SUMATRIPTAN 20 mg Spray
Coverage in Michigan (CMS PDP Region 13).
9 of 12 stand-alone Part D plans in Michigan cover this drug on tier 2–4.
Lowest 30-day cost $7.00 at a preferred pharmacy. 9 of 9 plans apply a prior authorization, step therapy or quantity limit.
165 Medicare Advantage plans in MI do cover it
Medicare Advantage plans carry their own formularies, separate from stand-alone Part D. A patient on an MA-PD plan may have coverage even where no PDP lists the drug. MI: 165 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| SilverScript Choice (PDP)$78.30/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $6.2976 | $75.5712 units |
|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 28% | 28% | $35.7477 | $679.2119 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $35.7331 | $678.9319 units |
|
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $31.8964 | $606.0319 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$14.10/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | — | $22.7156 | $272.5912 units |
|
| HealthSpring Extra Rx (PDP)$50.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | 32% | $32.9410 | $625.8819 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$78.30/mo premium · $130.00 deductible | 4Non-Preferred Drug | 32% | — | $22.6055 | $271.2712 units |
|
| Prescription Blue Select (PDP)$78.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 25% | 25% | $25.7483 | $308.9812 units |
|
| Prescription Blue Premium (PDP)$106.70/mo premium · $0.00 deductible | 4Non-Preferred Drug | 27% | 27% | $25.7483 | $308.9812 units |
|
Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity.