GABAPENTIN 400 mg Capsule
Package: 500 CAPSULE in 1 BOTTLE (65162-103-50). NDC 65162010350.
- Plans covering it
- 367
- across 39 regions checked
- Lowest tier
- 2
- lower tiers cost less
- Plans with restrictions
- 294
- prior auth, step therapy or quantity limit
Coverage by region
Covered by at least one plan in 39 of 39 CMS regions.
| Region | Plans covering | Tiers | Lowest 30-day cost | Restrictions |
|---|---|---|---|---|
| New Jersey | 12 of 12 | 2–3 | $0.00 | 10 of 12 plans |
| Pennsylvania and West Virginia | 12 of 12 | 2–3 | $0.00 | 10 of 12 plans |
| North Carolina | 12 of 12 | 2–3 | $0.00 | 10 of 12 plans |
| Alabama and Tennessee | 12 of 12 | 2–3 | $0.00 | 10 of 12 plans |
| Michigan | 12 of 12 | 2–3 | $0.00 | 10 of 12 plans |
| Illinois | 12 of 12 | 2–3 | $0.00 | 10 of 12 plans |
| Arkansas | 12 of 12 | 2–3 | $0.00 | 10 of 12 plans |
| Texas | 12 of 12 | 2–3 | $0.00 | 10 of 12 plans |
| Kansas | 12 of 12 | 2–3 | $0.00 | 10 of 12 plans |
| California | 12 of 12 | 2–3 | $0.00 | 10 of 12 plans |
| Connecticut, Massachusetts, Rhode Island and Vermont | 11 of 11 | 2–3 | $0.00 | 9 of 11 plans |
| South Carolina | 11 of 11 | 2–3 | $0.00 | 9 of 11 plans |
| Oklahoma | 11 of 11 | 2–3 | $0.00 | 9 of 11 plans |
| Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming | 11 of 11 | 2–3 | $0.00 | 9 of 11 plans |
| New Mexico | 11 of 11 | 2–3 | $0.00 | 9 of 11 plans |
| New York | 10 of 10 | 2–3 | $0.00 | 8 of 10 plans |
| Delaware, DC and Maryland | 10 of 10 | 2–3 | $0.00 | 8 of 10 plans |
| Georgia | 10 of 10 | 2–3 | $0.00 | 8 of 10 plans |
| Florida | 10 of 10 | 2–3 | $0.00 | 8 of 10 plans |
| Ohio | 10 of 10 | 2–3 | $0.00 | 8 of 10 plans |
| Indiana and Kentucky | 10 of 10 | 2–3 | $0.00 | 8 of 10 plans |
| Wisconsin | 10 of 10 | 2–3 | $0.00 | 8 of 10 plans |
| Missouri | 10 of 10 | 2–3 | $0.00 | 8 of 10 plans |
| Mississippi | 10 of 10 | 2–3 | $0.00 | 8 of 10 plans |
| Louisiana | 10 of 10 | 2–3 | $0.00 | 8 of 10 plans |
| Colorado | 10 of 10 | 2–3 | $0.00 | 8 of 10 plans |
| Arizona | 10 of 10 | 2–3 | $0.00 | 8 of 10 plans |
| Nevada | 10 of 10 | 2–3 | $0.00 | 8 of 10 plans |
| Oregon and Washington | 10 of 10 | 2–3 | $0.00 | 8 of 10 plans |
| Idaho and Utah | 10 of 10 | 2–3 | $0.00 | 8 of 10 plans |
| Maine and New Hampshire | 9 of 9 | 2–3 | $0.00 | 7 of 9 plans |
| Virginia | 9 of 9 | 2–3 | $0.00 | 7 of 9 plans |
| Alaska | 9 of 9 | 2–3 | $0.00 | 7 of 9 plans |
| Hawaii | 8 of 8 | 2–3 | $0.00 | 6 of 8 plans |
| Puerto Rico | 3 of 3 | 2 | $2.00 | 2 of 3 plans |
| American Samoa | 1 of 1 | 2 | — | none |
| Guam | 1 of 1 | 2 | — | none |
| Northern Mariana Islands | 1 of 1 | 2 | — | none |
| U.S. Virgin Islands | 1 of 1 | 2 | — | none |
Plan-by-plan detail
Open a region to see every plan that covers this drug, with tier, cost-sharing and restrictions.
