CLOBETASOL PROPIONATE .5 mg/g Ointment
Coverage in New Mexico (CMS PDP Region 26).
7 of 11 stand-alone Part D plans in New Mexico cover this drug on tier 4.
6 of 7 plans apply a prior authorization, step therapy or quantity limit.
67 Medicare Advantage plans in NM 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. NM: 67 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)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $1.2888 | $16.7513 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | — | $0.2861 | $3.7213 units |
|
| Humana Value Rx Plan (PDP)$69.60/mo premium · $601.00 deductible | 4Non-Preferred Drug | 30% | — | $0.2926 | $3.8013 units |
|
| Humana Premier Rx Plan (PDP)$75.60/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $0.2826 | $3.6713 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible | 4Non-Preferred Drug | 35% | — | $0.2189 | — | None |
| SilverScript Choice (PDP)$104.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $1.3146 | $7.896 units |
|
| Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $0.3700 | $8.1422 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.