MedicarePartD.guide

A non-government resource built from CMS public data

VELTASSA 16.8 g Powder, For Suspension

Also known as Patiromer. Package: 30 PACKET in 1 CARTON (53436-168-30) / 1 POWDER, FOR SUSPENSION in 1 PACKET (53436-168-01). NDC 53436016830.

Plans covering it
100
across 39 regions checked
Lowest tier
4
lower tiers cost less
Plans with restrictions
99
prior auth, step therapy or quantity limit

Coverage by region

Covered by at least one plan in 39 of 39 CMS regions.

RegionPlans coveringTiersLowest 30-day costRestrictions
South Carolina4 of 114—3 of 4 plans
New York3 of 104—3 of 3 plans
New Jersey3 of 124—3 of 3 plans
Delaware, DC and Maryland3 of 104—3 of 3 plans
Pennsylvania and West Virginia3 of 124—3 of 3 plans
North Carolina3 of 124—3 of 3 plans
Georgia3 of 104—3 of 3 plans
Alabama and Tennessee3 of 124—3 of 3 plans
Michigan3 of 124—3 of 3 plans
Ohio3 of 104—3 of 3 plans
Indiana and Kentucky3 of 104—3 of 3 plans
Wisconsin3 of 104—3 of 3 plans
Illinois3 of 124—3 of 3 plans
Missouri3 of 104—3 of 3 plans
Arkansas3 of 124—3 of 3 plans
Mississippi3 of 104—3 of 3 plans
Louisiana3 of 104—3 of 3 plans
Texas3 of 124—3 of 3 plans
Oklahoma3 of 114—3 of 3 plans
Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming3 of 114—3 of 3 plans
Colorado3 of 104—3 of 3 plans
Arizona3 of 104—3 of 3 plans
Nevada3 of 104—3 of 3 plans
Oregon and Washington3 of 104—3 of 3 plans
Idaho and Utah3 of 104—3 of 3 plans
California3 of 124—3 of 3 plans
Puerto Rico3 of 34—3 of 3 plans
Maine and New Hampshire2 of 94—2 of 2 plans
Connecticut, Massachusetts, Rhode Island and Vermont2 of 114—2 of 2 plans
Virginia2 of 94—2 of 2 plans
Kansas2 of 124—2 of 2 plans
New Mexico2 of 114—2 of 2 plans
Alaska2 of 94—2 of 2 plans
Florida1 of 104—1 of 1 plans
Hawaii1 of 84—1 of 1 plans
American Samoa1 of 14—1 of 1 plans
Guam1 of 14—1 of 1 plans
Northern Mariana Islands1 of 14—1 of 1 plans
U.S. Virgin Islands1 of 14—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.

South Carolina — 4 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$33.9189$101.763 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible4Non-Preferred Drug35%—$36.3577$109.073 units
  • Quantity limit 3 per 30 days
BlueCross Rx Value (PDP)$139.70/mo premium · $615.00 deductible4Non-Preferred Drug50%50%$34.1499—None
HealthSpring Assurance Rx (PDP)$152.50/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$33.9623$101.893 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

New York — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$35.70/mo premium · $615.00 deductible4Non-Preferred Drug29%29%$32.5909$97.773 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$91.60/mo premium · $615.00 deductible4Non-Preferred Drug29%29%$32.6026$97.813 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$163.70/mo premium · $130.00 deductible4Non-Preferred Drug28%—$35.9013$107.703 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

New Jersey — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$59.90/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$33.0432$99.133 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$109.30/mo premium · $615.00 deductible4Non-Preferred Drug27%27%$33.0315$99.093 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$118.90/mo premium · $130.00 deductible4Non-Preferred Drug33%—$36.2734$108.823 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Delaware, DC and Maryland — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$32.60/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$33.5019$100.513 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible4Non-Preferred Drug32%32%$33.5127$100.543 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible4Non-Preferred Drug34%—$36.2852$108.863 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Pennsylvania and West Virginia — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$62.60/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$33.2211$99.663 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$74.00/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$33.2305$99.693 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$121.90/mo premium · $130.00 deductible4Non-Preferred Drug33%—$35.9464$107.843 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

