MedicarePartD.guide

A non-government resource built from CMS public data

LAMIVUDINE 100 mg Tablet, Film Coated

Package: 60 TABLET, FILM COATED in 1 BOTTLE (60505-3250-6). NDC 60505325006.

Plans covering it
367
across 39 regions checked
Lowest tier
2
lower tiers cost less
Plans with restrictions
162
prior auth, step therapy or quantity limit

Medicare Advantage plans in your county

Medicare Advantage drug plans in 51 states list this drug on their own formularies. Enter a ZIP code or choose a state to see every plan in a county, with its tier, cost-sharing and restrictions.

Coverage by region

Covered by at least one plan in 39 of 39 CMS regions.

RegionPlans coveringTiersLowest 30-day costRestrictions
New Jersey12 of 123–4$45.005 of 12 plans
Pennsylvania and West Virginia12 of 122–4$5.005 of 12 plans
North Carolina12 of 123–4$45.005 of 12 plans
Alabama and Tennessee12 of 123–4$45.005 of 12 plans
Michigan12 of 123–4$45.005 of 12 plans
Illinois12 of 123–4$45.005 of 12 plans
Arkansas12 of 123–4$45.005 of 12 plans
Texas12 of 123–4$45.005 of 12 plans
Kansas12 of 123–4$45.004 of 12 plans
California12 of 123–4$45.005 of 12 plans
Connecticut, Massachusetts, Rhode Island and Vermont11 of 113–4$30.004 of 11 plans
South Carolina11 of 113–4$45.005 of 11 plans
Oklahoma11 of 113–4$45.005 of 11 plans
Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming11 of 113–4$45.005 of 11 plans
New Mexico11 of 113–4$45.004 of 11 plans
New York10 of 103–4$45.005 of 10 plans
Delaware, DC and Maryland10 of 103–4$45.005 of 10 plans
Georgia10 of 103–4$45.005 of 10 plans
Florida10 of 103–4$45.003 of 10 plans
Ohio10 of 103–4$45.005 of 10 plans
Indiana and Kentucky10 of 103–4$45.005 of 10 plans
Wisconsin10 of 103–4$45.005 of 10 plans
Missouri10 of 103–4$45.005 of 10 plans
Mississippi10 of 103–4$45.005 of 10 plans
Louisiana10 of 103–4$45.005 of 10 plans
Colorado10 of 103–4$45.005 of 10 plans
Arizona10 of 103–4$45.005 of 10 plans
Nevada10 of 103–4$45.005 of 10 plans
Oregon and Washington10 of 103–4$45.005 of 10 plans
Idaho and Utah10 of 103–4$45.005 of 10 plans
Maine and New Hampshire9 of 93–4$45.004 of 9 plans
Virginia9 of 93–4$45.004 of 9 plans
Alaska9 of 93–4$45.004 of 9 plans
Hawaii8 of 83–4$45.003 of 8 plans
Puerto Rico3 of 33—2 of 3 plans
American Samoa1 of 13—none
Guam1 of 13—none
Northern Mariana Islands1 of 13—none
U.S. Virgin Islands1 of 13—none

Plan-by-plan detail

Open a region to see every plan that covers this drug, with tier, cost-sharing and restrictions.

New Jersey — 12 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 12 of 12 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$4.40/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Wellcare Value Script (PDP)$22.80/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$9.3789—None
Wellcare Classic (PDP)$28.20/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug29%29%$9.3789—None
Humana Value Rx Plan (PDP)$35.60/mo premium · $601.00 deductible3Preferred Brand19%14%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
HealthSpring Extra Rx (PDP)$59.90/mo premium · $615.00 deductible3Preferred Brand16%16%$8.9511$26.853 units
  • Quantity limit 3 per 30 days
Horizon Medicare Blue Rx Standard (PDP)$72.30/mo premium · $615.00 deductible3Preferred Brand18%18%$13.3563—None
AARP Medicare Rx Saver from UHC (PDP)$77.40/mo premium · $615.00 deductible3Preferred Brand17%17%$9.7754—None
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible3Preferred Brand18%18%$5.5394—None
HealthSpring Assurance Rx (PDP)$109.30/mo premium · $615.00 deductible3Preferred Brand20%20%$8.9511$26.853 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$111.90/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$118.90/mo premium · $130.00 deductible3Preferred Brand15%15%$9.8495—None
Horizon Medicare Blue Rx Enhanced (PDP)$139.10/mo premium · $200.00 deductible3Preferred Brand20%20%$13.3563—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 — elsewhere it depends on what is prescribed.

