MedicarePartD.guide

A non-government resource built from CMS public data

PAROXETINE 30 mg Tablet, Film Coated

Package: 500 TABLET, FILM COATED in 1 BOTTLE (68382-099-05). NDC 68382009905.

Plans covering it
367
across 39 regions checked
Lowest tier
1
lower tiers cost less
Plans with restrictions
189
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
New Jersey12 of 121–2$0.007 of 12 plans
Pennsylvania and West Virginia12 of 121–2$0.007 of 12 plans
North Carolina12 of 121–2$0.007 of 12 plans
Alabama and Tennessee12 of 121–2$0.007 of 12 plans
Michigan12 of 121–2$0.007 of 12 plans
Illinois12 of 121–2$0.007 of 12 plans
Arkansas12 of 121–2$0.007 of 12 plans
Texas12 of 121–2$0.007 of 12 plans
Kansas12 of 122$0.007 of 12 plans
California12 of 121–2$0.005 of 12 plans
Connecticut, Massachusetts, Rhode Island and Vermont11 of 111–2$0.006 of 11 plans
South Carolina11 of 111–2$0.005 of 11 plans
Oklahoma11 of 111–2$0.006 of 11 plans
Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming11 of 111–2$0.006 of 11 plans
New Mexico11 of 112$0.006 of 11 plans
New York10 of 101–2$0.005 of 10 plans
Delaware, DC and Maryland10 of 101–2$0.005 of 10 plans
Georgia10 of 101–2$0.005 of 10 plans
Florida10 of 102$0.005 of 10 plans
Ohio10 of 101–2$0.005 of 10 plans
Indiana and Kentucky10 of 101–2$0.005 of 10 plans
Wisconsin10 of 101–2$0.005 of 10 plans
Missouri10 of 101–2$0.005 of 10 plans
Mississippi10 of 101–2$0.005 of 10 plans
Louisiana10 of 101–2$0.005 of 10 plans
Colorado10 of 101–2$0.005 of 10 plans
Arizona10 of 101–2$0.005 of 10 plans
Nevada10 of 101–2$0.005 of 10 plans
Oregon and Washington10 of 101–2$0.005 of 10 plans
Idaho and Utah10 of 101–2$0.005 of 10 plans
Maine and New Hampshire9 of 92$0.004 of 9 plans
Virginia9 of 92$0.004 of 9 plans
Alaska9 of 92$0.004 of 9 plans
Hawaii8 of 81–2$0.003 of 8 plans
Puerto Rico3 of 31–2$0.002 of 3 plans
American Samoa1 of 12—none
Guam1 of 12—none
Northern Mariana Islands1 of 12—none
U.S. Virgin Islands1 of 12—none

Plan-by-plan detail

Open a region to see every plan that covers this drug, with tier, cost-sharing and restrictions.

New Jersey — 12 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$59.90/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1144$0.696 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$4.40/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3007—None
Wellcare Value Script (PDP)$22.80/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1115$0.676 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$28.20/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2758$1.656 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$35.60/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3042—None
Horizon Medicare Blue Rx Standard (PDP)$72.30/mo premium · $615.00 deductible2Generic$3.00$4.50$0.1889$1.136 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$77.40/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2845—None
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2136$1.286 units
  • Prior authorization
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$109.30/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1641$0.986 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$111.90/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3007—None
AARP Medicare Rx Preferred from UHC (PDP)$118.90/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4988—None
Horizon Medicare Blue Rx Enhanced (PDP)$139.10/mo premium · $200.00 deductible2Generic$6.00$9.00$0.1889$1.136 units
  • Quantity limit 6 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.

