TRAMADOL HYDROCHLORIDE 100 mg Tablet, Extended Release
Coverage in Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming (CMS PDP Region 25).
6 of 11 stand-alone Part D plans in Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming cover this drug on tier 4.
5 of 6 plans apply a prior authorization, step therapy or quantity limit.
Every plan that covers it
Showing 6 of 6 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$4.70/mo premium · $615.00 deductible · $0 with full Extra Help | 4Non-Preferred Drug | 34% | — | $1.9107 | $5.733 units |
|
| Humana Value Rx Plan (PDP)$20.80/mo premium · $601.00 deductible | 4Non-Preferred Drug | 34% | — | $1.9343 | $5.803 units |
|
| SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible · $0 with full Extra Help | 4Non-Preferred Drug | 35% | 35% | $1.7054 | $5.123 units |
|
| HealthSpring Extra Rx (PDP)$66.50/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $1.6174 | — | None |
| MedicareBlue Rx Standard (PDP)$101.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 42% | 42% | $1.7670 | $5.303 units |
|
| Humana Premier Rx Plan (PDP)$103.70/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $1.8974 | $5.693 units |
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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.
Medicare Advantage plans
Medicare Advantage plans carry their own formularies, separate from stand-alone Part D, and are sold county by county. Pick a county to see every Medicare Advantage drug plan there that covers this drug.
94 Medicare Advantage plans in IA, MN, MT, ND, NE, SD, WY do cover it
A patient on an MA-PD plan may have coverage even where no PDP lists the drug. IA: 17 plans · MN: 29 plans · MT: 20 plans · ND: 4 plans · NE: 16 plans · SD: 4 plans · WY: 4 plans.