Pennsylvania and West Virginia — 12 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 12 of 12 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$6.60/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Wellcare Value Script (PDP)$8.20/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$9.6019—None
Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug28%28%$9.6019—None
Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$22.70/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand19%19%$4.9644—None
AARP Medicare Rx Saver from UHC (PDP)$43.50/mo premium · $615.00 deductible3Preferred Brand16%16%$9.8252—None
HealthSpring Extra Rx (PDP)$62.60/mo premium · $615.00 deductible3Preferred Brand17%17%$9.2245$27.673 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$74.00/mo premium · $615.00 deductible3Preferred Brand21%21%$9.2245$27.673 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$121.90/mo premium · $130.00 deductible3Preferred Brand16%16%$9.8516—None
Humana Premier Rx Plan (PDP)$123.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Blue Rx PDP Complete (PDP)$164.80/mo premium · $200.00 deductible2Generic$5.00$12.50$9.2296—None
Blue Rx PDP Plus (PDP)$193.20/mo premium · $615.00 deductible2Generic25%25%$9.2332—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 — elsewhere it depends on what is prescribed.

North Carolina — 12 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 12 of 12 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$10.5401—None
Wellcare Classic (PDP)$4.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug27%27%$10.5401—None
Humana Basic Rx Plan (PDP)$6.80/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Humana Value Rx Plan (PDP)$32.00/mo premium · $601.00 deductible3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$56.90/mo premium · $615.00 deductible3Preferred Brand18%18%$9.8711—None
HealthSpring Extra Rx (PDP)$78.00/mo premium · $615.00 deductible3Preferred Brand17%17%$9.8828$29.653 units
  • Quantity limit 3 per 30 days
Blue Medicare Rx Standard (PDP)$83.90/mo premium · $615.00 deductible3Preferred Brand20%20%$12.4857—None
SilverScript Choice (PDP)$90.20/mo premium · $615.00 deductible3Preferred Brand18%18%$5.6814—None
HealthSpring Assurance Rx (PDP)$110.40/mo premium · $615.00 deductible3Preferred Brand22%22%$9.8828$29.653 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$110.90/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$119.80/mo premium · $130.00 deductible3Preferred Brand17%17%$9.8711—None
Blue Medicare Rx Enhanced (PDP)$163.20/mo premium · $0.00 deductible3Preferred Brand$45.00$135.00$12.4857—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 — elsewhere it depends on what is prescribed.

Alabama and Tennessee — 12 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 12 of 12 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$10.4588—None
Wellcare Classic (PDP)$3.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug27%27%$10.4588—None
Humana Value Rx Plan (PDP)$37.70/mo premium · $601.00 deductible3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$63.20/mo premium · $615.00 deductible3Preferred Brand17%17%$9.7325—None
BlueRx Essential (PDP)$76.20/mo premium · $615.00 deductible3Preferred Brand19%19%$9.0851—None
HealthSpring Extra Rx (PDP)$77.50/mo premium · $615.00 deductible3Preferred Brand17%17%$9.7791$29.343 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$87.20/mo premium · $615.00 deductible3Preferred Brand22%22%$9.7791$29.343 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$97.30/mo premium · $615.00 deductible3Preferred Brand18%18%$5.7499—None
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$119.30/mo premium · $130.00 deductible3Preferred Brand17%17%$9.7325—None
BlueRx Enhanced Plus (PDP)$129.50/mo premium · $150.00 deductible3Preferred Brand$47.00$94.00$9.0851—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 — elsewhere it depends on what is prescribed.

Michigan — 12 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 12 of 12 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%25%$9.0917$27.283 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible · $0 with full Extra Help3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug28%28%$9.6004—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$9.6004—None
AARP Medicare Rx Saver from UHC (PDP)$14.10/mo premium · $615.00 deductible3Preferred Brand17%17%$9.6083—None
HealthSpring Extra Rx (PDP)$50.40/mo premium · $615.00 deductible3Preferred Brand17%17%$9.0917$27.283 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$78.30/mo premium · $615.00 deductible3Preferred Brand18%18%$5.4710—None
AARP Medicare Rx Preferred from UHC (PDP)$78.30/mo premium · $130.00 deductible3Preferred Brand18%18%$9.6083—None
Prescription Blue Select (PDP)$78.40/mo premium · $615.00 deductible3Preferred Brand20%20%$9.4489—None
Humana Premier Rx Plan (PDP)$98.10/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Prescription Blue Premium (PDP)$106.70/mo premium · $0.00 deductible3Preferred Brand24%24%$9.4489—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 — elsewhere it depends on what is prescribed.

