ENALAPRIL MALEATE 20 mg Tablet
Package: 1000 TABLET in 1 BOTTLE (51672-4040-3). NDC 51672404003.
- Plans covering it
- 367
- across 39 regions checked
- Lowest tier
- 1
- lower tiers cost less
- Plans with restrictions
- 75
- prior auth, step therapy or quantity limit
Coverage by region
Covered by at least one plan in 39 of 39 CMS regions.
| Region | Plans covering | Tiers | Lowest 30-day cost | Restrictions |
|---|---|---|---|---|
| New Jersey | 12 of 12 | 1–2 | $0.00 | 2 of 12 plans |
| Pennsylvania and West Virginia | 12 of 12 | 1–2 | $0.00 | 2 of 12 plans |
| North Carolina | 12 of 12 | 1–2 | $0.00 | 2 of 12 plans |
| Alabama and Tennessee | 12 of 12 | 1–2 | $0.00 | 2 of 12 plans |
| Michigan | 12 of 12 | 1–2 | $0.00 | 4 of 12 plans |
| Illinois | 12 of 12 | 1–2 | $0.00 | 2 of 12 plans |
| Arkansas | 12 of 12 | 1–2 | $0.00 | 2 of 12 plans |
| Texas | 12 of 12 | 1–2 | $0.00 | 2 of 12 plans |
| Kansas | 12 of 12 | 1–2 | $0.00 | 2 of 12 plans |
| California | 12 of 12 | 1–2 | $0.00 | 2 of 12 plans |
| Connecticut, Massachusetts, Rhode Island and Vermont | 11 of 11 | 1–2 | $0.00 | 2 of 11 plans |
| South Carolina | 11 of 11 | 1–6 | $0.00 | 2 of 11 plans |
| Oklahoma | 11 of 11 | 1–2 | $0.00 | 2 of 11 plans |
| Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming | 11 of 11 | 1–2 | $0.00 | 2 of 11 plans |
| New Mexico | 11 of 11 | 1–2 | $0.00 | 2 of 11 plans |
| New York | 10 of 10 | 1–2 | $0.00 | 2 of 10 plans |
| Delaware, DC and Maryland | 10 of 10 | 1–2 | $0.00 | 2 of 10 plans |
| Georgia | 10 of 10 | 1–2 | $0.00 | 2 of 10 plans |
| Florida | 10 of 10 | 1–6 | $0.00 | 2 of 10 plans |
| Ohio | 10 of 10 | 1–2 | $0.00 | 2 of 10 plans |
| Indiana and Kentucky | 10 of 10 | 1–2 | $0.00 | 2 of 10 plans |
| Wisconsin | 10 of 10 | 1–2 | $0.00 | 2 of 10 plans |
| Missouri | 10 of 10 | 1–2 | $0.00 | 2 of 10 plans |
| Mississippi | 10 of 10 | 1–2 | $0.00 | 2 of 10 plans |
| Louisiana | 10 of 10 | 1–2 | $0.00 | 2 of 10 plans |
| Colorado | 10 of 10 | 1–2 | $0.00 | 2 of 10 plans |
| Arizona | 10 of 10 | 1–2 | $0.00 | 2 of 10 plans |
| Nevada | 10 of 10 | 1–2 | $0.00 | 2 of 10 plans |
| Oregon and Washington | 10 of 10 | 1–2 | $0.00 | 2 of 10 plans |
| Idaho and Utah | 10 of 10 | 1–2 | $0.00 | 2 of 10 plans |
| Maine and New Hampshire | 9 of 9 | 1–2 | $0.00 | 2 of 9 plans |
| Virginia | 9 of 9 | 1–2 | $0.00 | 2 of 9 plans |
| Alaska | 9 of 9 | 1–2 | $0.00 | 2 of 9 plans |
| Hawaii | 8 of 8 | 1–2 | $0.00 | 2 of 8 plans |
| Puerto Rico | 3 of 3 | 1–2 | $0.00 | 1 of 3 plans |
| American Samoa | 1 of 1 | 2 | — | 1 of 1 plans |
| Guam | 1 of 1 | 2 | — | 1 of 1 plans |
| Northern Mariana Islands | 1 of 1 | 2 | — | 1 of 1 plans |
| U.S. Virgin Islands | 1 of 1 | 2 | — | 1 of 1 plans |
Plan-by-plan detail
Open a region to see every plan that covers this drug, with tier, cost-sharing and restrictions.
