GLYBURIDE AND METFORMIN HYDROCHLORIDE 1.25/250 mg Tablet, Film Coated
Coverage in New Mexico (CMS PDP Region 26).
1 of 11 stand-alone Part D plans in New Mexico cover this drug on tier 3.
1 of 1 plans apply a prior authorization, step therapy or quantity limit.
11 Medicare Advantage plans in NM 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. NM: 11 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible | 3Preferred Brand | 14% | 14% | $0.3010 | $7.2224 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.