MedicarePartD.guide

A non-government resource built from CMS public data

GLIMEPIRIDE 1 mg Tablet

Package: 100 TABLET in 1 BOTTLE (55111-320-01). NDC 55111032001.

Plans covering it
367
across 39 regions checked
Lowest tier
1
lower tiers cost less
Plans with restrictions
260
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
New Jersey12 of 121$0.009 of 12 plans
Pennsylvania and West Virginia12 of 121$0.007 of 12 plans
North Carolina12 of 121$0.009 of 12 plans
Alabama and Tennessee12 of 121$0.009 of 12 plans
Michigan12 of 121$0.009 of 12 plans
Illinois12 of 121$0.009 of 12 plans
Arkansas12 of 121$0.009 of 12 plans
Texas12 of 121$0.009 of 12 plans
Kansas12 of 121$0.009 of 12 plans
California12 of 121$0.007 of 12 plans
Connecticut, Massachusetts, Rhode Island and Vermont11 of 111$0.008 of 11 plans
South Carolina11 of 111–6$0.007 of 11 plans
Oklahoma11 of 111$0.008 of 11 plans
Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming11 of 111$0.008 of 11 plans
New Mexico11 of 111$0.008 of 11 plans
New York10 of 101$0.007 of 10 plans
Delaware, DC and Maryland10 of 101$0.007 of 10 plans
Georgia10 of 101$0.007 of 10 plans
Florida10 of 101–6$0.007 of 10 plans
Ohio10 of 101$0.007 of 10 plans
Indiana and Kentucky10 of 101$0.007 of 10 plans
Wisconsin10 of 101$0.007 of 10 plans
Missouri10 of 101$0.007 of 10 plans
Mississippi10 of 101$0.007 of 10 plans
Louisiana10 of 101$0.007 of 10 plans
Colorado10 of 101$0.007 of 10 plans
Arizona10 of 101$0.007 of 10 plans
Nevada10 of 101$0.007 of 10 plans
Oregon and Washington10 of 101$0.007 of 10 plans
Idaho and Utah10 of 101$0.007 of 10 plans
Maine and New Hampshire9 of 91$0.006 of 9 plans
Virginia9 of 91$0.006 of 9 plans
Alaska9 of 91$0.006 of 9 plans
Hawaii8 of 81$0.005 of 8 plans
Puerto Rico3 of 31$0.003 of 3 plans
American Samoa1 of 11—1 of 1 plans
Guam1 of 11—1 of 1 plans
Northern Mariana Islands1 of 11—1 of 1 plans
U.S. Virgin Islands1 of 11—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, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$4.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0782—None
Wellcare Value Script (PDP)$22.80/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0495$1.1924 units
  • Quantity limit 24 per 30 days
Wellcare Classic (PDP)$28.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1065$2.5624 units
  • Quantity limit 24 per 30 days
Humana Value Rx Plan (PDP)$35.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0792—None
HealthSpring Extra Rx (PDP)$59.90/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1508$3.6224 units
  • Quantity limit 24 per 30 days
Horizon Medicare Blue Rx Standard (PDP)$72.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0764$1.8324 units
  • Quantity limit 24 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$77.40/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1696$4.0724 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0352$0.329 units
  • Quantity limit 9 per 30 days
HealthSpring Assurance Rx (PDP)$109.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2587$6.2124 units
  • Quantity limit 24 per 30 days
Humana Premier Rx Plan (PDP)$111.90/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0782—None
AARP Medicare Rx Preferred from UHC (PDP)$118.90/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.2252$5.4024 units
  • Quantity limit 24 per 30 days
Horizon Medicare Blue Rx Enhanced (PDP)$139.10/mo premium · $200.00 deductible1Preferred Generic$0.00$0.00$0.0764$1.8324 units
  • Quantity limit 24 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 — 12 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$6.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0733—None
Wellcare Value Script (PDP)$8.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0613$1.4724 units
  • Quantity limit 24 per 30 days
Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1068$2.5624 units
  • Quantity limit 24 per 30 days
Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0753—None
SilverScript Choice (PDP)$22.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0574$0.529 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$43.50/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1659$3.9824 units
  • Quantity limit 24 per 30 days
HealthSpring Extra Rx (PDP)$62.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1510$3.6224 units
  • Quantity limit 24 per 30 days
HealthSpring Assurance Rx (PDP)$74.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2695$6.4724 units
  • Quantity limit 24 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$121.90/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.2211$5.3124 units
  • Quantity limit 24 per 30 days
Humana Premier Rx Plan (PDP)$123.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0733—None
Blue Rx PDP Complete (PDP)$164.80/mo premium · $200.00 deductible1Preferred Generic$0.00$0.00$0.1353—None
Blue Rx PDP Plus (PDP)$193.20/mo premium · $615.00 deductible1Preferred Generic25%25%$0.1353—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.

