ELIGARD 45 mg/.375mL Injection, Suspension, Extended Release
Also known as Leuprolide Acetate. Coverage in Missouri (CMS PDP Region 18).
8 of 10 stand-alone Part D plans in Missouri cover this drug on tier 3–4.
8 of 8 plans apply a prior authorization, step therapy or quantity limit.
138 Medicare Advantage plans in MO 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. MO: 138 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $2409.6092 | — |
|
| Wellcare Classic (PDP)$10.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $2409.6092 | — |
|
| Humana Basic Rx Plan (PDP)$16.50/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | — | $2547.5222 | — |
|
| Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible | 4Non-Preferred Drug | 34% | — | $2547.5222 | — |
|
| AARP Medicare Rx Saver from UHC (PDP)$71.90/mo premium · $615.00 deductible | 4Non-Preferred Drug | 39% | — | $2715.5538 | $488.800.18 units |
|
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $2666.7712 | — |
|
| AARP Medicare Rx Preferred from UHC (PDP)$125.40/mo premium · $130.00 deductible | 4Non-Preferred Drug | 35% | — | $2715.5538 | $488.800.18 units |
|
| Humana Premier Rx Plan (PDP)$126.40/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $2547.5222 | — |
|
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.