MedicarePartD.guide

A non-government resource built from CMS public data

GUANFACINE HYDROCHLORIDE 1 mg Tablet

Also known as Guanfacine. Package: 100 TABLET in 1 BOTTLE (65162-711-10). NDC 65162071110.

Plans covering it
235
across 39 regions checked
Lowest tier
2
lower tiers cost less
Plans with restrictions
51
prior auth, step therapy or quantity limit

Coverage by region

Covered by at least one plan in 39 of 39 CMS regions.

RegionPlans coveringTiersLowest 30-day costRestrictions
Connecticut, Massachusetts, Rhode Island and Vermont9 of 112–4$0.004 of 9 plans
Michigan8 of 122–4$0.001 of 8 plans
Arkansas8 of 122–4$0.003 of 8 plans
Kansas8 of 122–4$0.001 of 8 plans
California8 of 122–4$0.001 of 8 plans
New Jersey7 of 122–4$0.001 of 7 plans
Pennsylvania and West Virginia7 of 122–4$0.002 of 7 plans
North Carolina7 of 122–4$0.001 of 7 plans
Florida7 of 102–4$0.001 of 7 plans
Alabama and Tennessee7 of 122–4$0.001 of 7 plans
Indiana and Kentucky7 of 102–4$0.002 of 7 plans
Wisconsin7 of 102–4$0.002 of 7 plans
Illinois7 of 122–4$0.001 of 7 plans
Louisiana7 of 102–4$0.002 of 7 plans
Texas7 of 122–4$0.001 of 7 plans
Oklahoma7 of 112–4$0.001 of 7 plans
Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming7 of 112–4$0.002 of 7 plans
New Mexico7 of 112–4$0.001 of 7 plans
Idaho and Utah7 of 102–4$0.002 of 7 plans
Hawaii7 of 82–4$0.002 of 7 plans
Maine and New Hampshire6 of 92–4$0.001 of 6 plans
New York6 of 102–4$0.001 of 6 plans
Delaware, DC and Maryland6 of 102–4$0.001 of 6 plans
Virginia6 of 92–4$0.001 of 6 plans
South Carolina6 of 112–4$0.001 of 6 plans
Georgia6 of 102–4$0.001 of 6 plans
Ohio6 of 102–4$0.001 of 6 plans
Missouri6 of 102–4$0.001 of 6 plans
Mississippi6 of 102–4$0.001 of 6 plans
Colorado6 of 102–4$0.001 of 6 plans
Arizona6 of 102–4$0.001 of 6 plans
Nevada6 of 102–4$0.001 of 6 plans
Oregon and Washington6 of 102–4$0.001 of 6 plans
Alaska6 of 92–4$0.001 of 6 plans
American Samoa1 of 12—1 of 1 plans
Guam1 of 12—1 of 1 plans
Northern Mariana Islands1 of 12—1 of 1 plans
Puerto Rico1 of 32—1 of 1 plans
U.S. Virgin Islands1 of 12—1 of 1 plans

Plan-by-plan detail

Open a region to see every plan that covers this drug, with tier, cost-sharing and restrictions.

Connecticut, Massachusetts, Rhode Island and Vermont — 9 plans, 4 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$8.40/mo premium · $615.00 deductible2Generic$1.00$0.00$0.4370—None
Humana Value Rx Plan (PDP)$73.60/mo premium · $601.00 deductible2Generic$0.00$0.00$0.4388—None
Humana Premier Rx Plan (PDP)$138.60/mo premium · $0.00 deductible2Generic$4.00$0.00$0.4370—None
AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible2Generic$10.00$0.00$0.5295$3.186 units
  • Quantity limit 6 per 30 days
Blue MedicareRx Value Plus (PDP)$20.70/mo premium · $615.00 deductible3Preferred Brand17%17%$0.2692—
  • Prior authorization
Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible3Preferred Brand$30.00$60.00$0.2692—
  • Prior authorization
Wellcare Value Script (PDP)$16.40/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.7087—None
Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible4Non-Preferred Drug29%29%$0.7080—None
SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible4Non-Preferred Drug35%35%$0.4552—
  • Prior authorization

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 — 8 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3767—None
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3820—None
AARP Medicare Rx Preferred from UHC (PDP)$78.30/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4951$2.976 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$98.10/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3767—None
Prescription Blue Select (PDP)$78.40/mo premium · $615.00 deductible3Preferred Brand20%20%$0.5192—None
Prescription Blue Premium (PDP)$106.70/mo premium · $0.00 deductible3Preferred Brand24%24%$0.5192—None
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug28%28%$0.6169—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.6154—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.