North Carolina — 12 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0521$1.2524 units
  • Quantity limit 24 per 30 days
Wellcare Classic (PDP)$4.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1088$2.6124 units
  • Quantity limit 24 per 30 days
Humana Basic Rx Plan (PDP)$6.80/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0777—None
Humana Value Rx Plan (PDP)$32.00/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0804—None
AARP Medicare Rx Saver from UHC (PDP)$56.90/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1466$3.5224 units
  • Quantity limit 24 per 30 days
HealthSpring Extra Rx (PDP)$78.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1868$4.4824 units
  • Quantity limit 24 per 30 days
Blue Medicare Rx Standard (PDP)$83.90/mo premium · $615.00 deductible1Preferred Generic$5.00$15.00$0.0841$2.0224 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$90.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0409$0.379 units
  • Quantity limit 9 per 30 days
HealthSpring Assurance Rx (PDP)$110.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2913$6.9924 units
  • Quantity limit 24 per 30 days
Humana Premier Rx Plan (PDP)$110.90/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0777—None
AARP Medicare Rx Preferred from UHC (PDP)$119.80/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.2007$4.8224 units
  • Quantity limit 24 per 30 days
Blue Medicare Rx Enhanced (PDP)$163.20/mo premium · $0.00 deductible1Preferred Generic$3.00$9.00$0.0841$2.0224 units
  • Quantity limit 24 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 — 12 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0744—None
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0632$1.5224 units
  • Quantity limit 24 per 30 days
Wellcare Classic (PDP)$3.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1079$2.5924 units
  • Quantity limit 24 per 30 days
Humana Value Rx Plan (PDP)$37.70/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0772—None
AARP Medicare Rx Saver from UHC (PDP)$63.20/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1320$3.1724 units
  • Quantity limit 24 per 30 days
BlueRx Essential (PDP)$76.20/mo premium · $615.00 deductible1Preferred Generic$2.00$4.00$0.0805$1.9324 units
  • Quantity limit 24 per 30 days
HealthSpring Extra Rx (PDP)$77.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1885$4.5224 units
  • Quantity limit 24 per 30 days
HealthSpring Assurance Rx (PDP)$87.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2625$6.3024 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$97.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0478$0.439 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0744—None
AARP Medicare Rx Preferred from UHC (PDP)$119.30/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1930$4.6324 units
  • Quantity limit 24 per 30 days
BlueRx Enhanced Plus (PDP)$129.50/mo premium · $150.00 deductible1Preferred Generic$0.00$0.00$0.0805$1.9324 units
  • Quantity limit 24 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 — 12 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1064$2.5524 units
  • Quantity limit 24 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0627$1.5024 units
  • Quantity limit 24 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.2337$5.6124 units
  • Quantity limit 24 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0708—None
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0723—None
AARP Medicare Rx Saver from UHC (PDP)$14.10/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1522$3.6524 units
  • Quantity limit 24 per 30 days
HealthSpring Extra Rx (PDP)$50.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1636$3.9324 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$78.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0478$0.439 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$78.30/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.2171$5.2124 units
  • Quantity limit 24 per 30 days
Prescription Blue Select (PDP)$78.40/mo premium · $615.00 deductible1Preferred Generic$1.00$3.00$0.0634$1.5224 units
  • Quantity limit 72 per 90 days
Humana Premier Rx Plan (PDP)$98.10/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0708—None
Prescription Blue Premium (PDP)$106.70/mo premium · $0.00 deductible1Preferred Generic$1.00$2.00$0.0634$1.5224 units
  • Quantity limit 72 per 90 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 — 12 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1084$2.6024 units
  • Quantity limit 24 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0457$1.1024 units
  • Quantity limit 24 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0741—None
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0756—None
AARP Medicare Rx Saver from UHC (PDP)$40.20/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1103$2.6524 units
  • Quantity limit 24 per 30 days
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1806$4.3324 units
  • Quantity limit 24 per 30 days
Blue Cross MedicareRx Basic (PDP)$89.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0686$1.6524 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0482$0.439 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$103.90/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1727$4.1424 units
  • Quantity limit 24 per 30 days
HealthSpring Assurance Rx (PDP)$104.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3157$7.5824 units
  • Quantity limit 24 per 30 days