New Jersey — 12 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$22.80/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1000 | — | None |
| Humana Value Rx Plan (PDP)$35.60/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3290 | — | None |
| HealthSpring Extra Rx (PDP)$59.90/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1378 | — | None |
| HealthSpring Assurance Rx (PDP)$109.30/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1700 | — | None |
| Humana Premier Rx Plan (PDP)$111.90/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3253 | — | None |
| Humana Basic Rx Plan (PDP)$4.40/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3253 | — | None |
| Wellcare Classic (PDP)$28.20/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3007 | — | None |
| Horizon Medicare Blue Rx Standard (PDP)$72.30/mo premium · $615.00 deductible | 2Generic | $3.00 | $4.50 | $0.1594 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$77.40/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2191 | $1.316 units |
|
| SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2194 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$118.90/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3847 | $2.316 units |
|
| Horizon Medicare Blue Rx Enhanced (PDP)$139.10/mo premium · $200.00 deductible | 2Generic | $6.00 | $9.00 | $0.1594 | — | None |
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 — elsewhere it depends on what is prescribed.
Pennsylvania and West Virginia — 12 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$8.20/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0935 | — | None |
| Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3159 | — | None |
| SilverScript Choice (PDP)$22.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0682 | — | None |
| HealthSpring Extra Rx (PDP)$62.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1476 | — | None |
| HealthSpring Assurance Rx (PDP)$74.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1673 | — | None |
| Humana Premier Rx Plan (PDP)$123.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3084 | — | None |
| Blue Rx PDP Complete (PDP)$164.80/mo premium · $200.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1484 | — | None |
| Blue Rx PDP Plus (PDP)$193.20/mo premium · $615.00 deductible | 1Preferred Generic | 25% | 25% | $0.1484 | — | None |
| Humana Basic Rx Plan (PDP)$6.60/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3084 | — | None |
| Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3074 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$43.50/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2232 | $1.346 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$121.90/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3785 | $2.276 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 — elsewhere it depends on what is prescribed.
North Carolina — 12 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1033 | — | None |
| Humana Value Rx Plan (PDP)$32.00/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3370 | — | None |
| HealthSpring Extra Rx (PDP)$78.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1561 | — | None |
| HealthSpring Assurance Rx (PDP)$110.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1897 | — | None |
| Humana Premier Rx Plan (PDP)$110.90/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3270 | — | None |
| Wellcare Classic (PDP)$4.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3006 | — | None |
| Humana Basic Rx Plan (PDP)$6.80/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3270 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$56.90/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2139 | $1.286 units |
|
| Blue Medicare Rx Standard (PDP)$83.90/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.1823 | — | None |
| SilverScript Choice (PDP)$90.20/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2446 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$119.80/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3469 | $2.086 units |
|
| Blue Medicare Rx Enhanced (PDP)$163.20/mo premium · $0.00 deductible | 2Generic | $6.00 | $18.00 | $0.1823 | — | None |
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 — elsewhere it depends on what is prescribed.
Alabama and Tennessee — 12 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1214 | — | None |
| Humana Value Rx Plan (PDP)$37.70/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3215 | — | None |
| HealthSpring Extra Rx (PDP)$77.50/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1727 | — | None |
| HealthSpring Assurance Rx (PDP)$87.20/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2002 | — | None |
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3104 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3104 | — | None |
| Wellcare Classic (PDP)$3.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.2922 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$63.20/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2095 | $1.266 units |
|
| BlueRx Essential (PDP)$76.20/mo premium · $615.00 deductible | 2Generic | $10.00 | $20.00 | $0.1806 | — | None |
| SilverScript Choice (PDP)$97.30/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2425 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$119.30/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3441 | $2.066 units |
|
| BlueRx Enhanced Plus (PDP)$129.50/mo premium · $150.00 deductible | 2Generic | $12.00 | $24.00 | $0.1806 | — | None |
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 — elsewhere it depends on what is prescribed.