Illinois — 12 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 12 of 12 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible · $0 with full Extra Help3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug31%31%$11.4789—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$11.4789—None
AARP Medicare Rx Saver from UHC (PDP)$40.20/mo premium · $615.00 deductible3Preferred Brand17%17%$10.0480—None
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible3Preferred Brand17%17%$10.7362$32.213 units
  • Quantity limit 3 per 30 days
Blue Cross MedicareRx Basic (PDP)$89.70/mo premium · $615.00 deductible3Preferred Brand20%20%$13.7524—None
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible3Preferred Brand18%18%$5.2660—None
AARP Medicare Rx Preferred from UHC (PDP)$103.90/mo premium · $130.00 deductible3Preferred Brand17%17%$10.0719—None
HealthSpring Assurance Rx (PDP)$104.20/mo premium · $615.00 deductible3Preferred Brand21%21%$10.7362$32.213 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$119.40/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Blue Cross MedicareRx Value (PDP)$119.70/mo premium · $615.00 deductible3Preferred Brand18%18%$13.8862—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 — elsewhere it depends on what is prescribed.

Arkansas — 12 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 12 of 12 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%25%$8.9416$26.823 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible · $0 with full Extra Help3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug26%26%$9.6303—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$9.6303—None
BlueMedicare Value Rx (PDP)$52.50/mo premium · $615.00 deductible3Preferred Brand19%19%$3.5257—None
HealthSpring Extra Rx (PDP)$54.50/mo premium · $615.00 deductible3Preferred Brand17%17%$8.9416$26.823 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$65.10/mo premium · $615.00 deductible3Preferred Brand18%18%$9.6950—None
SilverScript Choice (PDP)$73.50/mo premium · $615.00 deductible3Preferred Brand18%18%$5.9499—None
Humana Premier Rx Plan (PDP)$92.40/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$114.90/mo premium · $130.00 deductible3Preferred Brand16%16%$9.6950—None
BlueMedicare Premier Rx (PDP)$181.20/mo premium · $0.00 deductible3Preferred Brand20%20%$3.5257—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 — elsewhere it depends on what is prescribed.

Texas — 12 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 12 of 12 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug29%29%$10.4539—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$10.4539—None
Humana Value Rx Plan (PDP)$22.90/mo premium · $601.00 deductible3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$41.70/mo premium · $615.00 deductible3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
HealthSpring Extra Rx (PDP)$70.00/mo premium · $615.00 deductible3Preferred Brand17%17%$9.9042$29.713 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$89.20/mo premium · $615.00 deductible3Preferred Brand18%18%$9.8827—None
SilverScript Choice (PDP)$94.80/mo premium · $615.00 deductible3Preferred Brand18%18%$5.5275—None
Blue Cross MedicareRx Basic (PDP)$104.70/mo premium · $615.00 deductible3Preferred Brand19%19%$12.8533—None
HealthSpring Assurance Rx (PDP)$111.40/mo premium · $615.00 deductible3Preferred Brand21%21%$9.9042$29.713 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $130.00 deductible3Preferred Brand18%18%$9.8827—None
Humana Premier Rx Plan (PDP)$118.20/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Blue Cross MedicareRx Value (PDP)$167.40/mo premium · $615.00 deductible3Preferred Brand18%18%$12.8895—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 — elsewhere it depends on what is prescribed.

Kansas — 12 plans, 4 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 12 of 12 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Blue MedicareRx Essentials (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand20%20%$13.7827—None
Blue MedicareRx Value (PDP)$0.70/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand18%18%$13.8224—None
HealthSpring Assurance Rx (PDP)$6.70/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%25%$11.7300$35.193 units
  • Quantity limit 3 per 30 days
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$12.5736—None
Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug26%26%$12.5736—None
Humana Basic Rx Plan (PDP)$15.50/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Humana Value Rx Plan (PDP)$55.60/mo premium · $601.00 deductible3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Blue MedicareRx Plus (PDP)$67.40/mo premium · $0.00 deductible3Preferred Brand20%20%$13.8224—None
SilverScript Choice (PDP)$88.30/mo premium · $615.00 deductible3Preferred Brand18%18%$5.3821—None
AARP Medicare Rx Saver from UHC (PDP)$105.40/mo premium · $615.00 deductible3Preferred Brand17%17%$10.5244—None
Humana Premier Rx Plan (PDP)$116.30/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$147.00/mo premium · $130.00 deductible3Preferred Brand15%15%$10.6312—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 — elsewhere it depends on what is prescribed.