Humana Premier Rx Plan (PDP)$119.40/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0741—None
Blue Cross MedicareRx Value (PDP)$119.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0719$1.7324 units
  • Quantity limit 24 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 — 12 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1087$2.6124 units
  • Quantity limit 24 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0850$2.0424 units
  • Quantity limit 24 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.2533$6.0824 units
  • Quantity limit 24 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0677—None
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0724—None
BlueMedicare Value Rx (PDP)$52.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1846$1.669 units
  • Quantity limit 9 per 30 days
HealthSpring Extra Rx (PDP)$54.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2194$5.2724 units
  • Quantity limit 24 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$65.10/mo premium · $615.00 deductible1Preferred Generic$2.00$24.00$0.1270$3.0524 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$73.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0541$0.499 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$92.40/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0677—None
AARP Medicare Rx Preferred from UHC (PDP)$114.90/mo premium · $130.00 deductible1Preferred Generic$5.00$39.00$0.1855$4.4524 units
  • Quantity limit 24 per 30 days
BlueMedicare Premier Rx (PDP)$181.20/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1846$1.669 units
  • Quantity limit 9 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 — 12 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1082$2.6024 units
  • Quantity limit 24 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0622$1.4924 units
  • Quantity limit 24 per 30 days
Humana Value Rx Plan (PDP)$22.90/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0786—None
Humana Basic Rx Plan (PDP)$41.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0755—None
HealthSpring Extra Rx (PDP)$70.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1875$4.5024 units
  • Quantity limit 24 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$89.20/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1217$2.9224 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$94.80/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0483$0.439 units
  • Quantity limit 9 per 30 days
Blue Cross MedicareRx Basic (PDP)$104.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0758$1.8224 units
  • Quantity limit 24 per 30 days
HealthSpring Assurance Rx (PDP)$111.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2788$6.6924 units
  • Quantity limit 24 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1819$4.3724 units
  • Quantity limit 24 per 30 days
Humana Premier Rx Plan (PDP)$118.20/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0755—None
Blue Cross MedicareRx Value (PDP)$167.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0892$2.1424 units
  • Quantity limit 24 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 — 12 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Blue MedicareRx Essentials (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1028$2.4724 units
  • Quantity limit 24 per 30 days
Blue MedicareRx Value (PDP)$0.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0986$2.3724 units
  • Quantity limit 24 per 30 days
HealthSpring Assurance Rx (PDP)$6.70/mo premium · $615.00 deductible1Preferred Generic5%5%$0.2850$6.8424 units
  • Quantity limit 24 per 30 days
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0767$1.8424 units
  • Quantity limit 24 per 30 days
Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1143$2.7424 units
  • Quantity limit 24 per 30 days
Humana Basic Rx Plan (PDP)$15.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0690—None
Humana Value Rx Plan (PDP)$55.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0726—None
Blue MedicareRx Plus (PDP)$67.40/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0986$2.3724 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$88.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0667$0.609 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$105.40/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1335$3.2024 units
  • Quantity limit 24 per 30 days
Humana Premier Rx Plan (PDP)$116.30/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0690—None
AARP Medicare Rx Preferred from UHC (PDP)$147.00/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1923$4.6224 units
  • Quantity limit 24 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 — 12 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.2673$6.4224 units
  • Quantity limit 24 per 30 days
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0526$1.2624 units
  • Quantity limit 24 per 30 days
Wellcare Classic (PDP)$6.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1068$2.5624 units
  • Quantity limit 24 per 30 days
HealthSpring Extra Rx (PDP)$70.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1505$3.6124 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$103.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0323$0.299 units
  • Quantity limit 9 per 30 days
Humana Value Rx Plan (PDP)$104.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0781—None
AARP Medicare Rx Saver from UHC (PDP)$109.40/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1718$4.1224 units