Michigan — 12 plans, 4 with restrictions
| 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 | 1Preferred Generic | $0.00 | $0.00 | $0.1019 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | 5% | 5% | $0.1783 | — | None |
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3058 | — | None |
| HealthSpring Extra Rx (PDP)$50.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1533 | — | None |
| Prescription Blue Select (PDP)$78.40/mo premium · $615.00 deductible | 1Preferred Generic | $1.00 | $3.00 | $0.2864 | $1.726 units |
|
| Humana Premier Rx Plan (PDP)$98.10/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2994 | — | None |
| Prescription Blue Premium (PDP)$106.70/mo premium · $0.00 deductible | 1Preferred Generic | $1.00 | $2.00 | $0.2864 | $1.726 units |
|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3017 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.2994 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$14.10/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2101 | $1.266 units |
|
| SilverScript Choice (PDP)$78.30/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2575 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$78.30/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3628 | $2.186 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 — elsewhere it depends on what is prescribed.
Illinois — 12 plans, 2 with restrictions
| 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0644 | — | None |
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3361 | — | None |
| HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1116 | — | None |
| HealthSpring Assurance Rx (PDP)$104.20/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1764 | — | None |
| Humana Premier Rx Plan (PDP)$119.40/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3302 | — | None |
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3193 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3302 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$40.20/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.1982 | $1.196 units |
|
| Blue Cross MedicareRx Basic (PDP)$89.70/mo premium · $615.00 deductible | 2Generic | $5.00 | $15.00 | $0.1475 | — | None |
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2830 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$103.90/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3023 | $1.816 units |
|
| Blue Cross MedicareRx Value (PDP)$119.70/mo premium · $615.00 deductible | 2Generic | $1.00 | $3.00 | $0.1524 | — | None |
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 — elsewhere it depends on what is prescribed.
Arkansas — 12 plans, 2 with restrictions
| 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 | 1Preferred Generic | $0.00 | $0.00 | $0.1879 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | 5% | 5% | $0.2367 | — | None |
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3026 | — | None |
| HealthSpring Extra Rx (PDP)$54.50/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2098 | — | None |
| Humana Premier Rx Plan (PDP)$92.40/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2833 | — | None |
| BlueMedicare Premier Rx (PDP)$181.20/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3394 | — | None |
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.2709 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.2833 | — | None |
| BlueMedicare Value Rx (PDP)$52.50/mo premium · $615.00 deductible | 2Generic | $5.00 | $15.00 | $0.3394 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$65.10/mo premium · $615.00 deductible | 2Generic | $7.00 | $27.00 | $0.2054 | $1.236 units |
|
| SilverScript Choice (PDP)$73.50/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2390 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$114.90/mo premium · $130.00 deductible | 2Generic | $10.00 | $54.00 | $0.3391 | $2.036 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 — elsewhere it depends on what is prescribed.
Texas — 12 plans, 2 with restrictions
| 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0948 | — | None |
| Humana Value Rx Plan (PDP)$22.90/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3208 | — | None |
| HealthSpring Extra Rx (PDP)$70.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1507 | — | None |
| HealthSpring Assurance Rx (PDP)$111.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1827 | — | None |
| Humana Premier Rx Plan (PDP)$118.20/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3098 | — | None |
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3083 | — | None |
| Humana Basic Rx Plan (PDP)$41.70/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3098 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$89.20/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2037 | $1.226 units |
|
| SilverScript Choice (PDP)$94.80/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2839 | — | None |
| Blue Cross MedicareRx Basic (PDP)$104.70/mo premium · $615.00 deductible | 2Generic | $5.00 | $15.00 | $0.1712 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3173 | $1.906 units |
|
| Blue Cross MedicareRx Value (PDP)$167.40/mo premium · $615.00 deductible | 2Generic | $1.00 | $3.00 | $0.2093 | — | None |
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 — elsewhere it depends on what is prescribed.
