MedicarePartD.guide

A non-government resource built from CMS public data

EZETIMIBE AND SIMVASTATIN 10/10 mg Tablet

Package: 30 TABLET in 1 BOTTLE (43598-742-30). NDC 43598074230.

Plans covering it
287
across 39 regions checked
Lowest tier
1
lower tiers cost less
Plans with restrictions
245
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
Pennsylvania and West Virginia10 of 121–3$0.009 of 10 plans
Michigan10 of 121–4$0.009 of 10 plans
California10 of 121–4$0.007 of 10 plans
New Jersey9 of 121–3$0.008 of 9 plans
North Carolina9 of 121–3$0.008 of 9 plans
South Carolina9 of 111–6$0.007 of 9 plans
Alabama and Tennessee9 of 121–4$0.008 of 9 plans
Illinois9 of 121–3$0.008 of 9 plans
Arkansas9 of 121–3$0.008 of 9 plans
Texas9 of 121–3$0.008 of 9 plans
Kansas9 of 121–4$0.008 of 9 plans
Connecticut, Massachusetts, Rhode Island and Vermont8 of 111–3$0.007 of 8 plans
New York8 of 101–3$0.007 of 8 plans
Delaware, DC and Maryland8 of 101–3$0.007 of 8 plans
Georgia8 of 101–3$0.007 of 8 plans
Ohio8 of 101–3$0.007 of 8 plans
Indiana and Kentucky8 of 101–3$0.007 of 8 plans
Wisconsin8 of 101–3$0.007 of 8 plans
Missouri8 of 101–3$0.007 of 8 plans
Mississippi8 of 101–3$0.007 of 8 plans
Louisiana8 of 101–3$0.007 of 8 plans
Oklahoma8 of 111–3$0.007 of 8 plans
Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming8 of 111–3$0.007 of 8 plans
New Mexico8 of 111–4$0.007 of 8 plans
Colorado8 of 101–3$0.007 of 8 plans
Arizona8 of 101–3$0.007 of 8 plans
Nevada8 of 101–3$0.007 of 8 plans
Oregon and Washington8 of 101–3$0.007 of 8 plans
Idaho and Utah8 of 101–3$0.007 of 8 plans
Maine and New Hampshire7 of 91–3$0.006 of 7 plans
Virginia7 of 91–3$0.006 of 7 plans
Florida7 of 101–6$0.006 of 7 plans
Alaska7 of 91–3$0.006 of 7 plans
Hawaii6 of 81–3$0.005 of 6 plans
Puerto Rico3 of 31–3$0.002 of 3 plans
American Samoa1 of 13—none
Guam1 of 13—none
Northern Mariana Islands1 of 13—none
U.S. Virgin Islands1 of 13—none

Plan-by-plan detail

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

Pennsylvania and West Virginia — 10 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$8.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1446$0.433 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$22.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1045$0.313 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$62.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2820$0.853 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$74.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3892$1.173 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$6.60/mo premium · $615.00 deductible3Preferred Brand25%20%$1.3723$4.123 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible3Preferred Brand20%15%$1.3863$4.163 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$121.90/mo premium · $130.00 deductible3Preferred Brand16%16%$0.5991—None
Humana Premier Rx Plan (PDP)$123.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.3723$4.123 units
  • Quantity limit 3 per 30 days
Blue Rx PDP Complete (PDP)$164.80/mo premium · $200.00 deductible3Preferred Brand25%25%$0.2897$8.6930 units
  • Quantity limit 31 per 31 days
Blue Rx PDP Plus (PDP)$193.20/mo premium · $615.00 deductible3Preferred Brand25%25%$0.2897$8.6930 units
  • Quantity limit 31 per 31 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 — 10 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2266$0.683 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.4583$1.373 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$50.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3205$0.963 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$78.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.3404$1.023 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$1.3125$3.943 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible3Preferred Brand20%15%$1.3222$3.973 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$78.30/mo premium · $130.00 deductible3Preferred Brand18%18%$0.5998—None
Humana Premier Rx Plan (PDP)$98.10/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.3125$3.943 units
  • Quantity limit 3 per 30 days
Prescription Blue Select (PDP)$78.40/mo premium · $615.00 deductible4Non-Preferred Drug25%25%$2.3342$7.003 units
  • Quantity limit 9 per 90 days
Prescription Blue Premium (PDP)$106.70/mo premium · $0.00 deductible4Non-Preferred Drug27%27%$2.3342$7.003 units
  • Quantity limit 9 per 90 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 — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.4029$1.213 units
  • Quantity limit 3 per 30 days
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1811$0.543 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$70.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2698$0.813 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$103.60/mo premium · $615.00 deductible2Generic$7.00$21.00$0.3078$0.923 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$104.60/mo premium · $601.00 deductible3Preferred Brand18%13%$1.3704$4.113 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$132.20/mo premium · $615.00 deductible3Preferred Brand25%20%$1.3567$4.073 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$165.40/mo premium · $130.00 deductible3Preferred Brand15%15%$0.6001—None
Humana Premier Rx Plan (PDP)$172.90/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.3567$4.073 units
  • Quantity limit 3 per 30 days
Blue Shield Rx Enhanced (PDP)$227.80/mo premium · $0.00 deductible3Preferred Brand19%19%$1.8664—None
Blue Shield Rx Plus (PDP)$199.70/mo premium · $615.00 deductible4Non-Preferred Drug49%49%$1.8664—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 Jersey — 9 plans, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$22.80/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1955$0.593 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$59.90/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2713$0.813 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$109.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.4100$1.233 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible2Generic$7.00$21.00$0.3029$0.913 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$4.40/mo premium · $615.00 deductible3Preferred Brand25%20%$1.4372$4.313 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$35.60/mo premium · $601.00 deductible3Preferred Brand19%14%$1.4447$4.333 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$111.90/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.4372$4.313 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$118.90/mo premium · $130.00 deductible3Preferred Brand15%15%$0.6015—None
Horizon Medicare Blue Rx Enhanced (PDP)$139.10/mo premium · $200.00 deductible3Preferred Brand20%20%$0.6047$1.813 units
  • Quantity limit 3 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.