  • Quantity limit 24 per 30 days
Humana Basic Rx Plan (PDP)$132.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0766—None
AARP Medicare Rx Preferred from UHC (PDP)$165.40/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.2256$5.4124 units
  • Quantity limit 24 per 30 days
Humana Premier Rx Plan (PDP)$172.90/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0766—None
Blue Shield Rx Plus (PDP)$199.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1559—None
Blue Shield Rx Enhanced (PDP)$227.80/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.1559—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, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$8.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0836—None
Wellcare Value Script (PDP)$16.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0377$0.9024 units
  • Quantity limit 24 per 30 days
Blue MedicareRx Value Plus (PDP)$20.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1825$1.649 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1085$2.6024 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0604$0.549 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1813$4.3524 units
  • Quantity limit 24 per 30 days
Humana Value Rx Plan (PDP)$73.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0846—None
Humana Premier Rx Plan (PDP)$138.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0836—None
HealthSpring Assurance Rx (PDP)$139.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2933$7.0424 units
  • Quantity limit 24 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.2264$5.4324 units
  • Quantity limit 24 per 30 days
Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible1Preferred Generic$1.00$1.00$0.1825$1.649 units
  • Quantity limit 9 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.

South Carolina — 11 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$4.80/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0536$1.2924 units
  • Quantity limit 24 per 30 days
Wellcare Classic (PDP)$9.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1078$2.5924 units
  • Quantity limit 24 per 30 days
Humana Basic Rx Plan (PDP)$10.10/mo premium · $615.00 deductible1Preferred Generic$1.00$0.00$0.0795—None
Humana Value Rx Plan (PDP)$65.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0820—None
HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1706$4.0924 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$98.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0385$0.359 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$122.10/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1555$3.7324 units
  • Quantity limit 24 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.2076$4.9824 units
  • Quantity limit 24 per 30 days
Humana Premier Rx Plan (PDP)$145.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0795—None
HealthSpring Assurance Rx (PDP)$152.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2811$6.7524 units
  • Quantity limit 24 per 30 days
BlueCross Rx Value (PDP)$139.70/mo premium · $615.00 deductible6Select Care Drugs$5.00$12.50$0.1238—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, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Blue Cross MedicareRx Basic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0834$2.0024 units
  • Quantity limit 24 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$1.00$0.00$0.0744—None
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0797$1.9124 units
  • Quantity limit 24 per 30 days
Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1113$2.6724 units
  • Quantity limit 24 per 30 days
Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0796—None
HealthSpring Extra Rx (PDP)$65.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2271$5.4524 units
  • Quantity limit 24 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1243$2.9824 units
  • Quantity limit 24 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0744—None
AARP Medicare Rx Preferred from UHC (PDP)$121.00/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1767$4.2424 units
  • Quantity limit 24 per 30 days
HealthSpring Assurance Rx (PDP)$126.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2835$6.8024 units
  • Quantity limit 24 per 30 days
Blue Cross MedicareRx Value (PDP)$167.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1062$2.5524 units
  • Quantity limit 24 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 — 11 plans, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$4.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0666—None
AARP Medicare Rx Saver from UHC (PDP)$5.30/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1135$2.7224 units
  • Quantity limit 24 per 30 days
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0908$2.1824 units
  • Quantity limit 24 per 30 days
Wellcare Classic (PDP)$12.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1088$2.6124 units
  • Quantity limit 24 per 30 days
Humana Value Rx Plan (PDP)$20.80/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0689—None
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0655$0.599 units
  • Quantity limit 9 per 30 days
HealthSpring Extra Rx (PDP)$66.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1707$4.1024 units
  • Quantity limit 24 per 30 days
MedicareBlue Rx Standard (PDP)$101.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0930$2.2324 units
  • Quantity limit 24 per 30 days
