MedicarePartD.guide

A non-government resource built from CMS public data

KINERET 100 mg/.67mL Injection, Solution

Also known as Anakinra. Package: 7 SYRINGE, GLASS in 1 CARTON (66658-234-07) / .67 mL in 1 SYRINGE, GLASS. NDC 66658023407.

Plans covering it
243
across 39 regions checked
Lowest tier
5
lower tiers cost less
Plans with restrictions
243
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
Pennsylvania and West Virginia9 of 125—9 of 9 plans
Michigan9 of 125—9 of 9 plans
Arkansas9 of 125—9 of 9 plans
Connecticut, Massachusetts, Rhode Island and Vermont8 of 115—8 of 8 plans
South Carolina8 of 115—8 of 8 plans
New York7 of 105—7 of 7 plans
New Jersey7 of 125—7 of 7 plans
Delaware, DC and Maryland7 of 105—7 of 7 plans
North Carolina7 of 125—7 of 7 plans
Georgia7 of 105—7 of 7 plans
Alabama and Tennessee7 of 125—7 of 7 plans
Ohio7 of 105—7 of 7 plans
Indiana and Kentucky7 of 105—7 of 7 plans
Wisconsin7 of 105—7 of 7 plans
Illinois7 of 125—7 of 7 plans
Missouri7 of 105—7 of 7 plans
Mississippi7 of 105—7 of 7 plans
Louisiana7 of 105—7 of 7 plans
Texas7 of 125—7 of 7 plans
Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming7 of 115—7 of 7 plans
Colorado7 of 105—7 of 7 plans
Arizona7 of 105—7 of 7 plans
Nevada7 of 105—7 of 7 plans
Oregon and Washington7 of 105—7 of 7 plans
Idaho and Utah7 of 105—7 of 7 plans
California7 of 125—7 of 7 plans
Maine and New Hampshire6 of 95—6 of 6 plans
Virginia6 of 95—6 of 6 plans
Oklahoma6 of 115—6 of 6 plans
Kansas6 of 125—6 of 6 plans
New Mexico6 of 115—6 of 6 plans
Alaska6 of 95—6 of 6 plans
Florida5 of 105—5 of 5 plans
Hawaii5 of 85—5 of 5 plans
Puerto Rico3 of 35—3 of 3 plans
American Samoa1 of 15—1 of 1 plans
Guam1 of 15—1 of 1 plans
Northern Mariana Islands1 of 15—1 of 1 plans
U.S. Virgin Islands1 of 15—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.

Pennsylvania and West Virginia — 9 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$8.20/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
SilverScript Choice (PDP)$22.70/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
AARP Medicare Rx Saver from UHC (PDP)$43.50/mo premium · $615.00 deductible5Specialty Tier25%—$337.1408—
  • Prior authorization
HealthSpring Extra Rx (PDP)$62.60/mo premium · $615.00 deductible5Specialty Tier25%—$297.7145$5,954.2920 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Assurance Rx (PDP)$74.00/mo premium · $615.00 deductible5Specialty Tier25%—$297.7145$5,954.2920 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$121.90/mo premium · $130.00 deductible5Specialty Tier31%—$337.1408—
  • Prior authorization
Blue Rx PDP Complete (PDP)$164.80/mo premium · $200.00 deductible5Specialty Tier25%—$297.7145$5,954.2920 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
Blue Rx PDP Plus (PDP)$193.20/mo premium · $615.00 deductible5Specialty Tier25%25%$297.7145$5,954.2920 units
  • Prior authorization
  • Quantity limit 18.76 per 28 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.

