ACYCLOVIR 50 mg/g Ointment
Coverage in Nevada (CMS PDP Region 29).
1 of 10 stand-alone Part D plans in Nevada cover this drug on tier 4.
1 of 1 plans apply a prior authorization, step therapy or quantity limit.
64 Medicare Advantage plans in NV do cover it
Medicare Advantage plans carry their own formularies, separate from stand-alone Part D. A patient on an MA-PD plan may have coverage even where no PDP lists the drug. NV: 64 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP)$139.10/mo premium · $130.00 deductible | 4Non-Preferred Drug | 36% | — | $0.7756 | $2.333 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.