MedicarePartD.guide

A non-government resource built from CMS public data

OSELTAMIVIR PHOSPHATE 6 mg/mL Powder, For Suspension

Coverage in New Mexico (CMS PDP Region 26).

11 of 11 stand-alone Part D plans in New Mexico cover this drug on tier 3–4.

10 of 11 plans apply a prior authorization, step therapy or quantity limit.

67 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: 67 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible3Preferred Brand16%16%$0.2930$22.8578 units
  • Quantity limit 78 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible3Preferred Brand16%16%$0.2930$22.8578 units
  • Quantity limit 78 per 30 days
SilverScript Choice (PDP)$104.00/mo premium · $615.00 deductible3Preferred Brand18%18%$0.5489$4.949 units
  • Quantity limit 108 per 365 days
Blue Cross MedicareRx Basic (PDP)$145.40/mo premium · $615.00 deductible3Preferred Brand18%18%$0.8854$7.979 units
  • Quantity limit 108 per 365 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$0.5458$4.919 units
  • Quantity limit 108 per 365 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$0.5458$4.919 units
  • Quantity limit 108 per 365 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug29%29%$0.4273—None
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug32%—$0.2950$3.5412 units
  • Quantity limit 144 per 365 days
Humana Value Rx Plan (PDP)$69.60/mo premium · $601.00 deductible4Non-Preferred Drug30%—$0.2970$3.5612 units
  • Quantity limit 144 per 365 days
Humana Premier Rx Plan (PDP)$75.60/mo premium · $0.00 deductible4Non-Preferred Drug50%50%$0.2939$3.5312 units
  • Quantity limit 144 per 365 days
Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible4Non-Preferred Drug33%33%$0.8585$7.739 units
  • Quantity limit 108 per 365 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.

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