New Jersey — 12 plans, 10 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$4.40/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0953 | $2.5727 units |
|
| Humana Value Rx Plan (PDP)$35.60/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0964 | $2.6027 units |
|
| HealthSpring Extra Rx (PDP)$59.90/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.0985 | $2.6627 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$77.40/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.1261 | — | None |
| HealthSpring Assurance Rx (PDP)$109.30/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.0992 | $2.6827 units |
|
| Humana Premier Rx Plan (PDP)$111.90/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0953 | $2.5727 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$118.90/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.2164 | — | None |
| Horizon Medicare Blue Rx Enhanced (PDP)$139.10/mo premium · $200.00 deductible | 2Generic | $6.00 | $9.00 | $0.1350 | $3.6527 units |
|
| Wellcare Value Script (PDP)$22.80/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2604 | $7.0327 units |
|
| Wellcare Classic (PDP)$28.20/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2604 | $7.0327 units |
|
| Horizon Medicare Blue Rx Standard (PDP)$72.30/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1350 | $3.6527 units |
|
| SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1141 | $3.0827 units |
|
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 — elsewhere it depends on what is prescribed.
Pennsylvania and West Virginia — 12 plans, 10 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$6.60/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0849 | $2.2927 units |
|
| Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0869 | $2.3527 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$43.50/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.1233 | — | None |
| HealthSpring Extra Rx (PDP)$62.60/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.1012 | $2.7327 units |
|
| HealthSpring Assurance Rx (PDP)$74.00/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.1077 | $2.9127 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$121.90/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.2069 | — | None |
| Humana Premier Rx Plan (PDP)$123.60/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0849 | $2.2927 units |
|
| Blue Rx PDP Complete (PDP)$164.80/mo premium · $200.00 deductible | 2Generic | $5.00 | $12.50 | $0.0807 | $2.1827 units |
|
| Blue Rx PDP Plus (PDP)$193.20/mo premium · $615.00 deductible | 2Generic | 25% | 25% | $0.0807 | $2.1827 units |
|
| Wellcare Value Script (PDP)$8.20/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2534 | $6.8427 units |
|
| Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2535 | $6.8427 units |
|
| SilverScript Choice (PDP)$22.70/mo premium · $615.00 deductible | 3Preferred Brand | 19% | 19% | $0.0921 | $2.4927 units |
|
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 — elsewhere it depends on what is prescribed.
North Carolina — 12 plans, 10 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$6.80/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0932 | $2.5227 units |
|
| Humana Value Rx Plan (PDP)$32.00/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0959 | $2.5927 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$56.90/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.1186 | — | None |
| HealthSpring Extra Rx (PDP)$78.00/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.1190 | $3.2127 units |
|
| HealthSpring Assurance Rx (PDP)$110.40/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.1268 | $3.4227 units |
|
| Humana Premier Rx Plan (PDP)$110.90/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0932 | $2.5227 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$119.80/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1917 | — | None |
| Blue Medicare Rx Enhanced (PDP)$163.20/mo premium · $0.00 deductible | 2Generic | $6.00 | $18.00 | $0.1652 | $4.4627 units |
|
| Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2613 | $7.0627 units |
|
| Wellcare Classic (PDP)$4.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2613 | $7.0627 units |
|
| Blue Medicare Rx Standard (PDP)$83.90/mo premium · $615.00 deductible | 3Preferred Brand | 20% | 20% | $0.1652 | $4.4627 units |
|
| SilverScript Choice (PDP)$90.20/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1227 | $3.3127 units |
|
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 — elsewhere it depends on what is prescribed.
Alabama and Tennessee — 12 plans, 10 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0895 | $2.4227 units |
|
| Humana Value Rx Plan (PDP)$37.70/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0916 | $2.4727 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$63.20/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.1183 | — | None |
| HealthSpring Extra Rx (PDP)$77.50/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.1147 | $3.1027 units |
|
| HealthSpring Assurance Rx (PDP)$87.20/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.1165 | $3.1527 units |
|
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0895 | $2.4227 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$119.30/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1902 | — | None |
| BlueRx Enhanced Plus (PDP)$129.50/mo premium · $150.00 deductible | 2Generic | $12.00 | $24.00 | $0.1364 | $3.6827 units |
|
| Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2529 | $6.8327 units |
|
| Wellcare Classic (PDP)$3.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2529 | $6.8327 units |
|
| BlueRx Essential (PDP)$76.20/mo premium · $615.00 deductible | 3Preferred Brand | 19% | 19% | $0.1364 | $3.6827 units |
|
| SilverScript Choice (PDP)$97.30/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1100 | $2.9727 units |
|
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 — elsewhere it depends on what is prescribed.