Kansas — 12 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| HealthSpring Assurance Rx (PDP)$6.70/mo premium · $615.00 deductible | 1Preferred Generic | 5% | 5% | $0.2038 | — | None |
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1387 | — | None |
| Humana Value Rx Plan (PDP)$55.60/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2946 | — | None |
| Humana Premier Rx Plan (PDP)$116.30/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2808 | — | None |
| Blue MedicareRx Essentials (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $0.00 | $0.00 | $0.2216 | — | None |
| Blue MedicareRx Value (PDP)$0.70/mo premium · $615.00 deductible | 2Generic | $2.00 | $6.00 | $0.2107 | — | None |
| Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible | 2Generic | $9.00 | $27.00 | $0.3247 | — | None |
| Humana Basic Rx Plan (PDP)$15.50/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.2808 | — | None |
| Blue MedicareRx Plus (PDP)$67.40/mo premium · $0.00 deductible | 2Generic | $0.00 | $0.00 | $0.2107 | — | None |
| SilverScript Choice (PDP)$88.30/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2894 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$105.40/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2124 | $1.276 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$147.00/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3339 | $2.006 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 — elsewhere it depends on what is prescribed.
California — 12 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | 5% | 5% | $0.1691 | — | None |
| Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0903 | — | None |
| HealthSpring Extra Rx (PDP)$70.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1373 | — | None |
| Humana Value Rx Plan (PDP)$104.60/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3345 | — | None |
| Humana Premier Rx Plan (PDP)$172.90/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3287 | — | None |
| Wellcare Classic (PDP)$6.20/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3039 | — | None |
| SilverScript Choice (PDP)$103.60/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2331 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$109.40/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2227 | $1.346 units |
|
| Humana Basic Rx Plan (PDP)$132.20/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3287 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$165.40/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3746 | $2.256 units |
|
| Blue Shield Rx Plus (PDP)$199.70/mo premium · $615.00 deductible | 2Generic | $7.00 | $17.50 | $0.3644 | — | None |
| Blue Shield Rx Enhanced (PDP)$227.80/mo premium · $0.00 deductible | 2Generic | $7.00 | $14.00 | $0.3644 | — | None |
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 — elsewhere it depends on what is prescribed.
Connecticut, Massachusetts, Rhode Island and Vermont — 11 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$16.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0659 | — | None |
| SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0626 | — | None |
| Humana Value Rx Plan (PDP)$73.60/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3481 | — | None |
| Humana Premier Rx Plan (PDP)$138.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3442 | — | None |
| HealthSpring Assurance Rx (PDP)$139.30/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1563 | — | None |
| Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible | 1Preferred Generic | $1.00 | $1.00 | $0.2209 | — | None |
| Humana Basic Rx Plan (PDP)$8.40/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3442 | — | None |
| Blue MedicareRx Value Plus (PDP)$20.70/mo premium · $615.00 deductible | 2Generic | $3.00 | $6.00 | $0.2209 | — | None |
| Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3171 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2320 | $1.396 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3826 | $2.306 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 — elsewhere it depends on what is prescribed.
South Carolina — 11 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$4.80/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0944 | — | None |
| Humana Value Rx Plan (PDP)$65.60/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3432 | — | None |
| HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1558 | — | None |
| Humana Premier Rx Plan (PDP)$145.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3327 | — | None |
| HealthSpring Assurance Rx (PDP)$152.50/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1808 | — | None |
| Wellcare Classic (PDP)$9.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3034 | — | None |
| Humana Basic Rx Plan (PDP)$10.10/mo premium · $615.00 deductible | 2Generic | $2.00 | $0.00 | $0.3327 | — | None |
| SilverScript Choice (PDP)$98.40/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2485 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$122.10/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2221 | $1.336 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3625 | $2.176 units |
|
| BlueCross Rx Value (PDP)$139.70/mo premium · $615.00 deductible | 6Select Care Drugs | $5.00 | $12.50 | $0.9537 | — | None |
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 — elsewhere it depends on what is prescribed.
