1.196 units
  • Quantity limit 6 per 30 days
SilverScript Choice (PDP)$78.20/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0635$0.579 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

Alaska — 9 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$2.00$0.00$0.1453$0.876 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$10.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1476$0.896 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$112.40/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1453$0.876 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.4309—None
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible2Generic10%10%$0.4062$2.446 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$19.70/mo premium · $615.00 deductible2Generic$3.00$9.00$0.3851—None
AARP Medicare Rx Saver from UHC (PDP)$53.20/mo premium · $615.00 deductible2Generic$8.00$24.00$0.3662—None
AARP Medicare Rx Preferred from UHC (PDP)$100.20/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4743—None
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible3Preferred Brand18%18%$0.0709$0.649 units
  • Quantity limit 9 per 30 days

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 — elsewhere it depends on what is prescribed.

Hawaii — 8 plans, 4 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.40/mo premium · $615.00 deductible1Preferred Generic$3.00$0.00$0.1917$1.156 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$51.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.1936$1.166 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$90.20/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1917$1.156 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2516—None
SilverScript Choice (PDP)$14.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2080$1.879 units
  • Quantity limit 9 per 30 days
Wellcare Value Script (PDP)$21.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1878—None
Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2749—None
AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4590—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 — elsewhere it depends on what is prescribed.

Puerto Rico — 3 plans, 2 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible2Generic$5.00$3.00$0.3311$1.996 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$65.70/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1499$0.906 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$145.10/mo premium · $615.00 deductible2Generic25%25%$0.3768—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 — elsewhere it depends on what is prescribed.

American Samoa — 1 plan
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible2Generic25%25%$0.5546—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 — elsewhere it depends on what is prescribed.

Guam — 1 plan
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible2Generic25%25%$0.4280—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 — elsewhere it depends on what is prescribed.

Northern Mariana Islands — 1 plan
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$32.10/mo premium · $615.00 deductible2Generic25%25%$0.5546—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 — elsewhere it depends on what is prescribed.

U.S. Virgin Islands — 1 plan
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $615.00 deductible2Generic25%25%$0.4280—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 — elsewhere it depends on what is prescribed.