Michigan — 12 plans, 10 with restrictions
| 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 | 2Generic | 10% | 10% | $0.1033 | $2.7927 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0881 | $2.3827 units |
|
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0895 | $2.4227 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$14.10/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.1217 | — | None |
| HealthSpring Extra Rx (PDP)$50.40/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.1033 | $2.7927 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$78.30/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1984 | — | None |
| Prescription Blue Select (PDP)$78.40/mo premium · $615.00 deductible | 2Generic | $5.00 | $15.00 | $0.0462 | $1.2527 units |
|
| Humana Premier Rx Plan (PDP)$98.10/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0881 | $2.3827 units |
|
| Prescription Blue Premium (PDP)$106.70/mo premium · $0.00 deductible | 2Generic | $5.00 | $10.00 | $0.0462 | $1.2527 units |
|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2683 | $7.2427 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2683 | $7.2427 units |
|
| SilverScript Choice (PDP)$78.30/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1056 | $2.8527 units |
|
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 — elsewhere it depends on what is prescribed.
Illinois — 12 plans, 10 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0938 | $2.5327 units |
|
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0954 | $2.5827 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$40.20/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.1062 | — | None |
| HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.1148 | $3.1027 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$103.90/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1667 | — | None |
| HealthSpring Assurance Rx (PDP)$104.20/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.1352 | $3.6527 units |
|
| Humana Premier Rx Plan (PDP)$119.40/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0938 | $2.5327 units |
|
| Blue Cross MedicareRx Value (PDP)$119.70/mo premium · $615.00 deductible | 2Generic | $1.00 | $3.00 | $0.1596 | $4.3127 units |
|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.3264 | $8.8127 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.3264 | $8.8127 units |
|
| Blue Cross MedicareRx Basic (PDP)$89.70/mo premium · $615.00 deductible | 3Preferred Brand | 20% | 20% | $0.1615 | $4.3627 units |
|
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1132 | $3.0627 units |
|
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 — elsewhere it depends on what is prescribed.
Arkansas — 12 plans, 10 with restrictions
| 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 | 2Generic | 10% | 10% | $0.1343 | $3.6327 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0777 | $2.1027 units |
|
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0823 | $2.2227 units |
|
| BlueMedicare Value Rx (PDP)$52.50/mo premium · $615.00 deductible | 2Generic | $5.00 | $15.00 | $0.1060 | $2.8627 units |
|
| HealthSpring Extra Rx (PDP)$54.50/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.1331 | $3.5927 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$65.10/mo premium · $615.00 deductible | 2Generic | $7.00 | $27.00 | $0.1219 | — | None |
| Humana Premier Rx Plan (PDP)$92.40/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0777 | $2.1027 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$114.90/mo premium · $130.00 deductible | 2Generic | $10.00 | $54.00 | $0.1921 | — | None |
| BlueMedicare Premier Rx (PDP)$181.20/mo premium · $0.00 deductible | 2Generic | $5.00 | $15.00 | $0.1060 | $2.8627 units |
|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2093 | $5.6527 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2093 | $5.6527 units |
|
| SilverScript Choice (PDP)$73.50/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1182 | $3.1927 units |
|
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 — elsewhere it depends on what is prescribed.
Texas — 12 plans, 10 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Value Rx Plan (PDP)$22.90/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0949 | $2.5627 units |
|
| Humana Basic Rx Plan (PDP)$41.70/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0919 | $2.4827 units |
|
| HealthSpring Extra Rx (PDP)$70.00/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.1122 | $3.0327 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$89.20/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.1104 | — | None |
| HealthSpring Assurance Rx (PDP)$111.40/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.1241 | $3.3527 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1741 | — | None |
| Humana Premier Rx Plan (PDP)$118.20/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0919 | $2.4827 units |
|
| Blue Cross MedicareRx Value (PDP)$167.40/mo premium · $615.00 deductible | 2Generic | $1.00 | $3.00 | $0.1550 | $4.1827 units |
|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.3054 | $8.2527 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.3054 | $8.2527 units |
|
| SilverScript Choice (PDP)$94.80/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1202 | $3.2527 units |
|
| Blue Cross MedicareRx Basic (PDP)$104.70/mo premium · $615.00 deductible | 3Preferred Brand | 19% | 19% | $0.1460 | $3.9427 units |
|
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 — elsewhere it depends on what is prescribed.
