MedicarePartD.guide

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NUEDEXTA 20/10 mg Capsule, Gelatin Coated

Also known as Dextromethorphan Hydrobromide And Quinidine Sulfate. Coverage in Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming (CMS PDP Region 25).

11 of 11 stand-alone Part D plans in Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming cover this drug on tier 3–5.

11 of 11 plans apply a prior authorization, step therapy or quantity limit.

Every plan that covers it

Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 11 of 11 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$4.70/mo premium · $615.00 deductible · $0 with full Extra Help5Specialty Tier25%—$26.6833$160.106 units
  • Prior authorization
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$5.30/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug35%—$28.2978$169.796 units
  • Prior authorization
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible3Preferred Brand25%25%$27.9338$167.606 units
  • Prior authorization
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$12.70/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%25%$27.9338$167.606 units
  • Prior authorization
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$20.80/mo premium · $601.00 deductible5Specialty Tier26%—$26.6833$160.106 units
  • Prior authorization
  • Quantity limit 6 per 30 days
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible · $0 with full Extra Help5Specialty Tier25%—$27.4568$164.746 units
  • Prior authorization
  • Quantity limit 6 per 30 days
HealthSpring Extra Rx (PDP)$66.50/mo premium · $615.00 deductible5Specialty Tier25%—$27.9402—
  • Prior authorization
MedicareBlue Rx Standard (PDP)$101.00/mo premium · $615.00 deductible5Specialty Tier25%—$29.1080$174.656 units
  • Prior authorization
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$103.70/mo premium · $0.00 deductible5Specialty Tier33%—$26.6833$160.106 units
  • Prior authorization
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$125.90/mo premium · $615.00 deductible5Specialty Tier25%—$27.9473—
  • Prior authorization
AARP Medicare Rx Preferred from UHC (PDP)$140.20/mo premium · $130.00 deductible4Non-Preferred Drug34%—$28.2978$169.796 units
  • Prior authorization
  • Quantity limit 6 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.

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.

239 Medicare Advantage plans in IA, MN, MT, ND, NE, SD, WY do cover it

A patient on an MA-PD plan may have coverage even where no PDP lists the drug. IA: 54 plans · MN: 67 plans · MT: 25 plans · ND: 22 plans · NE: 44 plans · SD: 19 plans · WY: 8 plans.

See coverage in all 39 regions →