North Carolina — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$78.00/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$33.6693$101.013 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$110.40/mo premium · $615.00 deductible4Non-Preferred Drug32%32%$33.6671$101.003 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$119.80/mo premium · $130.00 deductible4Non-Preferred Drug33%—$36.1847$108.553 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Georgia — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$33.4888$100.473 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.80/mo premium · $130.00 deductible4Non-Preferred Drug36%—$36.5043$109.513 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$149.30/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$33.5979$100.793 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Alabama and Tennessee — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$77.50/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$32.2319$96.703 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$87.20/mo premium · $615.00 deductible4Non-Preferred Drug32%32%$32.2450$96.733 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$119.30/mo premium · $130.00 deductible4Non-Preferred Drug34%—$35.9036$107.713 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Michigan — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$33.2944$99.883 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$50.40/mo premium · $615.00 deductible4Non-Preferred Drug32%32%$33.2692$99.813 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$78.30/mo premium · $130.00 deductible4Non-Preferred Drug32%—$36.0029$108.013 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Ohio — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$65.70/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$33.4539$100.363 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$109.50/mo premium · $615.00 deductible4Non-Preferred Drug33%33%$33.4589$100.383 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$123.40/mo premium · $130.00 deductible4Non-Preferred Drug36%—$35.9723$107.923 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Indiana and Kentucky — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$78.20/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$33.5040$100.513 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$117.80/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$33.5532$100.663 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$127.10/mo premium · $130.00 deductible4Non-Preferred Drug34%—$36.3668$109.103 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Wisconsin — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$32.9095$98.733 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible4Non-Preferred Drug33%33%$32.9217$98.773 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$113.90/mo premium · $130.00 deductible4Non-Preferred Drug36%—$36.4505$109.353 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Illinois — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$33.7200$101.163 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$103.90/mo premium · $130.00 deductible4Non-Preferred Drug38%—$36.8734$110.623 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$104.20/mo premium · $615.00 deductible4Non-Preferred Drug32%32%$33.7320$101.203 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Missouri — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$33.6349$100.903 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$74.30/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$33.6150$100.843 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$125.40/mo premium · $130.00 deductible4Non-Preferred Drug35%—$36.9057$110.723 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Arkansas — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug29%29%$32.9527$98.863 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$54.50/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$32.9610$98.883 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$114.90/mo premium · $130.00 deductible4Non-Preferred Drug29%—$36.3204$108.963 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Mississippi — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$59.70/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$32.9176$98.753 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$77.10/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$32.8921$98.683 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$140.60/mo premium · $130.00 deductible4Non-Preferred Drug34%—$36.3501$109.053 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Louisiana — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$48.40/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$33.7841$101.353 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$60.60/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$33.7989$101.403 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.50/mo premium · $130.00 deductible4Non-Preferred Drug36%—$36.6473$109.943 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Texas — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$70.00/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$33.1660$99.503 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$111.40/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$33.1600$99.483 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $130.00 deductible4Non-Preferred Drug35%—$36.4543$109.363 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Oklahoma — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$65.40/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$33.7753$101.333 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$121.00/mo premium · $130.00 deductible4Non-Preferred Drug40%—$37.1244$111.373 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$126.50/mo premium · $615.00 deductible4Non-Preferred Drug29%29%$33.7539$101.263 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$66.50/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$33.1418$99.433 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$125.90/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$33.1510$99.453 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$140.20/mo premium · $130.00 deductible4Non-Preferred Drug34%—$36.1589$108.483 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Colorado — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$61.70/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$34.2021$102.613 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$34.0688$102.213 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$151.90/mo premium · $130.00 deductible4Non-Preferred Drug37%—$37.1618$111.493 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Arizona — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug29%29%$33.1796$99.543 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$66.40/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$33.1975$99.593 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$97.50/mo premium · $130.00 deductible4Non-Preferred Drug35%—$36.3117$108.943 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Nevada — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$52.60/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$33.6171$100.853 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$95.60/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$33.6261$100.883 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.10/mo premium · $130.00 deductible4Non-Preferred Drug36%—$36.5258$109.583 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Oregon and Washington — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$33.6103$100.833 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$33.5337$100.603 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$110.00/mo premium · $130.00 deductible4Non-Preferred Drug37%—$36.1506$108.453 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Idaho and Utah — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$33.1101$99.333 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$128.60/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$33.1488$99.453 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$132.60/mo premium · $130.00 deductible4Non-Preferred Drug36%—$35.9785$107.943 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

California — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug29%29%$32.8873$98.663 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$70.60/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$32.8952$98.693 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$165.40/mo premium · $130.00 deductible4Non-Preferred Drug31%—$35.9883$107.963 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Puerto Rico — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$32.5067$97.523 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$65.70/mo premium · $615.00 deductible4Non-Preferred Drug34%34%$32.4800$97.443 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$145.10/mo premium · $615.00 deductible4Non-Preferred Drug25%25%$35.7518$107.263 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Maine and New Hampshire — 2 plans, 2 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$33.2917$99.883 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$104.30/mo premium · $130.00 deductible4Non-Preferred Drug30%—$36.0798$108.243 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Connecticut, Massachusetts, Rhode Island and Vermont — 2 plans, 2 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$139.30/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$33.3076$99.923 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible4Non-Preferred Drug30%—$36.0851$108.263 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Virginia — 2 plans, 2 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$100.80/mo premium · $130.00 deductible4Non-Preferred Drug35%—$36.4631$109.393 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$133.80/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$34.1121$102.343 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Kansas — 2 plans, 2 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$6.70/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$33.2558$99.773 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$147.00/mo premium · $130.00 deductible4Non-Preferred Drug38%—$35.4395$106.323 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

New Mexico — 2 plans, 2 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug29%29%$34.0575$102.173 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible4Non-Preferred Drug35%—$37.3836$112.153 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Alaska — 2 plans, 2 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug29%29%$38.8939$116.683 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$100.20/mo premium · $130.00 deductible4Non-Preferred Drug35%—$34.4094$103.233 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Florida — 1 plan, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$119.10/mo premium · $130.00 deductible4Non-Preferred Drug34%—$36.1527$108.463 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Hawaii — 1 plan, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible4Non-Preferred Drug34%—$36.0690$108.213 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

American Samoa — 1 plan, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug25%25%$37.0783$111.233 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Guam — 1 plan, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug25%25%$37.0783$111.233 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

Northern Mariana Islands — 1 plan, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$32.10/mo premium · $615.00 deductible4Non-Preferred Drug25%25%$37.0783$111.233 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.

U.S. Virgin Islands — 1 plan, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $615.00 deductible4Non-Preferred Drug25%25%$37.0783$111.233 units
  • Quantity limit 3 per 30 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 — elsewhere it depends on what is prescribed.