Pennsylvania and West Virginia — 12 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
SilverScript Choice (PDP)$22.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0740$0.446 units
  • Prior authorization
  • Quantity limit 6 per 30 days
HealthSpring Extra Rx (PDP)$62.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1241$0.746 units
  • Quantity limit 6 per 30 days
Blue Rx PDP Complete (PDP)$164.80/mo premium · $200.00 deductible1Preferred Generic$0.00$0.00$0.1067—
  • Prior authorization
Blue Rx PDP Plus (PDP)$193.20/mo premium · $615.00 deductible1Preferred Generic25%25%$0.1067—
  • Prior authorization
Humana Basic Rx Plan (PDP)$6.60/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2784—None
Wellcare Value Script (PDP)$8.20/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1195$0.726 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2703$1.626 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible2Generic$0.00$0.00$0.2845—None
AARP Medicare Rx Saver from UHC (PDP)$43.50/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2802—None
HealthSpring Assurance Rx (PDP)$74.00/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1712$1.036 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$121.90/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4627—None
Humana Premier Rx Plan (PDP)$123.60/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2784—None

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 — 12 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$78.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1385$0.836 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1213$0.736 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$4.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2623$1.576 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$6.80/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2956—None
Humana Value Rx Plan (PDP)$32.00/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3037—None
AARP Medicare Rx Saver from UHC (PDP)$56.90/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2643—None
Blue Medicare Rx Standard (PDP)$83.90/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2750$1.656 units
  • Quantity limit 6 per 30 days
SilverScript Choice (PDP)$90.20/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2068$1.246 units
  • Prior authorization
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$110.40/mo premium · $615.00 deductible2Generic$2.00$2.00$0.2121$1.276 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$110.90/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2956—None
AARP Medicare Rx Preferred from UHC (PDP)$119.80/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4220—None
Blue Medicare Rx Enhanced (PDP)$163.20/mo premium · $0.00 deductible2Generic$6.00$18.00$0.2750$1.656 units
  • Quantity limit 6 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 — 12 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$77.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1438$0.866 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2802—None
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1213$0.736 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$3.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2416$1.456 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$37.70/mo premium · $601.00 deductible2Generic$0.00$0.00$0.2889—None
AARP Medicare Rx Saver from UHC (PDP)$63.20/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2545—None
BlueRx Essential (PDP)$76.20/mo premium · $615.00 deductible2Generic$10.00$20.00$0.2750$1.656 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$87.20/mo premium · $615.00 deductible2Generic$2.00$2.00$0.2084$1.256 units
  • Quantity limit 6 per 30 days
SilverScript Choice (PDP)$97.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1959$1.186 units
  • Prior authorization
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2802—None
AARP Medicare Rx Preferred from UHC (PDP)$119.30/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4022—None
BlueRx Enhanced Plus (PDP)$129.50/mo premium · $150.00 deductible2Generic$12.00$24.00$0.2750$1.656 units
  • Quantity limit 6 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.

Michigan — 12 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$50.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1237$0.746 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2576$1.556 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1171$0.706 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible2Generic10%10%$0.1750$1.056 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2743—None
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible2Generic$0.00$0.00$0.2795—None
AARP Medicare Rx Saver from UHC (PDP)$14.10/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2693—None
SilverScript Choice (PDP)$78.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2281$1.376 units
  • Prior authorization
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$78.30/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4447—None
Prescription Blue Select (PDP)$78.40/mo premium · $615.00 deductible2Generic$5.00$15.00$0.2179$1.316 units
  • Quantity limit 18 per 90 days
Humana Premier Rx Plan (PDP)$98.10/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2743—None
Prescription Blue Premium (PDP)$106.70/mo premium · $0.00 deductible2Generic$5.00$10.00$0.2179$1.316 units
  • Quantity limit 18 per 90 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.

