BOOSTRIX 5/2.5/8/8/2.5 [iU]/.5mL/ug/.5mL Suspension
Also known as Tetanus Toxoid, Reduced Diphtheria Toxoid And Acellular Pertussis Vaccine, Adsorbed. Coverage in Connecticut, Massachusetts, Rhode Island and Vermont (CMS PDP Region 02).
11 of 11 stand-alone Part D plans in Connecticut, Massachusetts, Rhode Island and Vermont cover this drug on tier 1–3.
Lowest 30-day cost $0.00 at a preferred pharmacy. 2 of 11 plans apply a prior authorization, step therapy or quantity limit.
Every plan that covers it
Showing 11 of 11 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$8.40/mo premium · $615.00 deductible · $0 with full Extra Help | 1Preferred Generic | $0.00 | $0.00 | $92.7039 | — | None |
| Wellcare Value Script (PDP)$16.40/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $90.9867 | — | None |
| Blue MedicareRx Value Plus (PDP)$20.70/mo premium · $615.00 deductible · $0 with full Extra Help | 1Preferred Generic | $0.00 | $0.00 | $94.9821 | — | None |
| Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible · $0 with full Extra Help | 3Preferred Brand | 25% | 25% | $90.9867 | — | None |
| SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible · $0 with full Extra Help | 1Preferred Generic | $2.00 | $6.00 | $93.1654 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $101.0133 | $1,515.2015 units |
|
| Humana Value Rx Plan (PDP)$73.60/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $92.7039 | — | None |
| Humana Premier Rx Plan (PDP)$138.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $92.7039 | — | None |
| HealthSpring Assurance Rx (PDP)$139.30/mo premium · $615.00 deductible | 3Preferred Brand | 21% | 21% | $95.1202 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible | 3Preferred Brand | 15% | 15% | $101.0133 | $1,515.2015 units |
|
| Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible | 1Preferred Generic | $1.00 | $1.00 | $94.9821 | — | 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.
Medicare Advantage plans
Medicare Advantage plans carry their own formularies, separate from stand-alone Part D, and are sold county by county. Pick a county to see every Medicare Advantage drug plan there that covers this drug.
152 Medicare Advantage plans in CT, MA, RI, VT do cover it
A patient on an MA-PD plan may have coverage even where no PDP lists the drug. CT: 42 plans · MA: 88 plans · RI: 20 plans · VT: 2 plans.