Michigan — 9 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$297.2435$5,944.8720 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$14.10/mo premium · $615.00 deductible5Specialty Tier25%—$337.1408—
  • Prior authorization
HealthSpring Extra Rx (PDP)$50.40/mo premium · $615.00 deductible5Specialty Tier25%—$297.2435$5,944.8720 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
SilverScript Choice (PDP)$78.30/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
AARP Medicare Rx Preferred from UHC (PDP)$78.30/mo premium · $130.00 deductible5Specialty Tier31%—$337.1408—
  • Prior authorization
Prescription Blue Select (PDP)$78.40/mo premium · $615.00 deductible5Specialty Tier25%—$322.8109$6,456.2220 units
  • Prior authorization
  • Quantity limit 18.8 per 28 days
Prescription Blue Premium (PDP)$106.70/mo premium · $0.00 deductible5Specialty Tier33%—$322.8109$6,456.2220 units
  • Prior authorization
  • Quantity limit 18.8 per 28 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.

Arkansas — 9 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$320.6849$6,413.7020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
BlueMedicare Value Rx (PDP)$52.50/mo premium · $615.00 deductible5Specialty Tier25%—$345.4522$6,909.0420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
HealthSpring Extra Rx (PDP)$54.50/mo premium · $615.00 deductible5Specialty Tier25%—$320.6415$6,412.8320 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$65.10/mo premium · $615.00 deductible5Specialty Tier25%—$350.0612—
  • Prior authorization
SilverScript Choice (PDP)$73.50/mo premium · $615.00 deductible5Specialty Tier25%—$355.3862$7,107.7220 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
AARP Medicare Rx Preferred from UHC (PDP)$114.90/mo premium · $130.00 deductible5Specialty Tier31%—$350.0612—
  • Prior authorization
BlueMedicare Premier Rx (PDP)$181.20/mo premium · $0.00 deductible5Specialty Tier33%—$345.4522$6,909.0420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 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.

Connecticut, Massachusetts, Rhode Island and Vermont — 8 plans, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$16.40/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Blue MedicareRx Value Plus (PDP)$20.70/mo premium · $615.00 deductible5Specialty Tier25%—$321.3940$6,427.8820 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible5Specialty Tier25%—$337.1408—
  • Prior authorization
HealthSpring Assurance Rx (PDP)$139.30/mo premium · $615.00 deductible5Specialty Tier25%—$298.3817$5,967.6320 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible5Specialty Tier31%—$337.1408—
  • Prior authorization
Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible5Specialty Tier33%—$321.3940$6,427.8820 units
  • Prior authorization
  • Quantity limit 18.76 per 28 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.

South Carolina — 8 plans, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$4.80/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Classic (PDP)$9.70/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible5Specialty Tier25%—$314.5400$6,290.8020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
SilverScript Choice (PDP)$98.40/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
AARP Medicare Rx Saver from UHC (PDP)$122.10/mo premium · $615.00 deductible5Specialty Tier25%—$337.1408—
  • Prior authorization
AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible5Specialty Tier31%—$337.1408—
  • Prior authorization
BlueCross Rx Value (PDP)$139.70/mo premium · $615.00 deductible5Specialty Tier25%—$333.7088—
  • Prior authorization
HealthSpring Assurance Rx (PDP)$152.50/mo premium · $615.00 deductible5Specialty Tier25%—$314.5400$6,290.8020 units
  • Prior authorization
  • Quantity limit 20.1 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.

New York — 7 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$35.70/mo premium · $615.00 deductible5Specialty Tier25%—$298.3109$5,966.2220 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Value Script (PDP)$42.40/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Classic (PDP)$45.70/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Extra Rx (PDP)$91.60/mo premium · $615.00 deductible5Specialty Tier25%—$298.3109$5,966.2220 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$105.80/mo premium · $615.00 deductible5Specialty Tier25%—$337.1408—
  • Prior authorization
SilverScript Choice (PDP)$116.00/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
AARP Medicare Rx Preferred from UHC (PDP)$163.70/mo premium · $130.00 deductible5Specialty Tier31%—$337.1408—
  • 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 Jersey — 7 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$22.80/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Classic (PDP)$28.20/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Extra Rx (PDP)$59.90/mo premium · $615.00 deductible5Specialty Tier25%—$320.6415$6,412.8320 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$77.40/mo premium · $615.00 deductible5Specialty Tier25%—$350.0612—
  • Prior authorization
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible5Specialty Tier25%—$355.3862$7,107.7220 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
HealthSpring Assurance Rx (PDP)$109.30/mo premium · $615.00 deductible5Specialty Tier25%—$320.6849$6,413.7020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$118.90/mo premium · $130.00 deductible5Specialty Tier31%—$350.0612—
  • 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.

