MedicarePartD.guide

A non-government resource built from CMS public data

PRASUGREL 5 mg Tablet, Film Coated

Coverage in Delaware, DC and Maryland (CMS PDP Region 05).

8 of 10 stand-alone Part D plans in Delaware, DC and Maryland cover this drug on tier 2–4.

Lowest 30-day cost $3.00 at a preferred pharmacy. 4 of 8 plans apply a prior authorization, step therapy or quantity limit.

97 Medicare Advantage plans in DE, DC, MD 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. DE: 32 plans · DC: 15 plans · MD: 50 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.2219—None
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand25%20%$0.6044$1.813 units
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$4.30/mo premium · $601.00 deductible3Preferred Brand20%15%$0.6122$1.843 units
  • Quantity limit 3 per 30 days
Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible3Preferred Brand25%25%$1.2277—None
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible3Preferred Brand17%17%$0.5757—None
AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible3Preferred Brand17%17%$0.5010$1.503 units
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$0.6002$1.803 units
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible4Non-Preferred Drug33%33%$1.7376—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.

See coverage in all 39 regions →