Humana Premier Rx Plan (PDP)$103.70/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0666—None
HealthSpring Assurance Rx (PDP)$125.90/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2218$5.3224 units
  • Quantity limit 24 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$140.20/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1878$4.5124 units
  • Quantity limit 24 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 — 11 plans, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1098$2.6424 units
  • Quantity limit 24 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0613$1.4724 units
  • Quantity limit 24 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.3067$7.3624 units
  • Quantity limit 24 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0773—None
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0932$2.2424 units
  • Quantity limit 24 per 30 days
Humana Value Rx Plan (PDP)$69.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0811—None
Humana Premier Rx Plan (PDP)$75.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0773—None
AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1561$3.7524 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$104.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0569$0.519 units
  • Quantity limit 9 per 30 days
Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0802$1.9224 units
  • Quantity limit 24 per 30 days
Blue Cross MedicareRx Basic (PDP)$145.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0715$1.7224 units
  • Quantity limit 24 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 — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$35.70/mo premium · $615.00 deductible1Preferred Generic5%5%$0.2315$5.5624 units
  • Quantity limit 24 per 30 days
Wellcare Value Script (PDP)$42.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0589$1.4124 units
  • Quantity limit 24 per 30 days
Wellcare Classic (PDP)$45.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1057$2.5424 units
  • Quantity limit 24 per 30 days
HealthSpring Extra Rx (PDP)$91.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1402$3.3624 units
  • Quantity limit 24 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$105.80/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1727$4.1424 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$116.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0338$0.309 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$140.90/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0740—None
Humana Value Rx Plan (PDP)$158.90/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0747—None
AARP Medicare Rx Preferred from UHC (PDP)$163.70/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.2332$5.6024 units
  • Quantity limit 24 per 30 days
Humana Premier Rx Plan (PDP)$173.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0740—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.

Delaware, DC and Maryland — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0785—None
Humana Value Rx Plan (PDP)$4.30/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0802—None
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0501$1.2024 units
  • Quantity limit 24 per 30 days
Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1070$2.5724 units
  • Quantity limit 24 per 30 days
HealthSpring Assurance Rx (PDP)$32.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2777$6.6624 units
  • Quantity limit 24 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$37.80/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1449$3.4824 units
  • Quantity limit 24 per 30 days
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1561$3.7524 units
  • Quantity limit 24 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.2028$4.8724 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0392$0.359 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0785—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, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1083$2.6024 units
  • Quantity limit 24 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0635$1.5224 units
  • Quantity limit 24 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0746—None
Humana Value Rx Plan (PDP)$36.40/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0771—None
HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1779$4.2724 units
  • Quantity limit 24 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$98.00/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1372$3.2924 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$100.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0467$0.429 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$129.50/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0746—None
AARP Medicare Rx Preferred from UHC (PDP)$139.80/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1987$4.7724 units
  • Quantity limit 24 per 30 days
HealthSpring Assurance Rx (PDP)$149.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2602$6.2424 units
  • Quantity limit 24 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 — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1070$2.5724 units
  • Quantity limit 24 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0575$1.3824 units
  • Quantity limit 24 per 30 days
Humana Value Rx Plan (PDP)$25.90/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0829—None
Humana Basic Rx Plan (PDP)$92.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0814—None
SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0456$0.419 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$98.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1193$2.8624 units
  • Quantity limit 24 per 30 days
Humana Premier Rx Plan (PDP)$115.90/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0814—None
AARP Medicare Rx Preferred from UHC (PDP)$119.10/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1865$4.4824 units
  • Quantity limit 24 per 30 days
BlueMedicare Premier Rx (PDP)$98.60/mo premium · $615.00 deductible6Select Care Drugs$3.00$9.00$0.0684$1.6424 units
  • Quantity limit 24 per 30 days
BlueMedicare Complete Rx (PDP)$217.00/mo premium · $615.00 deductible6Select Care Drugs$0.00$0.00$0.0684$1.6424 units
  • Quantity limit 24 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 — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0718—None
Wellcare Value Script (PDP)$7.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0557$1.3424 units
  • Quantity limit 24 per 30 days
Wellcare Classic (PDP)$7.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1077$2.5824 units
  • Quantity limit 24 per 30 days
Humana Value Rx Plan (PDP)$23.70/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0740—None
HealthSpring Extra Rx (PDP)$65.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1728$4.1524 units
  • Quantity limit 24 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$73.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1686$4.0524 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$90.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0468$0.429 units
  • Quantity limit 9 per 30 days
HealthSpring Assurance Rx (PDP)$109.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2899$6.9624 units
  • Quantity limit 24 per 30 days
Humana Premier Rx Plan (PDP)$117.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0718—None
AARP Medicare Rx Preferred from UHC (PDP)$123.40/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.2399$5.7624 units
  • Quantity limit 24 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 — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0749—None
Wellcare Value Script (PDP)$8.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0555$1.3324 units
  • Quantity limit 24 per 30 days
Wellcare Classic (PDP)$8.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1105$2.6524 units
  • Quantity limit 24 per 30 days
Humana Value Rx Plan (PDP)$9.90/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0775—None
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0602$0.549 units
  • Quantity limit 9 per 30 days
HealthSpring Extra Rx (PDP)$78.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1867$4.4824 units
  • Quantity limit 24 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$90.30/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1551$3.7224 units
  • Quantity limit 24 per 30 days
HealthSpring Assurance Rx (PDP)$117.80/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2945$7.0724 units
  • Quantity limit 24 per 30 days
Humana Premier Rx Plan (PDP)$125.30/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0749—None
AARP Medicare Rx Preferred from UHC (PDP)$127.10/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.2067$4.9624 units
  • Quantity limit 24 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 — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1098$2.6424 units
  • Quantity limit 24 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0561$1.3524 units
  • Quantity limit 24 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.2857$6.8624 units
  • Quantity limit 24 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0783—None
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0809—None
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1104$2.6524 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$26.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0619$0.569 units
  • Quantity limit 9 per 30 days
HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2047$4.9124 units
  • Quantity limit 24 per 30 days
Humana Premier Rx Plan (PDP)$110.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0783—None
AARP Medicare Rx Preferred from UHC (PDP)$113.90/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1738$4.1724 units
  • Quantity limit 24 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 — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0800$1.9224 units
  • Quantity limit 24 per 30 days
Wellcare Classic (PDP)$10.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1133$2.7224 units
  • Quantity limit 24 per 30 days
Humana Basic Rx Plan (PDP)$16.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0759—None
Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0800—None
HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2014$4.8324 units
  • Quantity limit 24 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$71.90/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1347$3.2324 units
  • Quantity limit 24 per 30 days
HealthSpring Assurance Rx (PDP)$74.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2785$6.6824 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0511$0.469 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$125.40/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1871$4.4924 units
  • Quantity limit 24 per 30 days
Humana Premier Rx Plan (PDP)$126.40/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0759—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.

