OXACILLIN 10 g/100mL Injection, Powder, For Solution
Also known as Oxacillin Sodium. Coverage in Michigan (CMS PDP Region 13).
5 of 12 stand-alone Part D plans in Michigan cover this drug on tier 4.
2 of 5 plans apply a prior authorization, step therapy or quantity limit.
132 Medicare Advantage plans in MI 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. MI: 132 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $77.2632 | — |
|
| AARP Medicare Rx Saver from UHC (PDP)$14.10/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | — | $55.9941 | — | None |
| HealthSpring Extra Rx (PDP)$50.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | 32% | $77.2632 | — |
|
| SilverScript Choice (PDP)$78.30/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | 33% | $41.4752 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$78.30/mo premium · $130.00 deductible | 4Non-Preferred Drug | 32% | — | $56.8445 | — | 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.