Delaware, DC and Maryland — 7 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Assurance Rx (PDP)$32.60/mo premium · $615.00 deductible5Specialty Tier25%—$296.6225$5,932.4520 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$37.80/mo premium · $615.00 deductible5Specialty Tier25%—$336.5800—
  • Prior authorization
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible5Specialty Tier25%—$296.6225$5,932.4520 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible5Specialty Tier31%—$336.5800—
  • Prior authorization
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 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.

North Carolina — 7 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Classic (PDP)$4.70/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$56.90/mo premium · $615.00 deductible5Specialty Tier25%—$337.1408—
  • Prior authorization
HealthSpring Extra Rx (PDP)$78.00/mo premium · $615.00 deductible5Specialty Tier25%—$303.6170$6,072.3420 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
SilverScript Choice (PDP)$90.20/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
HealthSpring Assurance Rx (PDP)$110.40/mo premium · $615.00 deductible5Specialty Tier25%—$303.6170$6,072.3420 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$119.80/mo premium · $130.00 deductible5Specialty Tier31%—$337.1408—
  • 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.

Georgia — 7 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible5Specialty Tier25%—$297.5800$5,951.6020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$98.00/mo premium · $615.00 deductible5Specialty Tier25%—$337.1408—
  • Prior authorization
SilverScript Choice (PDP)$100.70/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
AARP Medicare Rx Preferred from UHC (PDP)$139.80/mo premium · $130.00 deductible5Specialty Tier31%—$337.1408—
  • Prior authorization
HealthSpring Assurance Rx (PDP)$149.30/mo premium · $615.00 deductible5Specialty Tier25%—$297.5800$5,951.6020 units
  • Prior authorization
  • Quantity limit 20.1 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.

Alabama and Tennessee — 7 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Classic (PDP)$3.70/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$63.20/mo premium · $615.00 deductible5Specialty Tier25%—$331.8754—
  • Prior authorization
HealthSpring Extra Rx (PDP)$77.50/mo premium · $615.00 deductible5Specialty Tier25%—$320.6415$6,412.8320 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Assurance Rx (PDP)$87.20/mo premium · $615.00 deductible5Specialty Tier25%—$320.6849$6,413.7020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
SilverScript Choice (PDP)$97.30/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
AARP Medicare Rx Preferred from UHC (PDP)$119.30/mo premium · $130.00 deductible5Specialty Tier31%—$331.8754—
  • 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.

Ohio — 7 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$7.60/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Classic (PDP)$7.70/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Extra Rx (PDP)$65.70/mo premium · $615.00 deductible5Specialty Tier25%—$297.9850$5,959.7020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$73.70/mo premium · $615.00 deductible5Specialty Tier25%—$337.1408—
  • Prior authorization
SilverScript Choice (PDP)$90.30/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
HealthSpring Assurance Rx (PDP)$109.50/mo premium · $615.00 deductible5Specialty Tier25%—$297.9850$5,959.7020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$123.40/mo premium · $130.00 deductible5Specialty Tier31%—$337.1408—
  • 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.