Mississippi — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1090$2.6224 units
  • Quantity limit 24 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0699$1.6824 units
  • Quantity limit 24 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0705—None
Humana Value Rx Plan (PDP)$37.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0738—None
HealthSpring Assurance Rx (PDP)$59.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2625$6.3024 units
  • Quantity limit 24 per 30 days
HealthSpring Extra Rx (PDP)$77.10/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1996$4.7924 units
  • Quantity limit 24 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$84.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1394$3.3524 units
  • Quantity limit 24 per 30 days
Humana Premier Rx Plan (PDP)$89.90/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0705—None
SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0495$0.459 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$140.60/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1983$4.7624 units
  • Quantity limit 24 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 — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0758—None
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0695$1.6724 units
  • Quantity limit 24 per 30 days
Wellcare Classic (PDP)$6.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1084$2.6024 units
  • Quantity limit 24 per 30 days
Humana Value Rx Plan (PDP)$19.30/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0794—None
AARP Medicare Rx Saver from UHC (PDP)$37.00/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1377$3.3024 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$44.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0583$0.529 units
  • Quantity limit 9 per 30 days
HealthSpring Assurance Rx (PDP)$48.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2673$6.4224 units
  • Quantity limit 24 per 30 days
HealthSpring Extra Rx (PDP)$60.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1965$4.7224 units
  • Quantity limit 24 per 30 days
Humana Premier Rx Plan (PDP)$113.70/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0758—None
AARP Medicare Rx Preferred from UHC (PDP)$139.50/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1918$4.6024 units
  • Quantity limit 24 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 — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0582$1.4024 units
  • Quantity limit 24 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0696—None
Wellcare Classic (PDP)$2.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1088$2.6124 units
  • Quantity limit 24 per 30 days
Humana Value Rx Plan (PDP)$48.50/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0732—None
HealthSpring Assurance Rx (PDP)$61.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3121$7.4924 units
  • Quantity limit 24 per 30 days
HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2181$5.2324 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$105.10/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0600$0.549 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$125.00/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0992$2.3824 units
  • Quantity limit 24 per 30 days
Humana Premier Rx Plan (PDP)$137.10/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0696—None
AARP Medicare Rx Preferred from UHC (PDP)$151.90/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1645$3.9524 units
  • Quantity limit 24 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 — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1136$2.7324 units
  • Quantity limit 24 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0551$1.3224 units
  • Quantity limit 24 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.3256$7.8124 units
  • Quantity limit 24 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$2.00$0.00$0.0787—None
Humana Value Rx Plan (PDP)$2.50/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0811—None
AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1665$4.0024 units
  • Quantity limit 24 per 30 days
HealthSpring Extra Rx (PDP)$66.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1899$4.5624 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0503$0.459 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$97.50/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.2406$5.7724 units
  • Quantity limit 24 per 30 days
Humana Premier Rx Plan (PDP)$119.20/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0787—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.

Nevada — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0792—None
Wellcare Classic (PDP)$2.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1091$2.6224 units
  • Quantity limit 24 per 30 days
Wellcare Value Script (PDP)$2.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0434$1.0424 units
  • Quantity limit 24 per 30 days
Humana Value Rx Plan (PDP)$43.70/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0817—None
HealthSpring Extra Rx (PDP)$52.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1911$4.5924 units
  • Quantity limit 24 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$76.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1255$3.0124 units
  • Quantity limit 24 per 30 days
HealthSpring Assurance Rx (PDP)$95.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.3124$7.5024 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0473$0.439 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.10/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1827$4.3824 units
  • Quantity limit 24 per 30 days
Humana Premier Rx Plan (PDP)$148.70/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0792—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.