California — 12 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 12 of 12 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%25%$10.1070$30.323 units
  • Quantity limit 3 per 30 days
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$10.7474—None
Wellcare Classic (PDP)$6.20/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug31%31%$10.7448—None
HealthSpring Extra Rx (PDP)$70.60/mo premium · $615.00 deductible3Preferred Brand17%17%$10.1070$30.323 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$103.60/mo premium · $615.00 deductible3Preferred Brand18%18%$5.3504—None
Humana Value Rx Plan (PDP)$104.60/mo premium · $601.00 deductible3Preferred Brand18%13%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$109.40/mo premium · $615.00 deductible3Preferred Brand17%17%$9.9928—None
Humana Basic Rx Plan (PDP)$132.20/mo premium · $615.00 deductible3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$165.40/mo premium · $130.00 deductible3Preferred Brand15%15%$9.9977—None
Humana Premier Rx Plan (PDP)$172.90/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Blue Shield Rx Plus (PDP)$199.70/mo premium · $615.00 deductible3Preferred Brand19%19%$26.2208—None
Blue Shield Rx Enhanced (PDP)$227.80/mo premium · $0.00 deductible3Preferred Brand19%19%$26.2208—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 — elsewhere it depends on what is prescribed.

Connecticut, Massachusetts, Rhode Island and Vermont — 11 plans, 4 with restrictions
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)$8.40/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Wellcare Value Script (PDP)$16.40/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$10.4582—None
Blue MedicareRx Value Plus (PDP)$20.70/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand17%17%$7.2500—None
Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug29%29%$10.4582—None
SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand19%19%$5.5145—None
AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible3Preferred Brand17%17%$9.8455—None
Humana Value Rx Plan (PDP)$73.60/mo premium · $601.00 deductible3Preferred Brand18%13%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$138.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
HealthSpring Assurance Rx (PDP)$139.30/mo premium · $615.00 deductible3Preferred Brand21%21%$9.8525$29.563 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible3Preferred Brand15%15%$9.8455—None
Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible3Preferred Brand$30.00$60.00$7.2500—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 — elsewhere it depends on what is prescribed.

South Carolina — 11 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 11 of 11 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$4.80/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$8.9638—None
Wellcare Classic (PDP)$9.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug27%27%$8.9638—None
Humana Basic Rx Plan (PDP)$10.10/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Humana Value Rx Plan (PDP)$65.60/mo premium · $601.00 deductible3Preferred Brand19%14%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible3Preferred Brand17%17%$8.6714$26.013 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$98.40/mo premium · $615.00 deductible3Preferred Brand18%18%$5.5842—None
AARP Medicare Rx Saver from UHC (PDP)$122.10/mo premium · $615.00 deductible3Preferred Brand18%18%$9.5279—None
AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible3Preferred Brand17%17%$9.5279—None
BlueCross Rx Value (PDP)$139.70/mo premium · $615.00 deductible3Preferred Brand17%17%$8.9567—None
Humana Premier Rx Plan (PDP)$145.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
HealthSpring Assurance Rx (PDP)$152.50/mo premium · $615.00 deductible3Preferred Brand21%21%$8.6714$26.013 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 — elsewhere it depends on what is prescribed.

Oklahoma — 11 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 11 of 11 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Blue Cross MedicareRx Basic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand16%16%$12.8449—None
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$9.7870—None
Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug26%26%$9.7870—None
Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
HealthSpring Extra Rx (PDP)$65.40/mo premium · $615.00 deductible3Preferred Brand17%17%$9.1667$27.503 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible3Preferred Brand17%17%$9.7325—None
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$121.00/mo premium · $130.00 deductible3Preferred Brand16%16%$9.7325—None
HealthSpring Assurance Rx (PDP)$126.50/mo premium · $615.00 deductible3Preferred Brand20%20%$9.1667$27.503 units
  • Quantity limit 3 per 30 days
Blue Cross MedicareRx Value (PDP)$167.30/mo premium · $615.00 deductible3Preferred Brand18%18%$14.6605—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 — elsewhere it depends on what is prescribed.

Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming — 11 plans, 5 with restrictions
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 Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$5.30/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand17%17%$9.5466—None
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$9.8373—None
Wellcare Classic (PDP)$12.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug27%27%$9.8373—None
Humana Value Rx Plan (PDP)$20.80/mo premium · $601.00 deductible3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand19%19%$5.5908—None
HealthSpring Extra Rx (PDP)$66.50/mo premium · $615.00 deductible3Preferred Brand17%17%$8.7765$26.333 units
  • Quantity limit 3 per 30 days
MedicareBlue Rx Standard (PDP)$101.00/mo premium · $615.00 deductible3Preferred Brand22%22%$12.7362—None
Humana Premier Rx Plan (PDP)$103.70/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
HealthSpring Assurance Rx (PDP)$125.90/mo premium · $615.00 deductible3Preferred Brand21%21%$8.7765$26.333 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$140.20/mo premium · $130.00 deductible3Preferred Brand18%18%$9.5466—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 — elsewhere it depends on what is prescribed.

New Mexico — 11 plans, 4 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 11 of 11 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%25%$9.3000$27.903 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand16%16%$9.7146—None
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug31%31%$9.7250—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$9.7250—None
Humana Value Rx Plan (PDP)$69.60/mo premium · $601.00 deductible3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$75.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible3Preferred Brand16%16%$9.7146—None
SilverScript Choice (PDP)$104.00/mo premium · $615.00 deductible3Preferred Brand18%18%$5.8214—None
Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible3Preferred Brand14%14%$11.6970—None
Blue Cross MedicareRx Basic (PDP)$145.40/mo premium · $615.00 deductible3Preferred Brand18%18%$11.7128—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 — elsewhere it depends on what is prescribed.

New York — 10 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 10 of 10 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$35.70/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%25%$7.9282$23.783 units
  • Quantity limit 3 per 30 days
Wellcare Value Script (PDP)$42.40/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$8.2392—None
Wellcare Classic (PDP)$45.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug28%28%$8.2392—None
HealthSpring Extra Rx (PDP)$91.60/mo premium · $615.00 deductible3Preferred Brand17%17%$7.9282$23.783 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$105.80/mo premium · $615.00 deductible3Preferred Brand17%17%$9.3804—None
SilverScript Choice (PDP)$116.00/mo premium · $615.00 deductible3Preferred Brand18%18%$6.0551—None
Humana Basic Rx Plan (PDP)$140.90/mo premium · $615.00 deductible3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Humana Value Rx Plan (PDP)$158.90/mo premium · $601.00 deductible3Preferred Brand17%12%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$163.70/mo premium · $130.00 deductible3Preferred Brand15%15%$9.4053—None
Humana Premier Rx Plan (PDP)$173.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 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 — elsewhere it depends on what is prescribed.

Delaware, DC and Maryland — 10 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 10 of 10 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Humana Value Rx Plan (PDP)$4.30/mo premium · $601.00 deductible3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$8.2853—None
Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug31%31%$8.2853—None
HealthSpring Assurance Rx (PDP)$32.60/mo premium · $615.00 deductible3Preferred Brand22%22%$7.9245$23.773 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$37.80/mo premium · $615.00 deductible3Preferred Brand17%17%$9.2825—None
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible3Preferred Brand17%17%$7.9245$23.773 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible3Preferred Brand17%17%$9.2825—None
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible3Preferred Brand18%18%$5.8572—None
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 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 — elsewhere it depends on what is prescribed.

Georgia — 10 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 10 of 10 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug28%28%$9.2887—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$9.2887—None
Humana Value Rx Plan (PDP)$36.40/mo premium · $601.00 deductible3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible3Preferred Brand17%17%$8.8954$26.693 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$98.00/mo premium · $615.00 deductible3Preferred Brand18%18%$9.6161—None
SilverScript Choice (PDP)$100.70/mo premium · $615.00 deductible3Preferred Brand18%18%$5.6368—None
Humana Premier Rx Plan (PDP)$129.50/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.80/mo premium · $130.00 deductible3Preferred Brand16%16%$9.6161—None
HealthSpring Assurance Rx (PDP)$149.30/mo premium · $615.00 deductible3Preferred Brand21%21%$8.8954$26.693 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 — elsewhere it depends on what is prescribed.

Florida — 10 plans, 3 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 10 of 10 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug28%28%$9.3454—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$9.3454—None
Humana Value Rx Plan (PDP)$25.90/mo premium · $601.00 deductible3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$92.70/mo premium · $615.00 deductible3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible3Preferred Brand18%18%$5.6800—None
BlueMedicare Premier Rx (PDP)$98.60/mo premium · $615.00 deductible3Preferred Brand20%20%$12.1269—None
AARP Medicare Rx Saver from UHC (PDP)$98.70/mo premium · $615.00 deductible3Preferred Brand18%18%$9.6136—None
Humana Premier Rx Plan (PDP)$115.90/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$119.10/mo premium · $130.00 deductible3Preferred Brand17%17%$9.6174—None
BlueMedicare Complete Rx (PDP)$217.00/mo premium · $615.00 deductible3Preferred Brand18%18%$12.1269—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 — elsewhere it depends on what is prescribed.