Kansas — 12 plans, 10 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Blue MedicareRx Essentials (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $0.00 | $0.00 | $0.1843 | $4.9827 units |
|
| HealthSpring Assurance Rx (PDP)$6.70/mo premium · $615.00 deductible | 2Generic | 10% | 10% | $0.1351 | $3.6527 units |
|
| Humana Basic Rx Plan (PDP)$15.50/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0822 | $2.2227 units |
|
| Humana Value Rx Plan (PDP)$55.60/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0858 | $2.3227 units |
|
| Blue MedicareRx Plus (PDP)$67.40/mo premium · $0.00 deductible | 2Generic | $0.00 | $0.00 | $0.1769 | $4.7827 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$105.40/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.1212 | — | None |
| Humana Premier Rx Plan (PDP)$116.30/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0822 | $2.2227 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$147.00/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1918 | — | None |
| Blue MedicareRx Value (PDP)$0.70/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1769 | $4.7827 units |
|
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2901 | $7.8327 units |
|
| Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2901 | $7.8327 units |
|
| SilverScript Choice (PDP)$88.30/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1203 | $3.2527 units |
|
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 — elsewhere it depends on what is prescribed.
California — 12 plans, 10 with restrictions
| 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 | 2Generic | 10% | 10% | $0.1087 | $2.9327 units |
|
| HealthSpring Extra Rx (PDP)$70.60/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.1003 | $2.7127 units |
|
| Humana Value Rx Plan (PDP)$104.60/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0973 | $2.6327 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$109.40/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.1215 | — | None |
| Humana Basic Rx Plan (PDP)$132.20/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0959 | $2.5927 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$165.40/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.2042 | — | None |
| Humana Premier Rx Plan (PDP)$172.90/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0959 | $2.5927 units |
|
| Blue Shield Rx Plus (PDP)$199.70/mo premium · $615.00 deductible | 2Generic | $7.00 | $17.50 | $0.0943 | $16.97180 units |
|
| Blue Shield Rx Enhanced (PDP)$227.80/mo premium · $0.00 deductible | 2Generic | $7.00 | $14.00 | $0.0943 | $16.97180 units |
|
| Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2613 | $7.0627 units |
|
| Wellcare Classic (PDP)$6.20/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2613 | $7.0627 units |
|
| SilverScript Choice (PDP)$103.60/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1313 | $3.5527 units |
|
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 — elsewhere it depends on what is prescribed.
Connecticut, Massachusetts, Rhode Island and Vermont — 11 plans, 9 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$8.40/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.1036 | $2.8027 units |
|
| Blue MedicareRx Value Plus (PDP)$20.70/mo premium · $615.00 deductible | 2Generic | $3.00 | $6.00 | $0.1638 | $4.4227 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.1281 | — | None |
| Humana Value Rx Plan (PDP)$73.60/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.1045 | $2.8227 units |
|
| Humana Premier Rx Plan (PDP)$138.60/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.1036 | $2.8027 units |
|
| HealthSpring Assurance Rx (PDP)$139.30/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.1052 | $2.8427 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.2068 | — | None |
| Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible | 2Generic | $7.00 | $14.00 | $0.1638 | $4.4227 units |
|
| Wellcare Value Script (PDP)$16.40/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2825 | $7.6327 units |
|
| Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2826 | $7.6327 units |
|
| SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible | 3Preferred Brand | 19% | 19% | $0.0852 | $2.3027 units |
|
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 — elsewhere it depends on what is prescribed.
South Carolina — 11 plans, 9 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$10.10/mo premium · $615.00 deductible | 2Generic | $2.00 | $0.00 | $0.0956 | $2.5827 units |
|
| Humana Value Rx Plan (PDP)$65.60/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0985 | $2.6627 units |
|
| HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.1107 | $2.9927 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$122.10/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.1190 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1949 | — | None |
| BlueCross Rx Value (PDP)$139.70/mo premium · $615.00 deductible | 2Generic | $17.00 | $42.50 | $0.1067 | $2.8827 units |
|
| Humana Premier Rx Plan (PDP)$145.60/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0956 | $2.5827 units |
|
| HealthSpring Assurance Rx (PDP)$152.50/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.1209 | $3.2627 units |
|
| Wellcare Value Script (PDP)$4.80/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2769 | $7.4827 units |
|
| Wellcare Classic (PDP)$9.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2769 | $7.4827 units |
|
| SilverScript Choice (PDP)$98.40/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1373 | $3.7127 units |
|
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 — elsewhere it depends on what is prescribed.