Arkansas — 8 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3202—None
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3409—None
Humana Premier Rx Plan (PDP)$92.40/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3202—None
AARP Medicare Rx Preferred from UHC (PDP)$114.90/mo premium · $130.00 deductible2Generic$10.00$54.00$0.4607$2.766 units
  • Quantity limit 6 per 30 days
BlueMedicare Value Rx (PDP)$52.50/mo premium · $615.00 deductible3Preferred Brand19%19%$0.2505—
  • Prior authorization
BlueMedicare Premier Rx (PDP)$181.20/mo premium · $0.00 deductible3Preferred Brand20%20%$0.2505—
  • Prior authorization
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug26%26%$0.5348—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.5340—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.

Kansas — 8 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$15.50/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3187—None
Humana Value Rx Plan (PDP)$55.60/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3387—None
Humana Premier Rx Plan (PDP)$116.30/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3187—None
AARP Medicare Rx Preferred from UHC (PDP)$147.00/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4571$2.746 units
  • Quantity limit 6 per 30 days
Blue MedicareRx Plus (PDP)$67.40/mo premium · $0.00 deductible3Preferred Brand20%20%$0.7888—None
Blue MedicareRx Essentials (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$0.7693—None
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.6376—None
Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible4Non-Preferred Drug26%26%$0.6431—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.

California — 8 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$104.60/mo premium · $601.00 deductible2Generic$0.00$0.00$0.4106—None
Humana Basic Rx Plan (PDP)$132.20/mo premium · $615.00 deductible2Generic$1.00$0.00$0.4074—None
AARP Medicare Rx Preferred from UHC (PDP)$165.40/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4996$3.006 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$172.90/mo premium · $0.00 deductible2Generic$4.00$0.00$0.4074—None
Blue Shield Rx Enhanced (PDP)$227.80/mo premium · $0.00 deductible3Preferred Brand19%19%$0.3300—None
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.6795—None
Wellcare Classic (PDP)$6.20/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$0.6797—None
Blue Shield Rx Plus (PDP)$199.70/mo premium · $615.00 deductible4Non-Preferred Drug49%49%$0.3300—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.

New Jersey — 7 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$4.40/mo premium · $615.00 deductible2Generic$1.00$0.00$0.4334—None
Humana Value Rx Plan (PDP)$35.60/mo premium · $601.00 deductible2Generic$0.00$0.00$0.4360—None
Humana Premier Rx Plan (PDP)$111.90/mo premium · $0.00 deductible2Generic$4.00$0.00$0.4334—None
AARP Medicare Rx Preferred from UHC (PDP)$118.90/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4863$2.926 units
  • Quantity limit 6 per 30 days
Horizon Medicare Blue Rx Enhanced (PDP)$139.10/mo premium · $200.00 deductible3Preferred Brand20%20%$0.5529—None
Wellcare Value Script (PDP)$22.80/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.6906—None
Wellcare Classic (PDP)$28.20/mo premium · $615.00 deductible4Non-Preferred Drug29%29%$0.6906—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.

Pennsylvania and West Virginia — 7 plans, 2 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$6.60/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3703—None
Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3761—None
AARP Medicare Rx Preferred from UHC (PDP)$121.90/mo premium · $130.00 deductible2Generic$10.00$0.00$0.5103$3.066 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$123.60/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3703—None
Wellcare Value Script (PDP)$8.20/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.6613—None
Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible4Non-Preferred Drug28%28%$0.6614—None
SilverScript Choice (PDP)$22.70/mo premium · $615.00 deductible4Non-Preferred Drug35%35%$0.3999—
  • Prior authorization

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 — 7 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$6.80/mo premium · $615.00 deductible2Generic$1.00$0.00$0.4006—None
Humana Value Rx Plan (PDP)$32.00/mo premium · $601.00 deductible2Generic$0.00$0.00$0.4096—None
Humana Premier Rx Plan (PDP)$110.90/mo premium · $0.00 deductible2Generic$4.00$0.00$0.4006—None
AARP Medicare Rx Preferred from UHC (PDP)$119.80/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4750$2.856 units
  • Quantity limit 6 per 30 days
Blue Medicare Rx Enhanced (PDP)$163.20/mo premium · $0.00 deductible3Preferred Brand$45.00$135.00$0.5117—None
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.6699—None
Wellcare Classic (PDP)$4.70/mo premium · $615.00 deductible4Non-Preferred Drug27%27%$0.6699—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.

