METFORMIN 1000 mg Tablet, Extended Release
Coverage in Idaho and Utah (CMS PDP Region 31).
2 of 10 stand-alone Part D plans in Idaho and Utah cover this drug on tier 2–4.
Lowest 30-day cost $3.00 at a preferred pharmacy. 2 of 2 plans apply a prior authorization, step therapy or quantity limit.
2 Medicare Advantage plans in UT 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. UT: 2 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.3444 | $2.076 units |
|
| HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $1.7798 | $10.686 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.