MedicarePartD.guide

A non-government resource built from CMS public data

PAROXETINE HYDROCHLORIDE 12.5 mg Tablet, Film Coated, Extended Release

Coverage in New Jersey (CMS PDP Region 04).

4 of 12 stand-alone Part D plans in New Jersey cover this drug on tier 3–4.

3 of 4 plans apply a prior authorization, step therapy or quantity limit.

45 Medicare Advantage plans in NJ 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. NJ: 45 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$118.90/mo premium · $130.00 deductible3Preferred Brand15%15%$0.6910—None
Wellcare Value Script (PDP)$22.80/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$1.5435$9.266 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$111.90/mo premium · $0.00 deductible4Non-Preferred Drug50%50%$0.8401$5.046 units
  • Quantity limit 6 per 30 days
Horizon Medicare Blue Rx Enhanced (PDP)$139.10/mo premium · $200.00 deductible4Non-Preferred Drug45%45%$1.1465$3.443 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 →