Florida — 7 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$25.90/mo premium · $601.00 deductible2Generic$0.00$0.00$0.4492—None
Humana Basic Rx Plan (PDP)$92.70/mo premium · $615.00 deductible2Generic$1.00$0.00$0.4414—None
Humana Premier Rx Plan (PDP)$115.90/mo premium · $0.00 deductible2Generic$4.00$0.00$0.4414—None
AARP Medicare Rx Preferred from UHC (PDP)$119.10/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4146$2.496 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug28%28%$0.6774—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.6779—None
BlueMedicare Complete Rx (PDP)$217.00/mo premium · $615.00 deductible4Non-Preferred Drug29%29%$0.5100—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.

Alabama and Tennessee — 7 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3844—None
Humana Value Rx Plan (PDP)$37.70/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3943—None
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3844—None
AARP Medicare Rx Preferred from UHC (PDP)$119.30/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4618$2.776 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.6109—None
Wellcare Classic (PDP)$3.70/mo premium · $615.00 deductible4Non-Preferred Drug27%27%$0.6117—None
BlueRx Enhanced Plus (PDP)$129.50/mo premium · $150.00 deductible4Non-Preferred Drug42%42%$0.5580—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.

Indiana and Kentucky — 7 plans, 2 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3674—None
Humana Value Rx Plan (PDP)$9.90/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3770—None
Humana Premier Rx Plan (PDP)$125.30/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3674—None
AARP Medicare Rx Preferred from UHC (PDP)$127.10/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4743$2.856 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$8.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.6301—None
Wellcare Classic (PDP)$8.70/mo premium · $615.00 deductible4Non-Preferred Drug27%27%$0.6295—None
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible4Non-Preferred Drug35%35%$0.4421—
  • Prior authorization

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 — 7 plans, 2 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3928—None
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible2Generic$0.00$0.00$0.4027—None
Humana Premier Rx Plan (PDP)$110.60/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3928—None
AARP Medicare Rx Preferred from UHC (PDP)$113.90/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4468$2.686 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug26%26%$0.6092—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.6066—None
SilverScript Choice (PDP)$26.70/mo premium · $615.00 deductible4Non-Preferred Drug35%35%$0.4155—
  • Prior authorization

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 — 7 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3819—None
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3912—None
AARP Medicare Rx Preferred from UHC (PDP)$103.90/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4148$2.496 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$119.40/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3819—None
Blue Cross MedicareRx Value (PDP)$119.70/mo premium · $615.00 deductible3Preferred Brand18%18%$0.5809—None
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$0.7040—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.7029—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.

Louisiana — 7 plans, 2 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3793—None
Humana Value Rx Plan (PDP)$19.30/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3917—None
Humana Premier Rx Plan (PDP)$113.70/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3793—None
AARP Medicare Rx Preferred from UHC (PDP)$139.50/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4807$2.886 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.5870—None
Wellcare Classic (PDP)$6.70/mo premium · $615.00 deductible4Non-Preferred Drug28%28%$0.5909—None
SilverScript Choice (PDP)$44.70/mo premium · $615.00 deductible4Non-Preferred Drug35%35%$0.4211—
  • Prior authorization

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 — 7 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$22.90/mo premium · $601.00 deductible2Generic$0.00$0.00$0.4059—None
Humana Basic Rx Plan (PDP)$41.70/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3945—None
AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4098$2.466 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$118.20/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3945—None
Blue Cross MedicareRx Value (PDP)$167.40/mo premium · $615.00 deductible3Preferred Brand18%18%$0.5597—None
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug29%29%$0.6442—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.6442—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.

Oklahoma — 7 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$2.00$0.00$0.3684—None
Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3920—None
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3684—None
AARP Medicare Rx Preferred from UHC (PDP)$121.00/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4419$2.656 units
  • Quantity limit 6 per 30 days
Blue Cross MedicareRx Value (PDP)$167.30/mo premium · $615.00 deductible3Preferred Brand18%18%$0.5163—None
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.5549—None
Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible4Non-Preferred Drug26%26%$0.5574—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.

Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming — 7 plans, 2 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$4.70/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3445—None
Humana Value Rx Plan (PDP)$20.80/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3515—None
Humana Premier Rx Plan (PDP)$103.70/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3445—None
AARP Medicare Rx Preferred from UHC (PDP)$140.20/mo premium · $130.00 deductible2Generic$10.00$0.00$0.5166$3.106 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.6682—None
Wellcare Classic (PDP)$12.70/mo premium · $615.00 deductible4Non-Preferred Drug27%27%$0.6740—None
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible4Non-Preferred Drug35%35%$0.3966—
  • Prior authorization

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 — 7 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.4117—None
Humana Value Rx Plan (PDP)$69.60/mo premium · $601.00 deductible2Generic$0.00$0.00$0.4264—None
Humana Premier Rx Plan (PDP)$75.60/mo premium · $0.00 deductible2Generic$4.00$0.00$0.4117—None
AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3992$2.406 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$0.6559—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.6555—None
Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible4Non-Preferred Drug33%33%$0.5178—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.

Idaho and Utah — 7 plans, 2 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3443—None
Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3566—None
Humana Premier Rx Plan (PDP)$115.50/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3443—None
AARP Medicare Rx Preferred from UHC (PDP)$132.60/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4619$2.776 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.5630—None
Wellcare Classic (PDP)$23.70/mo premium · $615.00 deductible4Non-Preferred Drug27%27%$0.5635—None
SilverScript Choice (PDP)$27.70/mo premium · $615.00 deductible4Non-Preferred Drug35%35%$0.3920—
  • Prior authorization

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 — 7 plans, 2 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.40/mo premium · $615.00 deductible2Generic$4.00$0.00$0.4756—None
Humana Value Rx Plan (PDP)$51.60/mo premium · $601.00 deductible2Generic$0.00$0.00$0.4792—None
Humana Premier Rx Plan (PDP)$90.20/mo premium · $0.00 deductible2Generic$4.00$0.00$0.4756—None
AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible2Generic$10.00$0.00$0.5042$3.036 units
  • Quantity limit 6 per 30 days
SilverScript Choice (PDP)$14.70/mo premium · $615.00 deductible4Non-Preferred Drug35%35%$0.6680—
  • Prior authorization
Wellcare Value Script (PDP)$21.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.8068—None
Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible4Non-Preferred Drug35%35%$0.8077—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.

Maine and New Hampshire — 6 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3653—None
Humana Value Rx Plan (PDP)$54.40/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3739—None
AARP Medicare Rx Preferred from UHC (PDP)$104.30/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4543$2.736 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$150.20/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3653—None
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug27%27%$0.6335—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.6334—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.

New York — 6 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$140.90/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3915—None
Humana Value Rx Plan (PDP)$158.90/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3937—None
AARP Medicare Rx Preferred from UHC (PDP)$163.70/mo premium · $130.00 deductible2Generic$10.00$0.00$0.5139$3.086 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$173.60/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3915—None
Wellcare Value Script (PDP)$42.40/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.6279—None
Wellcare Classic (PDP)$45.70/mo premium · $615.00 deductible4Non-Preferred Drug28%28%$0.6262—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.

Delaware, DC and Maryland — 6 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3882—None
Humana Value Rx Plan (PDP)$4.30/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3920—None
AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4566$2.746 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3882—None
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.6626—None
Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$0.6626—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.

Virginia — 6 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.4130—None
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible2Generic$0.00$0.00$0.4220—None
Humana Premier Rx Plan (PDP)$87.60/mo premium · $0.00 deductible2Generic$4.00$0.00$0.4130—None
AARP Medicare Rx Preferred from UHC (PDP)$100.80/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4480$2.696 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$0.7036—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.7036—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.

South Carolina — 6 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$10.10/mo premium · $615.00 deductible2Generic$2.00$0.00$0.4104—None
Humana Value Rx Plan (PDP)$65.60/mo premium · $601.00 deductible2Generic$0.00$0.00$0.4203—None
AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4593$2.766 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$145.60/mo premium · $0.00 deductible2Generic$4.00$0.00$0.4104—None
Wellcare Value Script (PDP)$4.80/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.6835—None
Wellcare Classic (PDP)$9.70/mo premium · $615.00 deductible4Non-Preferred Drug27%27%$0.6835—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.