North Carolina — 9 plans, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1978$0.593 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$78.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2947$0.883 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$110.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.4320$1.303 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$90.20/mo premium · $615.00 deductible2Generic$7.00$21.00$0.3338$1.003 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$6.80/mo premium · $615.00 deductible3Preferred Brand25%20%$1.3809$4.143 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$32.00/mo premium · $601.00 deductible3Preferred Brand20%15%$1.3987$4.203 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$110.90/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.3809$4.143 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$119.80/mo premium · $130.00 deductible3Preferred Brand17%17%$0.5978—None
Blue Medicare Rx Enhanced (PDP)$163.20/mo premium · $0.00 deductible3Preferred Brand$45.00$135.00$0.7753$2.333 units
  • Quantity limit 3 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.

South Carolina — 9 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$4.80/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1891$0.573 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3223$0.973 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$152.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.4420$1.333 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$98.40/mo premium · $615.00 deductible2Generic$7.00$21.00$0.3154$0.953 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$10.10/mo premium · $615.00 deductible3Preferred Brand25%20%$1.4173$4.253 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$65.60/mo premium · $601.00 deductible3Preferred Brand19%14%$1.4365$4.313 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible3Preferred Brand17%17%$0.5986—None
Humana Premier Rx Plan (PDP)$145.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.4173$4.253 units
  • Quantity limit 3 per 30 days
BlueCross Rx Value (PDP)$139.70/mo premium · $615.00 deductible6Select Care Drugs$5.00$12.50$3.0392—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.

Alabama and Tennessee — 9 plans, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2406$0.723 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$77.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3769$1.133 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$87.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.4931$1.483 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$97.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.3263$0.983 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$1.3301$3.993 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$37.70/mo premium · $601.00 deductible3Preferred Brand20%15%$1.3499$4.053 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.3301$3.993 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$119.30/mo premium · $130.00 deductible3Preferred Brand17%17%$0.5996—None
BlueRx Enhanced Plus (PDP)$129.50/mo premium · $150.00 deductible4Non-Preferred Drug42%42%$0.7584$2.283 units
  • Quantity limit 3 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 — 9 plans, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0995$0.303 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2075$0.623 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$104.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3977$1.193 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible2Generic$7.00$21.00$0.3048$0.913 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$1.1606$3.483 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible3Preferred Brand20%15%$1.1666$3.503 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$103.90/mo premium · $130.00 deductible3Preferred Brand17%17%$0.5978—None
Humana Premier Rx Plan (PDP)$119.40/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.1606$3.483 units
  • Quantity limit 3 per 30 days
Blue Cross MedicareRx Value (PDP)$119.70/mo premium · $615.00 deductible3Preferred Brand18%18%$0.5686$1.713 units
  • Quantity limit 3 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 — 9 plans, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.5255$1.583 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.6207$1.863 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$54.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.5472$1.643 units
  • Quantity limit 3 per 30 days
BlueMedicare Premier Rx (PDP)$181.20/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$1.4428$4.333 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$73.50/mo premium · $615.00 deductible2Generic$7.00$21.00$0.3058$0.923 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$1.1363$3.413 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible3Preferred Brand20%15%$1.1907$3.573 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$92.40/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.1363$3.413 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$114.90/mo premium · $130.00 deductible3Preferred Brand16%16%$0.6029—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.

