MedicarePartD.guide

A non-government resource built from CMS public data

TOBI PODHALER 28 mg Capsule

Also known as Tobramycin. Coverage in Indiana and Kentucky (CMS PDP Region 15).

3 of 10 stand-alone Part D plans in Indiana and Kentucky cover this drug on tier 5.

3 of 3 plans apply a prior authorization, step therapy or quantity limit.

103 Medicare Advantage plans in IN, KY 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. IN: 62 plans · KY: 41 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible5Specialty Tier25%—$51.4794$6,177.53120 units
  • Prior authorization
  • Quantity limit 224 per 56 days
AARP Medicare Rx Saver from UHC (PDP)$90.30/mo premium · $615.00 deductible5Specialty Tier25%—$52.3083$12,553.99240 units
  • Prior authorization
  • Quantity limit 224 per 28 days
AARP Medicare Rx Preferred from UHC (PDP)$127.10/mo premium · $130.00 deductible5Specialty Tier31%—$52.3083$12,553.99240 units
  • Prior authorization
  • Quantity limit 224 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.

See coverage in all 39 regions →