MedicarePartD.guide

A non-government resource built from CMS public data

SUMATRIPTAN 5 mg Spray

Coverage in Georgia (CMS PDP Region 10).

7 of 10 stand-alone Part D plans in Georgia cover this drug on tier 2–4.

Lowest 30-day cost $7.00 at a preferred pharmacy. 7 of 7 plans apply a prior authorization, step therapy or quantity limit.

142 Medicare Advantage plans in GA 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. GA: 142 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
SilverScript Choice (PDP)$100.70/mo premium · $615.00 deductible2Generic$7.00$21.00$10.1743$122.0912 units
  • Quantity limit 12 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug28%28%$44.0740$837.4119 units
  • Quantity limit 18 per 28 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$44.0751$837.4319 units
  • Quantity limit 18 per 28 days
HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$44.1034$1,720.0339 units
  • Quantity limit 36 per 28 days
AARP Medicare Rx Saver from UHC (PDP)$98.00/mo premium · $615.00 deductible4Non-Preferred Drug35%—$29.7202$356.6412 units
  • Quantity limit 12 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.80/mo premium · $130.00 deductible4Non-Preferred Drug36%—$29.6320$355.5812 units
  • Quantity limit 12 per 30 days
HealthSpring Assurance Rx (PDP)$149.30/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$41.8107$1,630.6239 units
  • Quantity limit 36 per 28 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.

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