MedicarePartD.guide

A non-government resource built from CMS public data

SYMTUZA 800/150/200/10 mg Tablet, Film Coated

Also known as Darunavir, Cobicistat, Emtricitabine, And Tenofovir Alafenamide. Coverage in New Mexico (CMS PDP Region 26).

11 of 11 stand-alone Part D plans in New Mexico cover this drug on tier 5.

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

67 Medicare Advantage plans in NM do cover it

Medicare Advantage plans carry their own formularies, separate from stand-alone Part D. A patient on an MA-PD plan may have coverage even where no PDP lists the drug. NM: 67 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$143.1595—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$143.1595—None
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$140.4638—None
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$148.2585$444.783 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$159.3177$477.953 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$69.60/mo premium · $601.00 deductible5Specialty Tier26%—$148.2585$444.783 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$75.60/mo premium · $0.00 deductible5Specialty Tier33%—$148.2585$444.783 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible5Specialty Tier31%—$159.3177$477.953 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$104.00/mo premium · $615.00 deductible5Specialty Tier25%—$152.8279—None
Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible5Specialty Tier25%—$152.3236$456.973 units
  • Quantity limit 3 per 30 days
Blue Cross MedicareRx Basic (PDP)$145.40/mo premium · $615.00 deductible5Specialty Tier25%—$153.5495$460.653 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.

See coverage in all 39 regions →