Indiana and Kentucky — 7 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$8.60/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Classic (PDP)$8.70/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
HealthSpring Extra Rx (PDP)$78.20/mo premium · $615.00 deductible5Specialty Tier25%—$298.3513$5,967.0320 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$90.30/mo premium · $615.00 deductible5Specialty Tier25%—$337.1408—
  • Prior authorization
HealthSpring Assurance Rx (PDP)$117.80/mo premium · $615.00 deductible5Specialty Tier25%—$298.3513$5,967.0320 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$127.10/mo premium · $130.00 deductible5Specialty Tier31%—$337.1408—
  • 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, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$297.9850$5,959.7020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$337.1408—
  • Prior authorization
SilverScript Choice (PDP)$26.70/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible5Specialty Tier25%—$297.9850$5,959.7020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$113.90/mo premium · $130.00 deductible5Specialty Tier31%—$337.1408—
  • 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, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$40.20/mo premium · $615.00 deductible5Specialty Tier25%—$337.1408—
  • Prior authorization
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible5Specialty Tier25%—$320.6415$6,412.8320 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
AARP Medicare Rx Preferred from UHC (PDP)$103.90/mo premium · $130.00 deductible5Specialty Tier31%—$337.1408—
  • Prior authorization
HealthSpring Assurance Rx (PDP)$104.20/mo premium · $615.00 deductible5Specialty Tier25%—$320.6849$6,413.7020 units
  • Prior authorization
  • Quantity limit 20.1 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.

Missouri — 7 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Classic (PDP)$10.70/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible5Specialty Tier25%—$298.2167$5,964.3320 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$71.90/mo premium · $615.00 deductible5Specialty Tier25%—$337.1408—
  • Prior authorization
HealthSpring Assurance Rx (PDP)$74.30/mo premium · $615.00 deductible5Specialty Tier25%—$298.2167$5,964.3320 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
AARP Medicare Rx Preferred from UHC (PDP)$125.40/mo premium · $130.00 deductible5Specialty Tier31%—$337.1408—
  • 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.

Mississippi — 7 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Assurance Rx (PDP)$59.70/mo premium · $615.00 deductible5Specialty Tier25%—$320.6849$6,413.7020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Extra Rx (PDP)$77.10/mo premium · $615.00 deductible5Specialty Tier25%—$320.6415$6,412.8320 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$84.70/mo premium · $615.00 deductible5Specialty Tier25%—$350.0612—
  • Prior authorization
SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible5Specialty Tier25%—$355.3862$7,107.7220 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
AARP Medicare Rx Preferred from UHC (PDP)$140.60/mo premium · $130.00 deductible5Specialty Tier31%—$350.0612—
  • 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.

Louisiana — 7 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Classic (PDP)$6.70/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$37.00/mo premium · $615.00 deductible5Specialty Tier25%—$337.1408—
  • Prior authorization
SilverScript Choice (PDP)$44.70/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
HealthSpring Assurance Rx (PDP)$48.40/mo premium · $615.00 deductible5Specialty Tier25%—$299.2000$5,984.0020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Extra Rx (PDP)$60.60/mo premium · $615.00 deductible5Specialty Tier25%—$299.2000$5,984.0020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.50/mo premium · $130.00 deductible5Specialty Tier31%—$337.1408—
  • 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, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Extra Rx (PDP)$70.00/mo premium · $615.00 deductible5Specialty Tier25%—$297.5206$5,950.4120 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$89.20/mo premium · $615.00 deductible5Specialty Tier25%—$336.3389—
  • Prior authorization
SilverScript Choice (PDP)$94.80/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
HealthSpring Assurance Rx (PDP)$111.40/mo premium · $615.00 deductible5Specialty Tier25%—$297.5206$5,950.4120 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $130.00 deductible5Specialty Tier31%—$336.3389—
  • 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.

Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming — 7 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Saver from UHC (PDP)$5.30/mo premium · $615.00 deductible5Specialty Tier25%—$333.5352—
  • Prior authorization
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Classic (PDP)$12.70/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
HealthSpring Extra Rx (PDP)$66.50/mo premium · $615.00 deductible5Specialty Tier25%—$304.5974$6,091.9520 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Assurance Rx (PDP)$125.90/mo premium · $615.00 deductible5Specialty Tier25%—$304.5974$6,091.9520 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$140.20/mo premium · $130.00 deductible5Specialty Tier31%—$333.5352—
  • 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.