Oklahoma — 11 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1833 | — | None |
| Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3093 | — | None |
| HealthSpring Extra Rx (PDP)$65.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1978 | — | None |
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2928 | — | None |
| HealthSpring Assurance Rx (PDP)$126.50/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2311 | — | None |
| Blue Cross MedicareRx Basic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $5.00 | $15.00 | $0.1853 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $2.00 | $0.00 | $0.2928 | — | None |
| Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.2785 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2046 | $1.236 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$121.00/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3492 | $2.106 units |
|
| Blue Cross MedicareRx Value (PDP)$167.30/mo premium · $615.00 deductible | 2Generic | $1.00 | $3.00 | $0.2348 | — | None |
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 — elsewhere it depends on what is prescribed.
Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming — 11 plans, 2 with restrictions
| 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 | 1Preferred Generic | $0.00 | $0.00 | $0.1404 | — | None |
| Humana Value Rx Plan (PDP)$20.80/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2836 | — | None |
| SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0912 | — | None |
| HealthSpring Extra Rx (PDP)$66.50/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1664 | — | None |
| Humana Premier Rx Plan (PDP)$103.70/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2748 | — | None |
| HealthSpring Assurance Rx (PDP)$125.90/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1850 | — | None |
| Humana Basic Rx Plan (PDP)$4.70/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.2748 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$5.30/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.1975 | $1.196 units |
|
| Wellcare Classic (PDP)$12.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3169 | — | None |
| MedicareBlue Rx Standard (PDP)$101.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $3.00 | $0.2020 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$140.20/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3346 | $2.016 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 — elsewhere it depends on what is prescribed.
New Mexico — 11 plans, 2 with restrictions
| 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 | 1Preferred Generic | $0.00 | $0.00 | $0.1227 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | 5% | 5% | $0.2119 | — | None |
| Humana Value Rx Plan (PDP)$69.60/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3274 | — | None |
| Humana Premier Rx Plan (PDP)$75.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3120 | — | None |
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3023 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3120 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $6.00 | $18.00 | $0.2006 | $1.206 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3080 | $1.856 units |
|
| SilverScript Choice (PDP)$104.00/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2847 | — | None |
| Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible | 2Generic | $4.00 | $12.00 | $0.1838 | — | None |
| Blue Cross MedicareRx Basic (PDP)$145.40/mo premium · $615.00 deductible | 2Generic | $5.00 | $15.00 | $0.1652 | — | None |
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 — elsewhere it depends on what is prescribed.
New York — 10 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| HealthSpring Assurance Rx (PDP)$35.70/mo premium · $615.00 deductible | 1Preferred Generic | 5% | 5% | $0.1706 | — | None |
| Wellcare Value Script (PDP)$42.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1123 | — | None |
| HealthSpring Extra Rx (PDP)$91.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1437 | — | None |
| Humana Value Rx Plan (PDP)$158.90/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3110 | — | None |
| Humana Premier Rx Plan (PDP)$173.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3089 | — | None |
| Wellcare Classic (PDP)$45.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.2883 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$105.80/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2178 | $1.316 units |
|
| SilverScript Choice (PDP)$116.00/mo premium · $615.00 deductible | 2Generic | $6.00 | $18.00 | $0.1960 | — | None |
| Humana Basic Rx Plan (PDP)$140.90/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3089 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$163.70/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3940 | $2.366 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 — elsewhere it depends on what is prescribed.