Oklahoma — 11 plans, 9 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $2.00 | $0.00 | $0.0840 | $2.2727 units |
|
| Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0882 | $2.3827 units |
|
| HealthSpring Extra Rx (PDP)$65.40/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.1386 | $3.7427 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.1199 | — | None |
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0840 | $2.2727 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$121.00/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1933 | — | None |
| HealthSpring Assurance Rx (PDP)$126.50/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.1419 | $3.8327 units |
|
| Blue Cross MedicareRx Value (PDP)$167.30/mo premium · $615.00 deductible | 2Generic | $1.00 | $3.00 | $0.1770 | $4.7827 units |
|
| Blue Cross MedicareRx Basic (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 16% | 16% | $0.1624 | $4.3827 units |
|
| Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2241 | $6.0527 units |
|
| Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2241 | $6.0527 units |
|
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 — elsewhere it depends on what is prescribed.
Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming — 11 plans, 9 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$4.70/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0818 | $2.2127 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$5.30/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.1129 | — | None |
| Humana Value Rx Plan (PDP)$20.80/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0840 | $2.2727 units |
|
| HealthSpring Extra Rx (PDP)$66.50/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.1094 | $2.9527 units |
|
| Humana Premier Rx Plan (PDP)$103.70/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0818 | $2.2127 units |
|
| HealthSpring Assurance Rx (PDP)$125.90/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.1097 | $2.9627 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$140.20/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1823 | — | None |
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2934 | $7.9227 units |
|
| Wellcare Classic (PDP)$12.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2934 | $7.9227 units |
|
| SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible | 3Preferred Brand | 19% | 19% | $0.0985 | $2.6627 units |
|
| MedicareBlue Rx Standard (PDP)$101.00/mo premium · $615.00 deductible | 3Preferred Brand | 22% | 22% | $0.1728 | $4.6727 units |
|
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 — elsewhere it depends on what is prescribed.
New Mexico — 11 plans, 9 with restrictions
| 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 | 2Generic | 10% | 10% | $0.1652 | $4.4627 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0975 | $2.6327 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $6.00 | $18.00 | $0.1063 | — | None |
| Humana Value Rx Plan (PDP)$69.60/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.1013 | $2.7427 units |
|
| Humana Premier Rx Plan (PDP)$75.60/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0975 | $2.6327 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1605 | — | None |
| Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible | 2Generic | $4.00 | $12.00 | $0.1726 | $4.6627 units |
|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.3105 | $8.3827 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.3105 | $8.3827 units |
|
| SilverScript Choice (PDP)$104.00/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1159 | $3.1327 units |
|
| Blue Cross MedicareRx Basic (PDP)$145.40/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1669 | $4.5127 units |
|
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 — elsewhere it depends on what is prescribed.
New York — 10 plans, 8 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| HealthSpring Assurance Rx (PDP)$35.70/mo premium · $615.00 deductible | 2Generic | 10% | 10% | $0.0911 | $2.4627 units |
|
| HealthSpring Extra Rx (PDP)$91.60/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.0940 | $2.5427 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$105.80/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.1243 | — | None |
| Humana Basic Rx Plan (PDP)$140.90/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0870 | $2.3527 units |
|
| Humana Value Rx Plan (PDP)$158.90/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0879 | $2.3727 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$163.70/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.2111 | — | None |
| Humana Premier Rx Plan (PDP)$173.60/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0870 | $2.3527 units |
|
| Wellcare Value Script (PDP)$42.40/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2217 | $5.9927 units |
|
| Wellcare Classic (PDP)$45.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2217 | $5.9927 units |
|
| SilverScript Choice (PDP)$116.00/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1114 | $3.0127 units |
|
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 — elsewhere it depends on what is prescribed.
Delaware, DC and Maryland — 10 plans, 8 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0930 | $2.5127 units |
|
| Humana Value Rx Plan (PDP)$4.30/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0944 | $2.5527 units |
|
| HealthSpring Assurance Rx (PDP)$32.60/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.1059 | $2.8627 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$37.80/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.1160 | — | None |
| HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.0983 | $2.6527 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1925 | — | None |
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0930 | $2.5127 units |
|
| Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2801 | $7.5627 units |
|
| Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2801 | $7.5627 units |
|
| SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1169 | $3.1627 units |
|
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 — elsewhere it depends on what is prescribed.
