SUMATRIPTAN 20 mg Spray
Coverage in New York (CMS PDP Region 03).
7 of 10 stand-alone Part D plans in New York cover this drug on tier 2–4.
Lowest 30-day cost $6.00 at a preferred pharmacy. 7 of 7 plans apply a prior authorization, step therapy or quantity limit.
183 Medicare Advantage plans in NY 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. NY: 183 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| SilverScript Choice (PDP)$116.00/mo premium · $615.00 deductible | 2Generic | $6.00 | $18.00 | $7.5820 | $90.9812 units |
|
| HealthSpring Assurance Rx (PDP)$35.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 29% | 29% | $31.3831 | $596.2819 units |
|
| Wellcare Value Script (PDP)$42.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $37.0365 | $703.6919 units |
|
| Wellcare Classic (PDP)$45.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 28% | 28% | $37.0365 | $703.6919 units |
|
| HealthSpring Extra Rx (PDP)$91.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 29% | 29% | $33.8395 | $642.9519 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$105.80/mo premium · $615.00 deductible | 4Non-Preferred Drug | 38% | — | $22.9808 | $275.7712 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$163.70/mo premium · $130.00 deductible | 4Non-Preferred Drug | 28% | — | $22.9214 | $275.0612 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.