Delaware, DC and Maryland — 10 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Value Rx Plan (PDP)$4.30/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3330 | — | None |
| Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0721 | — | None |
| HealthSpring Assurance Rx (PDP)$32.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1701 | — | None |
| HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1357 | — | None |
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3271 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3271 | — | None |
| Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3131 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$37.80/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2144 | $1.296 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3519 | $2.116 units |
|
| SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2440 | — | None |
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 — elsewhere it depends on what is prescribed.
Georgia — 10 plans, 2 with restrictions
| 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 | 1Preferred Generic | $0.00 | $0.00 | $0.1054 | — | None |
| Humana Value Rx Plan (PDP)$36.40/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3240 | — | None |
| HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1714 | — | None |
| Humana Premier Rx Plan (PDP)$129.50/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3145 | — | None |
| HealthSpring Assurance Rx (PDP)$149.30/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1906 | — | None |
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3013 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3145 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$98.00/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2154 | $1.296 units |
|
| SilverScript Choice (PDP)$100.70/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2509 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$139.80/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3506 | $2.106 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 — elsewhere it depends on what is prescribed.
Florida — 10 plans, 2 with restrictions
| 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0892 | — | None |
| Humana Value Rx Plan (PDP)$25.90/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3395 | — | None |
| Humana Premier Rx Plan (PDP)$115.90/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3337 | — | None |
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3036 | — | None |
| Humana Basic Rx Plan (PDP)$92.70/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3337 | — | None |
| SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2400 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$98.70/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2085 | $1.256 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$119.10/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3448 | $2.076 units |
|
| BlueMedicare Premier Rx (PDP)$98.60/mo premium · $615.00 deductible | 6Select Care Drugs | $3.00 | $9.00 | $0.1411 | — | None |
| BlueMedicare Complete Rx (PDP)$217.00/mo premium · $615.00 deductible | 6Select Care Drugs | $0.00 | $0.00 | $0.1411 | — | None |
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 — elsewhere it depends on what is prescribed.
Ohio — 10 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$7.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0895 | — | None |
| Humana Value Rx Plan (PDP)$23.70/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3072 | — | None |
| HealthSpring Extra Rx (PDP)$65.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1513 | — | None |
| HealthSpring Assurance Rx (PDP)$109.50/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1669 | — | None |
| Humana Premier Rx Plan (PDP)$117.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2992 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.2992 | — | None |
| Wellcare Classic (PDP)$7.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3178 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$73.70/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2124 | $1.276 units |
|
| SilverScript Choice (PDP)$90.30/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2709 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$123.40/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.4152 | $2.496 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 — elsewhere it depends on what is prescribed.
Indiana and Kentucky — 10 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$8.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1074 | — | None |
| Humana Value Rx Plan (PDP)$9.90/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3277 | — | None |
| SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0674 | — | None |
| HealthSpring Extra Rx (PDP)$78.20/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1594 | — | None |
| HealthSpring Assurance Rx (PDP)$117.80/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1815 | — | None |
| Humana Premier Rx Plan (PDP)$125.30/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3173 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3173 | — | None |
| Wellcare Classic (PDP)$8.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3062 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$90.30/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2253 | $1.356 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$127.10/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3559 | $2.146 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 — elsewhere it depends on what is prescribed.
Wisconsin — 10 plans, 2 with restrictions
| 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 | 1Preferred Generic | $0.00 | $0.00 | $0.1056 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | 5% | 5% | $0.1994 | — | None |
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3413 | — | None |
| SilverScript Choice (PDP)$26.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0758 | — | None |
| HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1477 | — | None |
| Humana Premier Rx Plan (PDP)$110.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3310 | — | None |
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3052 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3310 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.1967 | $1.186 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$113.90/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3046 | $1.836 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 — elsewhere it depends on what is prescribed.