Georgia — 10 plans, 8 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0867 | $2.3427 units |
|
| Humana Value Rx Plan (PDP)$36.40/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0891 | $2.4127 units |
|
| HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.1170 | $3.1627 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$98.00/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.1193 | — | None |
| Humana Premier Rx Plan (PDP)$129.50/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0867 | $2.3427 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$139.80/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1932 | — | None |
| HealthSpring Assurance Rx (PDP)$149.30/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.1173 | $3.1727 units |
|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2608 | $7.0427 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2608 | $7.0427 units |
|
| SilverScript Choice (PDP)$100.70/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1199 | $3.2427 units |
|
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 — elsewhere it depends on what is prescribed.
Florida — 10 plans, 8 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Value Rx Plan (PDP)$25.90/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.1027 | $2.7727 units |
|
| Humana Basic Rx Plan (PDP)$92.70/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.1009 | $2.7227 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$98.70/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.1103 | — | None |
| Humana Premier Rx Plan (PDP)$115.90/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.1009 | $2.7227 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$119.10/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1793 | — | None |
| BlueMedicare Complete Rx (PDP)$217.00/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1411 | $3.8127 units |
|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.3051 | $8.2427 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.3051 | $8.2427 units |
|
| SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1170 | $3.1627 units |
|
| BlueMedicare Premier Rx (PDP)$98.60/mo premium · $615.00 deductible | 3Preferred Brand | 20% | 20% | $0.1411 | $3.8127 units |
|
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 — elsewhere it depends on what is prescribed.
Ohio — 10 plans, 8 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0869 | $2.3527 units |
|
| Humana Value Rx Plan (PDP)$23.70/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0891 | $2.4127 units |
|
| HealthSpring Extra Rx (PDP)$65.70/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.1126 | $3.0427 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$73.70/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.1266 | — | None |
| HealthSpring Assurance Rx (PDP)$109.50/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.1225 | $3.3127 units |
|
| Humana Premier Rx Plan (PDP)$117.60/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0869 | $2.3527 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$123.40/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.2100 | — | None |
| Wellcare Value Script (PDP)$7.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.3151 | $8.5127 units |
|
| Wellcare Classic (PDP)$7.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.3151 | $8.5127 units |
|
| SilverScript Choice (PDP)$90.30/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1149 | $3.1027 units |
|
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 — elsewhere it depends on what is prescribed.
Indiana and Kentucky — 10 plans, 8 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0857 | $2.3127 units |
|
| Humana Value Rx Plan (PDP)$9.90/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0878 | $2.3727 units |
|
| HealthSpring Extra Rx (PDP)$78.20/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.1166 | $3.1527 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$90.30/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.1257 | — | None |
| HealthSpring Assurance Rx (PDP)$117.80/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.1177 | $3.1827 units |
|
| Humana Premier Rx Plan (PDP)$125.30/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0857 | $2.3127 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$127.10/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1959 | — | None |
| Wellcare Value Script (PDP)$8.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2447 | $6.6127 units |
|
| Wellcare Classic (PDP)$8.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2447 | $6.6127 units |
|
| SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible | 3Preferred Brand | 19% | 19% | $0.0946 | $2.5527 units |
|
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 — elsewhere it depends on what is prescribed.
Wisconsin — 10 plans, 8 with restrictions
| 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 | 2Generic | 10% | 10% | $0.1307 | $3.5327 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0978 | $2.6427 units |
|
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.1003 | $2.7127 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.1117 | — | None |
| HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.1245 | $3.3627 units |
|
| Humana Premier Rx Plan (PDP)$110.60/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0978 | $2.6427 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$113.90/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1734 | — | None |
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2767 | $7.4727 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2767 | $7.4727 units |
|
| SilverScript Choice (PDP)$26.70/mo premium · $615.00 deductible | 3Preferred Brand | 19% | 19% | $0.0986 | $2.6627 units |
|
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 — elsewhere it depends on what is prescribed.
Missouri — 10 plans, 8 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$16.50/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0892 | $2.4127 units |
|
| Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0933 | $2.5227 units |
|
| HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.1248 | $3.3727 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$71.90/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.1183 | — | None |
| HealthSpring Assurance Rx (PDP)$74.30/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.1342 | $3.6227 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$125.40/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1900 | — | None |
| Humana Premier Rx Plan (PDP)$126.40/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0892 | $2.4127 units |
|
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2588 | $6.9927 units |
|
| Wellcare Classic (PDP)$10.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2588 | $6.9927 units |
|
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1310 | $3.5427 units |
|
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 — elsewhere it depends on what is prescribed.