Colorado — 7 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Classic (PDP)$2.20/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Assurance Rx (PDP)$61.70/mo premium · $615.00 deductible5Specialty Tier25%—$297.5800$5,951.6020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible5Specialty Tier25%—$297.5800$5,951.6020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
SilverScript Choice (PDP)$105.10/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
AARP Medicare Rx Saver from UHC (PDP)$125.00/mo premium · $615.00 deductible5Specialty Tier25%—$337.1408—
  • Prior authorization
AARP Medicare Rx Preferred from UHC (PDP)$151.90/mo premium · $130.00 deductible5Specialty Tier31%—$337.1408—
  • 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.

Arizona — 7 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$320.6849$6,413.7020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible5Specialty Tier25%—$350.0612—
  • Prior authorization
HealthSpring Extra Rx (PDP)$66.40/mo premium · $615.00 deductible5Specialty Tier25%—$320.6415$6,412.8320 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible5Specialty Tier25%—$355.3862$7,107.7220 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
AARP Medicare Rx Preferred from UHC (PDP)$97.50/mo premium · $130.00 deductible5Specialty Tier31%—$350.0612—
  • 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.

Nevada — 7 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$2.70/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Value Script (PDP)$2.70/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Extra Rx (PDP)$52.60/mo premium · $615.00 deductible5Specialty Tier25%—$320.6415$6,412.8320 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$76.70/mo premium · $615.00 deductible5Specialty Tier25%—$350.0612—
  • Prior authorization
HealthSpring Assurance Rx (PDP)$95.60/mo premium · $615.00 deductible5Specialty Tier25%—$320.6849$6,413.7020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible5Specialty Tier25%—$355.3862$7,107.7220 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
AARP Medicare Rx Preferred from UHC (PDP)$139.10/mo premium · $130.00 deductible5Specialty Tier31%—$350.0612—
  • 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.

Oregon and Washington — 7 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$303.7415$6,074.8320 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$38.40/mo premium · $615.00 deductible5Specialty Tier25%—$337.1408—
  • Prior authorization
HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible5Specialty Tier25%—$303.7415$6,074.8320 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
SilverScript Choice (PDP)$85.90/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
AARP Medicare Rx Preferred from UHC (PDP)$110.00/mo premium · $130.00 deductible5Specialty Tier31%—$337.1408—
  • 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.

Idaho and Utah — 7 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Classic (PDP)$23.70/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
SilverScript Choice (PDP)$27.70/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible5Specialty Tier25%—$289.8046$5,796.0920 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$56.50/mo premium · $615.00 deductible5Specialty Tier25%—$337.1408—
  • Prior authorization
HealthSpring Assurance Rx (PDP)$128.60/mo premium · $615.00 deductible5Specialty Tier25%—$289.8046$5,796.0920 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$132.60/mo premium · $130.00 deductible5Specialty Tier31%—$337.1408—
  • 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.

California — 7 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$295.7929$5,915.8620 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Classic (PDP)$6.20/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Extra Rx (PDP)$70.60/mo premium · $615.00 deductible5Specialty Tier25%—$295.7929$5,915.8620 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
SilverScript Choice (PDP)$103.60/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
AARP Medicare Rx Saver from UHC (PDP)$109.40/mo premium · $615.00 deductible5Specialty Tier25%—$325.8305—
  • Prior authorization
AARP Medicare Rx Preferred from UHC (PDP)$165.40/mo premium · $130.00 deductible5Specialty Tier31%—$325.8305—
  • 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.

Maine and New Hampshire — 6 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$314.5400$6,290.8020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible5Specialty Tier25%—$337.1408—
  • Prior authorization
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
AARP Medicare Rx Preferred from UHC (PDP)$104.30/mo premium · $130.00 deductible5Specialty Tier31%—$337.1408—
  • 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.

