MOMETASONE FUROATE 50 ug Spray, Metered
Coverage in New Mexico (CMS PDP Region 26).
6 of 11 stand-alone Part D plans in New Mexico cover this drug on tier 3–4.
5 of 6 plans apply a prior authorization, step therapy or quantity limit.
56 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: 56 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| SilverScript Choice (PDP)$104.00/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $1.5846 | $53.8834 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $4.8256 | $164.0734 units |
|
| Humana Value Rx Plan (PDP)$69.60/mo premium · $601.00 deductible | 4Non-Preferred Drug | 30% | — | $3.2948 | $112.0234 units |
|
| Humana Premier Rx Plan (PDP)$75.60/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $3.2415 | $110.2134 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible | 4Non-Preferred Drug | 35% | — | $2.7643 | — | None |
| Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $3.1983 | $108.7434 units |
|
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.