Mississippi — 10 plans, 8 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0815 | $2.2027 units |
|
| Humana Value Rx Plan (PDP)$37.60/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0847 | $2.2927 units |
|
| HealthSpring Assurance Rx (PDP)$59.70/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.1206 | $3.2627 units |
|
| HealthSpring Extra Rx (PDP)$77.10/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.1235 | $3.3327 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$84.70/mo premium · $615.00 deductible | 2Generic | $6.00 | $18.00 | $0.1217 | — | None |
| Humana Premier Rx Plan (PDP)$89.90/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0815 | $2.2027 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$140.60/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1963 | — | None |
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2030 | $5.4827 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2030 | $5.4827 units |
|
| SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1134 | $3.0627 units |
|
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 — elsewhere it depends on what is prescribed.
Louisiana — 10 plans, 8 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0917 | $2.4827 units |
|
| Humana Value Rx Plan (PDP)$19.30/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0949 | $2.5627 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$37.00/mo premium · $615.00 deductible | 2Generic | $6.00 | $18.00 | $0.1178 | — | None |
| HealthSpring Assurance Rx (PDP)$48.40/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.1256 | $3.3927 units |
|
| HealthSpring Extra Rx (PDP)$60.60/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.1228 | $3.3227 units |
|
| Humana Premier Rx Plan (PDP)$113.70/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0917 | $2.4827 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$139.50/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1891 | — | None |
| Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2298 | $6.2027 units |
|
| Wellcare Classic (PDP)$6.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2299 | $6.2127 units |
|
| SilverScript Choice (PDP)$44.70/mo premium · $615.00 deductible | 3Preferred Brand | 19% | 19% | $0.1039 | $2.8127 units |
|
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 — elsewhere it depends on what is prescribed.
Colorado — 10 plans, 8 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0835 | $2.2527 units |
|
| Humana Value Rx Plan (PDP)$48.50/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0864 | $2.3327 units |
|
| HealthSpring Assurance Rx (PDP)$61.70/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.1436 | $3.8827 units |
|
| HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.1303 | $3.5227 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$125.00/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.1103 | — | None |
| Humana Premier Rx Plan (PDP)$137.10/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0835 | $2.2527 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$151.90/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1649 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.3128 | $8.4527 units |
|
| Wellcare Classic (PDP)$2.20/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.3128 | $8.4527 units |
|
| SilverScript Choice (PDP)$105.10/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1062 | $2.8727 units |
|
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 — elsewhere it depends on what is prescribed.
Arizona — 10 plans, 8 with restrictions
| 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 | 2Generic | 10% | 10% | $0.1465 | $3.9627 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $3.00 | $0.00 | $0.0993 | $2.6827 units |
|
| Humana Value Rx Plan (PDP)$2.50/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.1019 | $2.7527 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.1239 | — | None |
| HealthSpring Extra Rx (PDP)$66.40/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.1251 | $3.3827 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$97.50/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.2045 | — | None |
| Humana Premier Rx Plan (PDP)$119.20/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0993 | $2.6827 units |
|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.3317 | $8.9627 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.3317 | $8.9627 units |
|
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1185 | $3.2027 units |
|
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 — elsewhere it depends on what is prescribed.
Nevada — 10 plans, 8 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.1011 | $2.7327 units |
|
| Humana Value Rx Plan (PDP)$43.70/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.1037 | $2.8027 units |
|
| HealthSpring Extra Rx (PDP)$52.60/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.1237 | $3.3427 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$76.70/mo premium · $615.00 deductible | 2Generic | $6.00 | $18.00 | $0.1090 | — | None |
| HealthSpring Assurance Rx (PDP)$95.60/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.1409 | $3.8027 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$139.10/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1671 | — | None |
| Humana Premier Rx Plan (PDP)$148.70/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.1011 | $2.7327 units |
|
| Wellcare Classic (PDP)$2.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.3263 | $8.8127 units |
|
| Wellcare Value Script (PDP)$2.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.3263 | $8.8127 units |
|
| SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1239 | $3.3527 units |
|
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 — elsewhere it depends on what is prescribed.
Oregon and Washington — 10 plans, 8 with restrictions
| 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 | 2Generic | 10% | 10% | $0.1354 | $3.6627 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0819 | $2.2127 units |
|
| Humana Value Rx Plan (PDP)$22.10/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0842 | $2.2727 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$38.40/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.1123 | — | None |
| HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.1169 | $3.1627 units |
|
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0819 | $2.2127 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$110.00/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1755 | — | None |
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.3026 | $8.1727 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.3028 | $8.1827 units |
|
| SilverScript Choice (PDP)$85.90/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1061 | $2.8627 units |
|
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 — elsewhere it depends on what is prescribed.