Missouri — 10 plans, 2 with restrictions
| 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 | 1Preferred Generic | $0.00 | $0.00 | $0.1204 | — | None |
| Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3431 | — | None |
| HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1591 | — | None |
| HealthSpring Assurance Rx (PDP)$74.30/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1933 | — | None |
| Humana Premier Rx Plan (PDP)$126.40/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3300 | — | None |
| Wellcare Classic (PDP)$10.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3148 | — | None |
| Humana Basic Rx Plan (PDP)$16.50/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3300 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$71.90/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2140 | $1.286 units |
|
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2644 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$125.40/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3421 | $2.056 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 — elsewhere it depends on what is prescribed.
Mississippi — 10 plans, 2 with restrictions
| 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 | 1Preferred Generic | $0.00 | $0.00 | $0.1634 | — | None |
| Humana Value Rx Plan (PDP)$37.60/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3056 | — | None |
| HealthSpring Assurance Rx (PDP)$59.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2148 | — | None |
| HealthSpring Extra Rx (PDP)$77.10/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1898 | — | None |
| Humana Premier Rx Plan (PDP)$89.90/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2917 | — | None |
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.2755 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.2917 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$84.70/mo premium · $615.00 deductible | 2Generic | $6.00 | $18.00 | $0.2089 | $1.256 units |
|
| SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2299 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$140.60/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3531 | $2.126 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 — elsewhere it depends on what is prescribed.
Louisiana — 10 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1466 | — | None |
| Humana Value Rx Plan (PDP)$19.30/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3289 | — | None |
| SilverScript Choice (PDP)$44.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0737 | — | None |
| HealthSpring Assurance Rx (PDP)$48.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2154 | — | None |
| HealthSpring Extra Rx (PDP)$60.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1831 | — | None |
| Humana Premier Rx Plan (PDP)$113.70/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3138 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3138 | — | None |
| Wellcare Classic (PDP)$6.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.2840 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$37.00/mo premium · $615.00 deductible | 2Generic | $6.00 | $18.00 | $0.2079 | $1.256 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$139.50/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3398 | $2.046 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 — elsewhere it depends on what is prescribed.
Colorado — 10 plans, 2 with restrictions
| 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0895 | — | None |
| Humana Value Rx Plan (PDP)$48.50/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2937 | — | None |
| HealthSpring Assurance Rx (PDP)$61.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1894 | — | None |
| HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1663 | — | None |
| Humana Premier Rx Plan (PDP)$137.10/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2840 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.2840 | — | None |
| Wellcare Classic (PDP)$2.20/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3148 | — | None |
| SilverScript Choice (PDP)$105.10/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2997 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$125.00/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2060 | $1.246 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$151.90/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3023 | $1.816 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 — elsewhere it depends on what is prescribed.
Arizona — 10 plans, 2 with restrictions
| 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0833 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | 5% | 5% | $0.1830 | — | None |
| Humana Value Rx Plan (PDP)$2.50/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3423 | — | None |
| HealthSpring Extra Rx (PDP)$66.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1354 | — | None |
| Humana Premier Rx Plan (PDP)$119.20/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3317 | — | None |
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3263 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $3.00 | $0.00 | $0.3317 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2088 | $1.256 units |
|
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.3008 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$97.50/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3957 | $2.376 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 — elsewhere it depends on what is prescribed.
Nevada — 10 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$2.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0898 | — | None |
| Humana Value Rx Plan (PDP)$43.70/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3399 | — | None |
| HealthSpring Extra Rx (PDP)$52.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1498 | — | None |
| HealthSpring Assurance Rx (PDP)$95.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1858 | — | None |
| Humana Premier Rx Plan (PDP)$148.70/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3283 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3283 | — | None |
| Wellcare Classic (PDP)$2.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3121 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$76.70/mo premium · $615.00 deductible | 2Generic | $6.00 | $18.00 | $0.2128 | $1.286 units |
|
| SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2858 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$139.10/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3243 | $1.956 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 — elsewhere it depends on what is prescribed.
Oregon and Washington — 10 plans, 2 with restrictions
| 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0866 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | 5% | 5% | $0.1866 | — | None |
| Humana Value Rx Plan (PDP)$22.10/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2822 | — | None |
| HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1438 | — | None |
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2755 | — | None |
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3199 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.2755 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$38.40/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2019 | $1.216 units |
|
| SilverScript Choice (PDP)$85.90/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2865 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$110.00/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3166 | $1.906 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 — elsewhere it depends on what is prescribed.