Virginia — 6 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$39.60/mo premium · $615.00 deductible5Specialty Tier25%—$332.4302—
  • Prior authorization
SilverScript Choice (PDP)$78.20/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
AARP Medicare Rx Preferred from UHC (PDP)$100.80/mo premium · $130.00 deductible5Specialty Tier31%—$332.4302—
  • Prior authorization
HealthSpring Assurance Rx (PDP)$133.80/mo premium · $615.00 deductible5Specialty Tier25%—$299.8393$5,996.7920 units
  • Prior authorization
  • Quantity limit 20.1 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.

Oklahoma — 6 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Extra Rx (PDP)$65.40/mo premium · $615.00 deductible5Specialty Tier25%—$297.5800$5,951.6020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible5Specialty Tier25%—$337.1408—
  • Prior authorization
AARP Medicare Rx Preferred from UHC (PDP)$121.00/mo premium · $130.00 deductible5Specialty Tier31%—$337.1408—
  • Prior authorization
HealthSpring Assurance Rx (PDP)$126.50/mo premium · $615.00 deductible5Specialty Tier25%—$297.5800$5,951.6020 units
  • Prior authorization
  • Quantity limit 20.1 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.

Kansas — 6 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$6.70/mo premium · $615.00 deductible5Specialty Tier25%—$283.0900$5,661.8020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
SilverScript Choice (PDP)$88.30/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
AARP Medicare Rx Saver from UHC (PDP)$105.40/mo premium · $615.00 deductible5Specialty Tier25%—$315.9433—
  • Prior authorization
AARP Medicare Rx Preferred from UHC (PDP)$147.00/mo premium · $130.00 deductible5Specialty Tier31%—$315.9433—
  • 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 — 6 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$320.6849$6,413.7020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$350.0612—
  • Prior authorization
AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible5Specialty Tier31%—$350.0612—
  • Prior authorization
SilverScript Choice (PDP)$104.00/mo premium · $615.00 deductible5Specialty Tier25%—$355.3862$7,107.7220 units
  • Prior authorization
  • Quantity limit 18.76 per 28 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.

Alaska — 6 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$320.6849$6,413.7020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Value Script (PDP)$19.70/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$53.20/mo premium · $615.00 deductible5Specialty Tier25%—$350.0612—
  • Prior authorization
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible5Specialty Tier25%—$355.3862$7,107.7220 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
AARP Medicare Rx Preferred from UHC (PDP)$100.20/mo premium · $130.00 deductible5Specialty Tier31%—$350.0612—
  • 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.

Florida — 5 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible5Specialty Tier25%—$343.1971$6,863.9420 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
AARP Medicare Rx Saver from UHC (PDP)$98.70/mo premium · $615.00 deductible5Specialty Tier25%—$323.5203—
  • Prior authorization
AARP Medicare Rx Preferred from UHC (PDP)$119.10/mo premium · $130.00 deductible5Specialty Tier31%—$323.5203—
  • 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 — 5 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$350.0612—
  • Prior authorization
SilverScript Choice (PDP)$14.70/mo premium · $615.00 deductible5Specialty Tier25%—$355.3862$7,107.7220 units
  • Prior authorization
  • Quantity limit 18.76 per 28 days
Wellcare Value Script (PDP)$21.60/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible5Specialty Tier25%—$403.7700$8,075.4020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible5Specialty Tier31%—$350.0612—
  • 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.

Puerto Rico — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible5Specialty Tier25%—$320.6415$6,412.8320 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
HealthSpring Assurance Rx (PDP)$65.70/mo premium · $615.00 deductible5Specialty Tier25%—$320.6849$6,413.7020 units
  • Prior authorization
  • Quantity limit 20.1 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$145.10/mo premium · $615.00 deductible5Specialty Tier25%25%$351.3946—
  • 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.

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 deductible5Specialty Tier25%25%$351.3946—
  • 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.

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 deductible5Specialty Tier25%25%$351.3946—
  • 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.

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 deductible5Specialty Tier25%25%$351.3946—
  • 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.

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 deductible5Specialty Tier25%25%$351.3946—
  • 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.