Oregon and Washington — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1086$2.6124 units
  • Quantity limit 24 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0677$1.6224 units
  • Quantity limit 24 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.2879$6.9124 units
  • Quantity limit 24 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0673—None
Humana Value Rx Plan (PDP)$22.10/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0694—None
AARP Medicare Rx Saver from UHC (PDP)$38.40/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1032$2.4824 units
  • Quantity limit 24 per 30 days
HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1826$4.3824 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$85.90/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0588$0.539 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0673—None
AARP Medicare Rx Preferred from UHC (PDP)$110.00/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1769$4.2524 units
  • Quantity limit 24 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 — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0661—None
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0694$1.6724 units
  • Quantity limit 24 per 30 days
Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0686—None
Wellcare Classic (PDP)$23.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1076$2.5824 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$27.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0611$0.559 units
  • Quantity limit 9 per 30 days
HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1964$4.7124 units
  • Quantity limit 24 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$56.50/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1148$2.7624 units
  • Quantity limit 24 per 30 days
Humana Premier Rx Plan (PDP)$115.50/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0661—None
HealthSpring Assurance Rx (PDP)$128.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2636$6.3324 units
  • Quantity limit 24 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$132.60/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1859$4.4624 units
  • Quantity limit 24 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 — 9 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1128$2.7124 units
  • Quantity limit 24 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0691$1.6624 units
  • Quantity limit 24 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.2782$6.6824 units
  • Quantity limit 24 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0778—None
Humana Value Rx Plan (PDP)$54.40/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0801—None
AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1277$3.0624 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0452$0.419 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$104.30/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1879$4.5124 units
  • Quantity limit 24 per 30 days
Humana Premier Rx Plan (PDP)$150.20/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0778—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.

Virginia — 9 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1099$2.6424 units
  • Quantity limit 24 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0528$1.2724 units
  • Quantity limit 24 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0777—None
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0807—None
AARP Medicare Rx Saver from UHC (PDP)$39.60/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1495$3.5924 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$78.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0404$0.369 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$87.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0777—None
AARP Medicare Rx Preferred from UHC (PDP)$100.80/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.2003$4.8124 units
  • Quantity limit 24 per 30 days
HealthSpring Assurance Rx (PDP)$133.80/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2955$7.0924 units
  • Quantity limit 24 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 — 9 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1121$2.6924 units
  • Quantity limit 24 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.2941$7.0624 units
  • Quantity limit 24 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$2.00$0.00$0.0595—None
Humana Value Rx Plan (PDP)$10.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0622—None
Wellcare Value Script (PDP)$19.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0775$1.8624 units
  • Quantity limit 24 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$53.20/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1092$2.6224 units
  • Quantity limit 24 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0633$0.579 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$100.20/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1840$4.4224 units
  • Quantity limit 24 per 30 days
Humana Premier Rx Plan (PDP)$112.40/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0595—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.

Hawaii — 8 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.2019$4.8524 units
  • Quantity limit 24 per 30 days
Humana Basic Rx Plan (PDP)$0.40/mo premium · $615.00 deductible1Preferred Generic$3.00$0.00$0.0859—None
SilverScript Choice (PDP)$14.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0635$0.579 units
  • Quantity limit 9 per 30 days
Wellcare Value Script (PDP)$21.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0394$0.9524 units
  • Quantity limit 24 per 30 days
Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1130$2.7124 units
  • Quantity limit 24 per 30 days
Humana Value Rx Plan (PDP)$51.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0867—None
Humana Premier Rx Plan (PDP)$90.20/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0859—None
AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.2446$5.8724 units
  • Quantity limit 24 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 deductible1Preferred Generic$0.00$0.00$0.1775$4.2624 units
  • Quantity limit 24 per 30 days
HealthSpring Assurance Rx (PDP)$65.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.2041$4.9024 units
  • Quantity limit 24 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$145.10/mo premium · $615.00 deductible1Preferred Generic25%25%$0.2291$5.5024 units
  • Quantity limit 24 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 deductible1Preferred Generic25%25%$0.2584$6.2024 units
  • Quantity limit 24 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 deductible1Preferred Generic25%25%$0.2722$6.5324 units
  • Quantity limit 24 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 deductible1Preferred Generic25%25%$0.2722$6.5324 units
  • Quantity limit 24 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 deductible1Preferred Generic25%25%$0.1867$4.4824 units
  • Quantity limit 24 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.