MOMETASONE FUROATE 50 ug Spray, Metered
Coverage in Texas (CMS PDP Region 22).
6 of 12 stand-alone Part D plans in Texas cover this drug on tier 3–4.
5 of 6 plans apply a prior authorization, step therapy or quantity limit.
339 Medicare Advantage plans in TX 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. TX: 339 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| SilverScript Choice (PDP)$94.80/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $1.7594 | $59.8234 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $4.5877 | $155.9834 units |
|
| Humana Value Rx Plan (PDP)$22.90/mo premium · $601.00 deductible | 4Non-Preferred Drug | 34% | — | $2.9443 | $100.1134 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $130.00 deductible | 4Non-Preferred Drug | 35% | — | $2.4045 | — | None |
| Humana Premier Rx Plan (PDP)$118.20/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $2.9069 | $98.8334 units |
|
| Blue Cross MedicareRx Value (PDP)$167.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | 32% | $3.1651 | $107.6134 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.