CHEMET 100 mg Capsule
Also known as Succimer. Coverage in Alaska (CMS PDP Region 34).
7 of 9 stand-alone Part D plans in Alaska cover this drug on tier 4–5.
1 of 7 plans apply a prior authorization, step therapy or quantity limit.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 28% | 28% | $20.4000 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 29% | 29% | $20.7600 | — |
|
| Wellcare Value Script (PDP)$19.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $20.4000 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $21.1531 | — | None |
| Humana Value Rx Plan (PDP)$10.60/mo premium · $601.00 deductible | 5Specialty Tier | 26% | — | $21.1531 | — | None |
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $21.6820 | — | None |
| Humana Premier Rx Plan (PDP)$112.40/mo premium · $0.00 deductible | 5Specialty Tier | 33% | — | $21.1531 | — | 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.