Texas — 9 plans, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1785$0.543 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$70.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3228$0.973 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$111.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.4500$1.353 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$94.80/mo premium · $615.00 deductible2Generic$7.00$21.00$0.3437$1.033 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$22.90/mo premium · $601.00 deductible3Preferred Brand20%15%$1.3641$4.093 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$41.70/mo premium · $615.00 deductible3Preferred Brand25%20%$1.3345$4.003 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $130.00 deductible3Preferred Brand18%18%$0.6059—None
Humana Premier Rx Plan (PDP)$118.20/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.3345$4.003 units
  • Quantity limit 3 per 30 days
Blue Cross MedicareRx Value (PDP)$167.40/mo premium · $615.00 deductible3Preferred Brand18%18%$0.8547$2.563 units
  • Quantity limit 3 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 — 9 plans, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$6.70/mo premium · $615.00 deductible1Preferred Generic5%5%$0.4164$1.253 units
  • Quantity limit 3 per 30 days
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1779$0.533 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$88.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.3364$1.013 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$15.50/mo premium · $615.00 deductible3Preferred Brand25%20%$1.3608$4.083 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$55.60/mo premium · $601.00 deductible3Preferred Brand20%15%$1.3986$4.203 units
  • Quantity limit 3 per 30 days
Blue MedicareRx Plus (PDP)$67.40/mo premium · $0.00 deductible3Preferred Brand20%20%$0.8019$2.413 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$116.30/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.3608$4.083 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$147.00/mo premium · $130.00 deductible3Preferred Brand15%15%$0.6495—None
Blue MedicareRx Essentials (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$0.7614$2.283 units
  • Quantity limit 3 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 — 8 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$16.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0917$0.283 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0816$0.243 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$139.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3329$1.003 units
  • Quantity limit 3 per 30 days
Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible1Preferred Generic$1.00$1.00$2.1663$6.503 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$8.40/mo premium · $615.00 deductible3Preferred Brand25%20%$1.4990$4.503 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$73.60/mo premium · $601.00 deductible3Preferred Brand18%13%$1.5026$4.513 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$138.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.4990$4.503 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible3Preferred Brand15%15%$0.6012—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 York — 8 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$35.70/mo premium · $615.00 deductible1Preferred Generic5%5%$0.4613$1.383 units
  • Quantity limit 3 per 30 days
Wellcare Value Script (PDP)$42.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2919$0.883 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$91.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3512$1.053 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$116.00/mo premium · $615.00 deductible2Generic$6.00$18.00$0.2795$0.843 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$140.90/mo premium · $615.00 deductible3Preferred Brand25%20%$1.3315$3.993 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$158.90/mo premium · $601.00 deductible3Preferred Brand17%12%$1.3352$4.013 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$163.70/mo premium · $130.00 deductible3Preferred Brand15%15%$0.6077—None
Humana Premier Rx Plan (PDP)$173.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.3315$3.993 units
  • Quantity limit 3 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 — 8 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1292$0.393 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$32.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3914$1.173 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2470$0.743 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible2Generic$7.00$21.00$0.3077$0.923 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$1.4180$4.253 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$4.30/mo premium · $601.00 deductible3Preferred Brand20%15%$1.4249$4.273 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible3Preferred Brand17%17%$0.5983—None
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.4180$4.253 units
  • Quantity limit 3 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 — 8 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3346$1.003 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.4662$1.403 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$149.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.5627$1.693 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$100.70/mo premium · $615.00 deductible2Generic$7.00$21.00$0.4120$1.243 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$1.3060$3.923 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$36.40/mo premium · $601.00 deductible3Preferred Brand20%15%$1.3341$4.003 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$129.50/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.3060$3.923 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.80/mo premium · $130.00 deductible3Preferred Brand16%16%$0.6007—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.

