MedicarePartD.guide

A non-government resource built from CMS public data

ELIGARD 45 mg/.375mL Injection, Suspension, Extended Release

Also known as Leuprolide Acetate. Coverage in Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming (CMS PDP Region 25).

9 of 11 stand-alone Part D plans in Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming cover this drug on tier 3–4.

9 of 9 plans apply a prior authorization, step therapy or quantity limit.

Every plan that covers it

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)$4.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug34%—$2547.5222—
  • Prior authorization
AARP Medicare Rx Saver from UHC (PDP)$5.30/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug35%—$2702.0031$486.360.18 units
  • Prior authorization
  • Quantity limit 1 per 168 days
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible3Preferred Brand25%25%$2544.0100—
  • Prior authorization
Wellcare Classic (PDP)$12.70/mo premium · $615.00 deductible · $0 with full Extra Help3Preferred Brand25%25%$2544.0100—
  • Prior authorization
Humana Value Rx Plan (PDP)$20.80/mo premium · $601.00 deductible4Non-Preferred Drug34%—$2547.5222—
  • Prior authorization
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug35%35%$2666.7712—
  • Prior authorization
MedicareBlue Rx Standard (PDP)$101.00/mo premium · $615.00 deductible4Non-Preferred Drug42%42%$1431.6717$257.700.18 units
  • Prior authorization
  • Quantity limit 1 per 168 days
Humana Premier Rx Plan (PDP)$103.70/mo premium · $0.00 deductible4Non-Preferred Drug50%50%$2547.5222—
  • Prior authorization
AARP Medicare Rx Preferred from UHC (PDP)$140.20/mo premium · $130.00 deductible4Non-Preferred Drug34%—$2702.0031$486.360.18 units
  • Prior authorization
  • Quantity limit 1 per 168 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.

Medicare Advantage plans

Medicare Advantage plans carry their own formularies, separate from stand-alone Part D, and are sold county by county. Pick a county to see every Medicare Advantage drug plan there that covers this drug.

202 Medicare Advantage plans in IA, MN, MT, ND, NE, SD, WY do cover it

A patient on an MA-PD plan may have coverage even where no PDP lists the drug. IA: 46 plans · MN: 55 plans · MT: 25 plans · ND: 15 plans · NE: 40 plans · SD: 15 plans · WY: 6 plans.

See coverage in all 39 regions →