Idaho and Utah — 10 plans, 2 with restrictions
| 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 | 1Preferred Generic | $0.00 | $0.00 | $0.1244 | — | None |
| Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2834 | — | None |
| SilverScript Choice (PDP)$27.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0802 | — | None |
| HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1757 | — | None |
| Humana Premier Rx Plan (PDP)$115.50/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2734 | — | None |
| HealthSpring Assurance Rx (PDP)$128.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2033 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.2734 | — | None |
| Wellcare Classic (PDP)$23.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.2977 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$56.50/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2029 | $1.226 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$132.60/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3264 | $1.966 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 — elsewhere it depends on what is prescribed.
Maine and New Hampshire — 9 plans, 2 with restrictions
| 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0936 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | 5% | 5% | $0.2012 | — | None |
| Humana Value Rx Plan (PDP)$54.40/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3186 | — | None |
| Humana Premier Rx Plan (PDP)$150.20/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3083 | — | None |
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3232 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3083 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.1995 | $1.206 units |
|
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2559 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$104.30/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3114 | $1.876 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 — elsewhere it depends on what is prescribed.
Virginia — 9 plans, 2 with restrictions
| 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0906 | — | None |
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3394 | — | None |
| Humana Premier Rx Plan (PDP)$87.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3285 | — | None |
| HealthSpring Assurance Rx (PDP)$133.80/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1840 | — | None |
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3122 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3285 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$39.60/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2232 | $1.346 units |
|
| SilverScript Choice (PDP)$78.20/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2563 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$100.80/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3490 | $2.096 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 — elsewhere it depends on what is prescribed.
Alaska — 9 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | 5% | 5% | $0.2205 | — | None |
| Humana Value Rx Plan (PDP)$10.60/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2629 | — | None |
| Wellcare Value Script (PDP)$19.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1014 | — | None |
| Humana Premier Rx Plan (PDP)$112.40/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2560 | — | None |
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3585 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $3.00 | $0.00 | $0.2560 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$53.20/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2288 | $1.376 units |
|
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.3308 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$100.20/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3228 | $1.946 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 — elsewhere it depends on what is prescribed.
Hawaii — 8 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| SilverScript Choice (PDP)$14.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0773 | — | None |
| Wellcare Value Script (PDP)$21.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0535 | — | None |
| Humana Value Rx Plan (PDP)$51.60/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3601 | — | None |
| Humana Premier Rx Plan (PDP)$90.20/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.3574 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2448 | $1.476 units |
|
| Humana Basic Rx Plan (PDP)$0.40/mo premium · $615.00 deductible | 2Generic | $4.00 | $0.00 | $0.3574 | — | None |
| Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3246 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.4136 | $2.486 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 — elsewhere it depends on what is prescribed.
Puerto Rico — 3 plans, 1 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1563 | — | None |
| HealthSpring Assurance Rx (PDP)$65.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.2031 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$145.10/mo premium · $615.00 deductible | 2Generic | 25% | 25% | $0.3955 | $2.376 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 — elsewhere it depends on what is prescribed.
American Samoa — 1 plan, 1 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | 25% | 25% | $0.4596 | $2.766 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 — elsewhere it depends on what is prescribed.
Guam — 1 plan, 1 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | 25% | 25% | $0.4517 | $2.716 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 — elsewhere it depends on what is prescribed.
Northern Mariana Islands — 1 plan, 1 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP)$32.10/mo premium · $615.00 deductible | 2Generic | 25% | 25% | $0.4596 | $2.766 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 — elsewhere it depends on what is prescribed.
U.S. Virgin Islands — 1 plan, 1 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $615.00 deductible | 2Generic | 25% | 25% | $0.4285 | $2.576 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 — elsewhere it depends on what is prescribed.