Ohio — 8 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$7.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2079$0.623 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$65.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2889$0.873 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$109.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.4151$1.253 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$90.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.3401$1.023 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$1.3027$3.913 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$23.70/mo premium · $601.00 deductible3Preferred Brand20%15%$1.3239$3.973 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$117.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.3027$3.913 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$123.40/mo premium · $130.00 deductible3Preferred Brand17%17%$0.6064—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.

Indiana and Kentucky — 8 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$8.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2015$0.603 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1044$0.313 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$78.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2898$0.873 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$117.80/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.4179$1.253 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$1.3431$4.033 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$9.90/mo premium · $601.00 deductible3Preferred Brand20%15%$1.3628$4.093 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$125.30/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.3431$4.033 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$127.10/mo premium · $130.00 deductible3Preferred Brand18%18%$0.5961—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 — 8 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1953$0.593 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.4646$1.393 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$26.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1286$0.393 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3055$0.923 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$1.3924$4.183 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible3Preferred Brand20%15%$1.4076$4.223 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$110.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.3924$4.183 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$113.90/mo premium · $130.00 deductible3Preferred Brand15%15%$0.5976—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 — 8 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3111$0.933 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3682$1.103 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$74.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.4852$1.463 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible2Generic$7.00$21.00$0.3668$1.103 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$16.50/mo premium · $615.00 deductible3Preferred Brand25%20%$1.3522$4.063 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible3Preferred Brand20%15%$1.3861$4.163 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$125.40/mo premium · $130.00 deductible3Preferred Brand17%17%$0.5988—None
Humana Premier Rx Plan (PDP)$126.40/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.3522$4.063 units
  • Quantity limit 3 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 — 8 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3310$0.993 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$59.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.5003$1.503 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$77.10/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3801$1.143 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.3150$0.953 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$1.2558$3.773 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$37.60/mo premium · $601.00 deductible3Preferred Brand20%15%$1.2721$3.823 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$89.90/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.2558$3.773 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$140.60/mo premium · $130.00 deductible3Preferred Brand16%16%$0.5996—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.

Louisiana — 8 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2258$0.683 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$44.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1118$0.343 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$48.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.4272$1.283 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$60.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2930$0.883 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$1.4134$4.243 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$19.30/mo premium · $601.00 deductible3Preferred Brand20%15%$1.4414$4.323 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$113.70/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.4134$4.243 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.50/mo premium · $130.00 deductible3Preferred Brand15%15%$0.5994—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.

Oklahoma — 8 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3533$1.063 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$65.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.4050$1.223 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$126.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.5243$1.573 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$1.3279$3.983 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible3Preferred Brand20%15%$1.3720$4.123 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.3279$3.983 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$121.00/mo premium · $130.00 deductible3Preferred Brand16%16%$0.5993—None
Blue Cross MedicareRx Value (PDP)$167.30/mo premium · $615.00 deductible3Preferred Brand18%18%$1.1151$3.353 units
  • Quantity limit 3 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 — 8 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2577$0.773 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1179$0.353 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$66.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3706$1.113 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$125.90/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.4708$1.413 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$4.70/mo premium · $615.00 deductible3Preferred Brand25%20%$1.1873$3.563 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$20.80/mo premium · $601.00 deductible3Preferred Brand20%15%$1.2032$3.613 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$103.70/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.1873$3.563 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$140.20/mo premium · $130.00 deductible3Preferred Brand18%18%$0.6051—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 — 8 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2798$0.843 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.5003$1.503 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$104.00/mo premium · $615.00 deductible2Generic$7.00$21.00$0.4678$1.403 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$1.3594$4.083 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$69.60/mo premium · $601.00 deductible3Preferred Brand20%15%$1.3884$4.173 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$75.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.3594$4.083 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible3Preferred Brand16%16%$0.6046—None
Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible4Non-Preferred Drug33%33%$0.8299$2.493 units
  • Quantity limit 3 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.

Colorado — 8 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1719$0.523 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$61.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.4123$1.243 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2560$0.773 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$105.10/mo premium · $615.00 deductible2Generic$7.00$21.00$0.3435$1.033 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$1.2498$3.753 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$48.50/mo premium · $601.00 deductible3Preferred Brand20%15%$1.2708$3.813 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$137.10/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.2498$3.753 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$151.90/mo premium · $130.00 deductible3Preferred Brand17%17%$0.5991—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.

