BUPROPION HYDROCHLORIDE SR 200 mg Tablet, Film Coated, Extended Release
Also known as Bupropion Hydrochloride. Coverage in Connecticut, Massachusetts, Rhode Island and Vermont (CMS PDP Region 02).
11 of 11 stand-alone Part D plans in Connecticut, Massachusetts, Rhode Island and Vermont cover this drug on tier 2–3.
Lowest 30-day cost $3.00 at a preferred pharmacy. 9 of 11 plans apply a prior authorization, step therapy or quantity limit.
Every plan that covers it
Showing 11 of 11 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$8.40/mo premium · $615.00 deductible · $0 with full Extra Help | 3Preferred Brand | 25% | 20% | $0.1726 | $1.046 units |
|
| Wellcare Value Script (PDP)$16.40/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.5897 | $3.546 units |
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| Blue MedicareRx Value Plus (PDP)$20.70/mo premium · $615.00 deductible · $0 with full Extra Help | 2Generic | $3.00 | $6.00 | $0.2534 | $1.526 units |
|
| Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible · $0 with full Extra Help | 3Preferred Brand | 25% | 25% | $0.5919 | $3.556 units |
|
| SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible · $0 with full Extra Help | 2Generic | $10.00 | $30.00 | $0.2453 | $1.476 units |
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| AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2282 | — | None |
| Humana Value Rx Plan (PDP)$73.60/mo premium · $601.00 deductible | 3Preferred Brand | 18% | 13% | $0.1733 | $1.046 units |
|
| Humana Premier Rx Plan (PDP)$138.60/mo premium · $0.00 deductible | 3Preferred Brand | $45.00 | $125.00 | $0.1722 | $1.036 units |
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| HealthSpring Assurance Rx (PDP)$139.30/mo premium · $615.00 deductible | 3Preferred Brand | 21% | 21% | $0.2345 | $1.416 units |
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| AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3566 | — | None |
| Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible | 2Generic | $7.00 | $14.00 | $0.2534 | $1.526 units |
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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.
Medicare Advantage plans
Medicare Advantage plans carry their own formularies, separate from stand-alone Part D, and are sold county by county. Pick a county to see every Medicare Advantage drug plan there that covers this drug.
152 Medicare Advantage plans in CT, MA, RI, VT do cover it
A patient on an MA-PD plan may have coverage even where no PDP lists the drug. CT: 42 plans · MA: 88 plans · RI: 20 plans · VT: 2 plans.