Ohio — 10 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 10 of 10 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Wellcare Value Script (PDP)$7.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$10.6954—None
Wellcare Classic (PDP)$7.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug27%27%$10.6954—None
Humana Value Rx Plan (PDP)$23.70/mo premium · $601.00 deductible3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
HealthSpring Extra Rx (PDP)$65.70/mo premium · $615.00 deductible3Preferred Brand17%17%$10.0671$30.203 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$73.70/mo premium · $615.00 deductible3Preferred Brand18%18%$9.8019—None
SilverScript Choice (PDP)$90.30/mo premium · $615.00 deductible3Preferred Brand18%18%$6.1356—None
HealthSpring Assurance Rx (PDP)$109.50/mo premium · $615.00 deductible3Preferred Brand21%21%$10.0671$30.203 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$117.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$123.40/mo premium · $130.00 deductible3Preferred Brand17%17%$9.8019—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 — elsewhere it depends on what is prescribed.

Indiana and Kentucky — 10 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 10 of 10 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Wellcare Value Script (PDP)$8.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$10.6531—None
Wellcare Classic (PDP)$8.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug27%27%$10.6531—None
Humana Value Rx Plan (PDP)$9.90/mo premium · $601.00 deductible3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand19%19%$5.5544—None
HealthSpring Extra Rx (PDP)$78.20/mo premium · $615.00 deductible3Preferred Brand17%17%$10.1189$30.363 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$90.30/mo premium · $615.00 deductible3Preferred Brand17%17%$10.0564—None
HealthSpring Assurance Rx (PDP)$117.80/mo premium · $615.00 deductible3Preferred Brand20%20%$10.1189$30.363 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$125.30/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$127.10/mo premium · $130.00 deductible3Preferred Brand18%18%$10.0564—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 — elsewhere it depends on what is prescribed.

Wisconsin — 10 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 10 of 10 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%25%$9.3287$27.993 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible · $0 with full Extra Help3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand17%17%$9.7667—None
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug26%26%$9.7856—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$9.7856—None
SilverScript Choice (PDP)$26.70/mo premium · $615.00 deductible3Preferred Brand19%19%$5.6145—None
HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible3Preferred Brand17%17%$9.3287$27.993 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$110.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$113.90/mo premium · $130.00 deductible3Preferred Brand15%15%$9.7667—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 — elsewhere it depends on what is prescribed.

Missouri — 10 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 10 of 10 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$12.3681—None
Wellcare Classic (PDP)$10.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug26%26%$12.3681—None
Humana Basic Rx Plan (PDP)$16.50/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible3Preferred Brand17%17%$11.3172$33.953 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$71.90/mo premium · $615.00 deductible3Preferred Brand17%17%$10.2193—None
HealthSpring Assurance Rx (PDP)$74.30/mo premium · $615.00 deductible3Preferred Brand20%20%$11.3172$33.953 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible3Preferred Brand18%18%$5.3436—None
AARP Medicare Rx Preferred from UHC (PDP)$125.40/mo premium · $130.00 deductible3Preferred Brand17%17%$10.2273—None
Humana Premier Rx Plan (PDP)$126.40/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 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 — elsewhere it depends on what is prescribed.

Mississippi — 10 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 10 of 10 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug29%29%$8.5898—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$8.5898—None
Humana Value Rx Plan (PDP)$37.60/mo premium · $601.00 deductible3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
HealthSpring Assurance Rx (PDP)$59.70/mo premium · $615.00 deductible3Preferred Brand21%21%$7.9849$23.953 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$77.10/mo premium · $615.00 deductible3Preferred Brand17%17%$7.9849$23.953 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$84.70/mo premium · $615.00 deductible3Preferred Brand17%17%$9.4020—None
Humana Premier Rx Plan (PDP)$89.90/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible3Preferred Brand18%18%$5.9518—None
AARP Medicare Rx Preferred from UHC (PDP)$140.60/mo premium · $130.00 deductible3Preferred Brand16%16%$9.4020—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 — elsewhere it depends on what is prescribed.