Arizona — 8 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1039$0.313 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.3638$1.093 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$66.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1809$0.543 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible2Generic$7.00$21.00$0.3428$1.033 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand23%18%$1.4547$4.363 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$2.50/mo premium · $601.00 deductible3Preferred Brand20%15%$1.4732$4.423 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$97.50/mo premium · $130.00 deductible3Preferred Brand18%18%$0.6021—None
Humana Premier Rx Plan (PDP)$119.20/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.4547$4.363 units
  • Quantity limit 3 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 — 8 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$2.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0776$0.233 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$52.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1873$0.563 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$95.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3217$0.973 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible2Generic$7.00$21.00$0.3133$0.943 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$1.5018$4.513 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$43.70/mo premium · $601.00 deductible3Preferred Brand18%13%$1.5039$4.513 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.10/mo premium · $130.00 deductible3Preferred Brand18%18%$0.5941—None
Humana Premier Rx Plan (PDP)$148.70/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.5018$4.513 units
  • Quantity limit 3 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 — 8 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1584$0.483 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.4740$1.423 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3162$0.953 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$85.90/mo premium · $615.00 deductible2Generic$7.00$21.00$0.3924$1.183 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$1.1496$3.453 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$22.10/mo premium · $601.00 deductible3Preferred Brand20%15%$1.1673$3.503 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.1496$3.453 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$110.00/mo premium · $130.00 deductible3Preferred Brand16%16%$0.6017—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.

Idaho and Utah — 8 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3150$0.953 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$27.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1155$0.353 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3938$1.183 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$128.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.5181$1.553 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$1.1110$3.333 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible3Preferred Brand20%15%$1.1426$3.433 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$115.50/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.1110$3.333 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$132.60/mo premium · $130.00 deductible3Preferred Brand17%17%$0.6013—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 — 7 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2008$0.603 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.4102$1.233 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible2Generic$7.00$21.00$0.3126$0.943 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$1.4421$4.333 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$54.40/mo premium · $601.00 deductible3Preferred Brand20%15%$1.4845$4.453 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$104.30/mo premium · $130.00 deductible3Preferred Brand15%15%$0.5964—None
Humana Premier Rx Plan (PDP)$150.20/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.4421$4.333 units
  • Quantity limit 3 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 — 7 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2374$0.713 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$133.80/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.5614$1.683 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$78.20/mo premium · $615.00 deductible2Generic$7.00$21.00$0.3418$1.033 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$1.3527$4.063 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible3Preferred Brand20%15%$1.3628$4.093 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$87.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.3527$4.063 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$100.80/mo premium · $130.00 deductible3Preferred Brand17%17%$0.5973—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.

Florida — 7 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1312$0.393 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.3342$1.003 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$25.90/mo premium · $601.00 deductible3Preferred Brand20%15%$1.4683$4.403 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$92.70/mo premium · $615.00 deductible3Preferred Brand25%20%$1.4550$4.373 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$115.90/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.4550$4.373 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$119.10/mo premium · $130.00 deductible3Preferred Brand17%17%$0.6039—None
BlueMedicare Complete Rx (PDP)$217.00/mo premium · $615.00 deductible6Select Care Drugs$0.00$0.00$0.5385$1.623 units
  • Quantity limit 3 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 — 7 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.4467$1.343 units
  • Quantity limit 3 per 30 days
Wellcare Value Script (PDP)$19.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2296$0.693 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible2Generic$7.00$21.00$0.3369$1.013 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand24%19%$0.9174$2.753 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$10.60/mo premium · $601.00 deductible3Preferred Brand20%15%$0.9174$2.753 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$100.20/mo premium · $130.00 deductible3Preferred Brand18%18%$0.6043—None
Humana Premier Rx Plan (PDP)$112.40/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$0.9174$2.753 units
  • Quantity limit 3 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 — 6 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
SilverScript Choice (PDP)$14.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0907$0.273 units
  • Quantity limit 3 per 30 days
Wellcare Value Script (PDP)$21.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1620$0.493 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.40/mo premium · $615.00 deductible3Preferred Brand23%18%$1.4317$4.303 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$51.60/mo premium · $601.00 deductible3Preferred Brand20%15%$1.4560$4.373 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$90.20/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$1.4317$4.303 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible3Preferred Brand17%17%$0.5956—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 deductible1Preferred Generic$0.00$0.00$0.4537$1.363 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$65.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.5902$1.773 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$145.10/mo premium · $615.00 deductible3Preferred Brand25%25%$0.5794—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 deductible3Preferred Brand25%25%$1.0087—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 deductible3Preferred Brand25%25%$1.0087—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 deductible3Preferred Brand25%25%$0.6145—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 deductible3Preferred Brand25%25%$0.6145—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.