Georgia — 6 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3741—None
Humana Value Rx Plan (PDP)$36.40/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3867—None
Humana Premier Rx Plan (PDP)$129.50/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3741—None
AARP Medicare Rx Preferred from UHC (PDP)$139.80/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4576$2.756 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug28%28%$0.6260—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.6259—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.

Ohio — 6 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3679—None
Humana Value Rx Plan (PDP)$23.70/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3745—None
Humana Premier Rx Plan (PDP)$117.60/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3679—None
AARP Medicare Rx Preferred from UHC (PDP)$123.40/mo premium · $130.00 deductible2Generic$10.00$0.00$0.5369$3.226 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$7.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.6848—None
Wellcare Classic (PDP)$7.70/mo premium · $615.00 deductible4Non-Preferred Drug27%27%$0.6852—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.

Missouri — 6 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$16.50/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3992—None
Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible2Generic$0.00$0.00$0.4162—None
AARP Medicare Rx Preferred from UHC (PDP)$125.40/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4543$2.736 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$126.40/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3992—None
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.6202—None
Wellcare Classic (PDP)$10.70/mo premium · $615.00 deductible4Non-Preferred Drug26%26%$0.6232—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.

Mississippi — 6 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3518—None
Humana Value Rx Plan (PDP)$37.60/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3680—None
Humana Premier Rx Plan (PDP)$89.90/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3518—None
AARP Medicare Rx Preferred from UHC (PDP)$140.60/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4668$2.806 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug29%29%$0.5604—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.5588—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.

Colorado — 6 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3309—None
Humana Value Rx Plan (PDP)$48.50/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3433—None
Humana Premier Rx Plan (PDP)$137.10/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3309—None
AARP Medicare Rx Preferred from UHC (PDP)$151.90/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4525$2.716 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.6693—None
Wellcare Classic (PDP)$2.20/mo premium · $615.00 deductible4Non-Preferred Drug29%29%$0.6700—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.

Arizona — 6 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$0.00$0.4129—None
Humana Value Rx Plan (PDP)$2.50/mo premium · $601.00 deductible2Generic$0.00$0.00$0.4221—None
AARP Medicare Rx Preferred from UHC (PDP)$97.50/mo premium · $130.00 deductible2Generic$10.00$0.00$0.5505$3.306 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$119.20/mo premium · $0.00 deductible2Generic$4.00$0.00$0.4129—None
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug32%32%$0.7048—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.7084—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.

Nevada — 6 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3832—None
Humana Value Rx Plan (PDP)$43.70/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3987—None
AARP Medicare Rx Preferred from UHC (PDP)$139.10/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4295$2.586 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$148.70/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3832—None
Wellcare Classic (PDP)$2.70/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$0.6259—None
Wellcare Value Script (PDP)$2.70/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.6259—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.

Oregon and Washington — 6 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3422—None
Humana Value Rx Plan (PDP)$22.10/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3501—None
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3422—None
AARP Medicare Rx Preferred from UHC (PDP)$110.00/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4589$2.756 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug28%28%$0.6561—None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.6556—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.

Alaska — 6 plans, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$0.00$0.3230—None
Humana Value Rx Plan (PDP)$10.60/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3337—None
AARP Medicare Rx Preferred from UHC (PDP)$100.20/mo premium · $130.00 deductible2Generic$10.00$0.00$0.8710$5.236 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$112.40/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3230—None
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug28%28%$0.6989—None
Wellcare Value Script (PDP)$19.70/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.6989—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, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible2Generic25%25%$0.6771$4.066 units
  • Quantity limit 6 per 30 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 — elsewhere it depends on what is prescribed.

Guam — 1 plan, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible2Generic25%25%$0.6771$4.066 units
  • Quantity limit 6 per 30 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 — elsewhere it depends on what is prescribed.

Northern Mariana Islands — 1 plan, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$32.10/mo premium · $615.00 deductible2Generic25%25%$0.6771$4.066 units
  • Quantity limit 6 per 30 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 — elsewhere it depends on what is prescribed.

Puerto Rico — 1 plan, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$145.10/mo premium · $615.00 deductible2Generic25%25%$0.4695$2.826 units
  • Quantity limit 6 per 30 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 — elsewhere it depends on what is prescribed.

U.S. Virgin Islands — 1 plan, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $615.00 deductible2Generic25%25%$0.6771$4.066 units
  • Quantity limit 6 per 30 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 — elsewhere it depends on what is prescribed.