Idaho and Utah — 10 plans, 8 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0777 | $2.1027 units |
|
| Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0804 | $2.1727 units |
|
| HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.1243 | $3.3627 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$56.50/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.1175 | — | None |
| Humana Premier Rx Plan (PDP)$115.50/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0777 | $2.1027 units |
|
| HealthSpring Assurance Rx (PDP)$128.60/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.1268 | $3.4227 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$132.60/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1848 | — | None |
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2482 | $6.7027 units |
|
| Wellcare Classic (PDP)$23.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2482 | $6.7027 units |
|
| SilverScript Choice (PDP)$27.70/mo premium · $615.00 deductible | 3Preferred Brand | 19% | 19% | $0.0998 | $2.6927 units |
|
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 — elsewhere it depends on what is prescribed.
Maine and New Hampshire — 9 plans, 7 with restrictions
| 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 | 2Generic | 10% | 10% | $0.1385 | $3.7427 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0909 | $2.4527 units |
|
| Humana Value Rx Plan (PDP)$54.40/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0935 | $2.5227 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.1073 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$104.30/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1704 | — | None |
| Humana Premier Rx Plan (PDP)$150.20/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0909 | $2.4527 units |
|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.3135 | $8.4627 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.3135 | $8.4627 units |
|
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1167 | $3.1527 units |
|
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 — elsewhere it depends on what is prescribed.
Virginia — 9 plans, 7 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.0920 | $2.4827 units |
|
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0954 | $2.5827 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$39.60/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.1190 | — | None |
| Humana Premier Rx Plan (PDP)$87.60/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0920 | $2.4827 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$100.80/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1900 | — | None |
| HealthSpring Assurance Rx (PDP)$133.80/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.1365 | $3.6927 units |
|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2778 | $7.5027 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2778 | $7.5027 units |
|
| SilverScript Choice (PDP)$78.20/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.1367 | $3.6927 units |
|
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 — elsewhere it depends on what is prescribed.
Alaska — 9 plans, 7 with restrictions
| 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 | 2Generic | 10% | 10% | $0.1417 | $3.8327 units |
|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $3.00 | $0.00 | $0.0720 | $1.9427 units |
|
| Humana Value Rx Plan (PDP)$10.60/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.0733 | $1.9827 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$53.20/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.1312 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$100.20/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.1950 | — | None |
| Humana Premier Rx Plan (PDP)$112.40/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.0720 | $1.9427 units |
|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2946 | $7.9527 units |
|
| Wellcare Value Script (PDP)$19.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2946 | $7.9527 units |
|
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $0.0993 | $2.6827 units |
|
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 — elsewhere it depends on what is prescribed.
Hawaii — 8 plans, 6 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.1296 | — | None |
| Humana Basic Rx Plan (PDP)$0.40/mo premium · $615.00 deductible | 2Generic | $4.00 | $0.00 | $0.1063 | $2.8727 units |
|
| Humana Value Rx Plan (PDP)$51.60/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.1071 | $2.8927 units |
|
| Humana Premier Rx Plan (PDP)$90.20/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.1063 | $2.8727 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.2246 | — | None |
| SilverScript Choice (PDP)$14.70/mo premium · $615.00 deductible | 3Preferred Brand | 19% | 19% | $0.0890 | $2.4027 units |
|
| Wellcare Value Script (PDP)$21.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2807 | $7.5827 units |
|
| Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $0.2807 | $7.5827 units |
|
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 — elsewhere it depends on what is prescribed.
Puerto Rico — 3 plans, 2 with restrictions
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.1176 | $3.1827 units |
|
| HealthSpring Assurance Rx (PDP)$65.70/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.1048 | $2.8327 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$145.10/mo premium · $615.00 deductible | 2Generic | 25% | 25% | $0.2360 | — | 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 — elsewhere it depends on what is prescribed.
American Samoa — 1 plan
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | 25% | 25% | $0.2490 | — | 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 — elsewhere it depends on what is prescribed.
Guam — 1 plan
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | 25% | 25% | $0.2432 | — | 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 — elsewhere it depends on what is prescribed.
Northern Mariana Islands — 1 plan
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP)$32.10/mo premium · $615.00 deductible | 2Generic | 25% | 25% | $0.2432 | — | 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 — elsewhere it depends on what is prescribed.
U.S. Virgin Islands — 1 plan
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $615.00 deductible | 2Generic | 25% | 25% | $0.2391 | — | 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 — elsewhere it depends on what is prescribed.