CLEMASTINE FUMARATE 2.68 mg Tablet
Coverage in Hawaii (CMS PDP Region 33).
1 of 8 stand-alone Part D plans in Hawaii cover this drug on tier 2.
Lowest 30-day cost $10.00 at a preferred pharmacy. 1 of 1 plans apply a prior authorization, step therapy or quantity limit.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| SilverScript Choice (PDP)$14.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $3.3210 | — |
|
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.