Louisiana — 10 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 10 of 10 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$8.3720—None
Wellcare Classic (PDP)$6.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug28%28%$8.3720—None
Humana Value Rx Plan (PDP)$19.30/mo premium · $601.00 deductible3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$37.00/mo premium · $615.00 deductible3Preferred Brand16%16%$9.2696—None
SilverScript Choice (PDP)$44.70/mo premium · $615.00 deductible3Preferred Brand19%19%$5.8402—None
HealthSpring Assurance Rx (PDP)$48.40/mo premium · $615.00 deductible3Preferred Brand20%20%$8.0360$24.113 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$60.60/mo premium · $615.00 deductible3Preferred Brand17%17%$8.0360$24.113 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$113.70/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.50/mo premium · $130.00 deductible3Preferred Brand15%15%$9.2748—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 — elsewhere it depends on what is prescribed.

Colorado — 10 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 10 of 10 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$10.0672—None
Wellcare Classic (PDP)$2.20/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug29%29%$10.0672—None
Humana Value Rx Plan (PDP)$48.50/mo premium · $601.00 deductible3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
HealthSpring Assurance Rx (PDP)$61.70/mo premium · $615.00 deductible3Preferred Brand20%20%$9.6112$28.833 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible3Preferred Brand17%17%$9.6112$28.833 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$105.10/mo premium · $615.00 deductible3Preferred Brand18%18%$5.3453—None
AARP Medicare Rx Saver from UHC (PDP)$125.00/mo premium · $615.00 deductible3Preferred Brand19%19%$10.1797—None
Humana Premier Rx Plan (PDP)$137.10/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$151.90/mo premium · $130.00 deductible3Preferred Brand17%17%$10.1797—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 — elsewhere it depends on what is prescribed.

Arizona — 10 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 10 of 10 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%25%$10.7126$32.143 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand23%18%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug32%32%$11.5505—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$11.5505—None
Humana Value Rx Plan (PDP)$2.50/mo premium · $601.00 deductible3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible3Preferred Brand18%18%$10.2070—None
HealthSpring Extra Rx (PDP)$66.40/mo premium · $615.00 deductible3Preferred Brand17%17%$10.7126$32.143 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible3Preferred Brand18%18%$5.4076—None
AARP Medicare Rx Preferred from UHC (PDP)$97.50/mo premium · $130.00 deductible3Preferred Brand18%18%$10.2070—None
Humana Premier Rx Plan (PDP)$119.20/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 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 — elsewhere it depends on what is prescribed.

Nevada — 10 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 10 of 10 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$2.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug31%31%$10.3219—None
Wellcare Value Script (PDP)$2.70/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$10.3219—None
Humana Value Rx Plan (PDP)$43.70/mo premium · $601.00 deductible3Preferred Brand18%13%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
HealthSpring Extra Rx (PDP)$52.60/mo premium · $615.00 deductible3Preferred Brand17%17%$9.8948$29.683 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$76.70/mo premium · $615.00 deductible3Preferred Brand19%19%$9.8899—None
HealthSpring Assurance Rx (PDP)$95.60/mo premium · $615.00 deductible3Preferred Brand20%20%$9.8948$29.683 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible3Preferred Brand18%18%$5.4541—None
AARP Medicare Rx Preferred from UHC (PDP)$139.10/mo premium · $130.00 deductible3Preferred Brand18%18%$9.8899—None
Humana Premier Rx Plan (PDP)$148.70/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 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 — elsewhere it depends on what is prescribed.

Oregon and Washington — 10 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 10 of 10 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand24%24%$8.8441$26.533 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug28%28%$9.2887—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$9.2887—None
Humana Value Rx Plan (PDP)$22.10/mo premium · $601.00 deductible3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$38.40/mo premium · $615.00 deductible3Preferred Brand17%17%$9.5024—None
HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible3Preferred Brand16%16%$8.8441$26.533 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$85.90/mo premium · $615.00 deductible3Preferred Brand18%18%$5.3449—None
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$110.00/mo premium · $130.00 deductible3Preferred Brand16%16%$9.5068—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 — elsewhere it depends on what is prescribed.

Idaho and Utah — 10 plans, 5 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 10 of 10 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$10.3292—None
Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$23.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug27%27%$10.3292—None
SilverScript Choice (PDP)$27.70/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand19%19%$5.3721—None
HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible3Preferred Brand17%17%$9.8135$29.443 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$56.50/mo premium · $615.00 deductible3Preferred Brand17%17%$9.8282—None
Humana Premier Rx Plan (PDP)$115.50/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
HealthSpring Assurance Rx (PDP)$128.60/mo premium · $615.00 deductible3Preferred Brand21%21%$9.8135$29.443 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$132.60/mo premium · $130.00 deductible3Preferred Brand17%17%$9.8282—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 — elsewhere it depends on what is prescribed.

Maine and New Hampshire — 9 plans, 4 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 9 of 9 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%25%$9.2227$27.673 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug27%27%$9.0127—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$9.0127—None
Humana Value Rx Plan (PDP)$54.40/mo premium · $601.00 deductible3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible3Preferred Brand17%17%$8.9567—None
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible3Preferred Brand18%18%$5.0259—None
AARP Medicare Rx Preferred from UHC (PDP)$104.30/mo premium · $130.00 deductible3Preferred Brand15%15%$8.9567—None
Humana Premier Rx Plan (PDP)$150.20/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 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 — elsewhere it depends on what is prescribed.

Virginia — 9 plans, 4 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 9 of 9 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%20%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible · $0 with full Extra Help3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug31%31%$10.5473—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug40%40%$10.5473—None
AARP Medicare Rx Saver from UHC (PDP)$39.60/mo premium · $615.00 deductible3Preferred Brand17%17%$9.7456—None
SilverScript Choice (PDP)$78.20/mo premium · $615.00 deductible3Preferred Brand18%18%$5.7082—None
Humana Premier Rx Plan (PDP)$87.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$100.80/mo premium · $130.00 deductible3Preferred Brand17%17%$9.7456—None
HealthSpring Assurance Rx (PDP)$133.80/mo premium · $615.00 deductible3Preferred Brand22%22%$9.9507$29.853 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 — elsewhere it depends on what is prescribed.

Alaska — 9 plans, 4 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 9 of 9 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%25%$8.9992$27.003 units
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand24%19%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug28%28%$8.9375—None
Humana Value Rx Plan (PDP)$10.60/mo premium · $601.00 deductible3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Wellcare Value Script (PDP)$19.70/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$8.9375—None
AARP Medicare Rx Saver from UHC (PDP)$53.20/mo premium · $615.00 deductible3Preferred Brand19%19%$8.9567—None
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible3Preferred Brand18%18%$5.0773—None
AARP Medicare Rx Preferred from UHC (PDP)$100.20/mo premium · $130.00 deductible3Preferred Brand18%18%$8.9567—None
Humana Premier Rx Plan (PDP)$112.40/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 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 — elsewhere it depends on what is prescribed.

Hawaii — 8 plans, 3 with restrictions
Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 8 of 8 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand16%16%$10.3413—None
Humana Basic Rx Plan (PDP)$0.40/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand23%18%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$14.70/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand19%19%$5.1006—None
Wellcare Value Script (PDP)$21.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$11.6317—None
Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug35%35%$11.6317—None
Humana Value Rx Plan (PDP)$51.60/mo premium · $601.00 deductible3Preferred Brand20%15%$9.1105$81.999 units
  • Quantity limit 9 per 30 days
Humana Premier Rx Plan (PDP)$90.20/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$9.1105$81.999 units
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible3Preferred Brand17%17%$10.3413—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 — elsewhere it depends on what is prescribed.

Puerto Rico — 3 plans, 2 with restrictions
Prior authorization
Step therapy
Quantity limit

Showing 3 of 3 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible3Preferred Brand17%17%$9.8877$29.663 units
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$65.70/mo premium · $615.00 deductible3Preferred Brand22%22%$9.8877$29.663 units
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$145.10/mo premium · $615.00 deductible3Preferred Brand25%25%$9.9798—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 — elsewhere it depends on what is prescribed.

American Samoa — 1 plan
Prior authorization
Step therapy
Quantity limit
Extra Help (LIS)

Showing 1 of 1 plan

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%25%$9.6411—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 — elsewhere it depends on what is prescribed.

Guam — 1 plan
Prior authorization
Step therapy
Quantity limit
Extra Help (LIS)

Showing 1 of 1 plan

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%25%$9.6411—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 — elsewhere it depends on what is prescribed.

Northern Mariana Islands — 1 plan
Prior authorization
Step therapy
Quantity limit

Showing 1 of 1 plan

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$32.10/mo premium · $615.00 deductible3Preferred Brand25%25%$9.6411—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 — elsewhere it depends on what is prescribed.

U.S. Virgin Islands — 1 plan
Prior authorization
Step therapy
Quantity limit

Showing 1 of 1 plan

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $615.00 deductible3Preferred Brand25%25%$9.6411—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 — elsewhere it depends on what is prescribed.