Illinois — 12 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1153$0.696 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2983$1.796 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1232$0.746 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2860—None
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible2Generic$0.00$0.00$0.2914—None
AARP Medicare Rx Saver from UHC (PDP)$40.20/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2491—None
Blue Cross MedicareRx Basic (PDP)$89.70/mo premium · $615.00 deductible2Generic$5.00$15.00$0.2366$1.426 units
  • Quantity limit 6 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2533$1.526 units
  • Prior authorization
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$103.90/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3786—None
HealthSpring Assurance Rx (PDP)$104.20/mo premium · $615.00 deductible2Generic$2.00$2.00$0.2257$1.356 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$119.40/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2860—None
Blue Cross MedicareRx Value (PDP)$119.70/mo premium · $615.00 deductible2Generic$1.00$3.00$0.2601$1.566 units
  • Quantity limit 6 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.

Arkansas — 12 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$54.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1724$1.036 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.1986$1.196 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1330$0.806 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible2Generic10%10%$0.2287$1.376 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2522—None
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible2Generic$0.00$0.00$0.2659—None
BlueMedicare Value Rx (PDP)$52.50/mo premium · $615.00 deductible2Generic$5.00$15.00$0.2422—
  • Prior authorization
AARP Medicare Rx Saver from UHC (PDP)$65.10/mo premium · $615.00 deductible2Generic$7.00$27.00$0.2410—None
SilverScript Choice (PDP)$73.50/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1500$0.906 units
  • Prior authorization
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$92.40/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2522—None
AARP Medicare Rx Preferred from UHC (PDP)$114.90/mo premium · $130.00 deductible2Generic$10.00$54.00$0.3910—None
BlueMedicare Premier Rx (PDP)$181.20/mo premium · $0.00 deductible2Generic$5.00$15.00$0.2422—
  • 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 — 12 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$70.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1343$0.816 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2808$1.686 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1288$0.776 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$22.90/mo premium · $601.00 deductible2Generic$0.00$0.00$0.2924—None
Humana Basic Rx Plan (PDP)$41.70/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2834—None
AARP Medicare Rx Saver from UHC (PDP)$89.20/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2522—None
SilverScript Choice (PDP)$94.80/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2321$1.396 units
  • Prior authorization
  • Quantity limit 6 per 30 days
Blue Cross MedicareRx Basic (PDP)$104.70/mo premium · $615.00 deductible2Generic$5.00$15.00$0.2517$1.516 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$111.40/mo premium · $615.00 deductible2Generic$2.00$2.00$0.2057$1.236 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3790—None
Humana Premier Rx Plan (PDP)$118.20/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2834—None
Blue Cross MedicareRx Value (PDP)$167.40/mo premium · $615.00 deductible2Generic$1.00$3.00$0.2870$1.726 units
  • Quantity limit 6 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 — 12 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Blue MedicareRx Essentials (PDP)$0.00/mo premium · $615.00 deductible2Generic$0.00$0.00$0.2977$1.796 units
  • Quantity limit 6 per 30 days
Blue MedicareRx Value (PDP)$0.70/mo premium · $615.00 deductible2Generic$2.00$6.00$0.3113$1.876 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$6.70/mo premium · $615.00 deductible2Generic10%10%$0.2312$1.396 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1599$0.966 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible2Generic$9.00$27.00$0.2824$1.696 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$15.50/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2655—None
Humana Value Rx Plan (PDP)$55.60/mo premium · $601.00 deductible2Generic$0.00$0.00$0.2768—None
Blue MedicareRx Plus (PDP)$67.40/mo premium · $0.00 deductible2Generic$0.00$0.00$0.3113$1.876 units
  • Quantity limit 6 per 30 days
SilverScript Choice (PDP)$88.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2085$1.256 units
  • Prior authorization
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$105.40/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2512—None
Humana Premier Rx Plan (PDP)$116.30/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2655—None
AARP Medicare Rx Preferred from UHC (PDP)$147.00/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3936—None

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 — 12 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$70.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1164$0.706 units
  • Quantity limit 6 per 30 days
Blue Shield Rx Enhanced (PDP)$227.80/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.4357—None
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible2Generic10%10%$0.1770$1.066 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1159$0.706 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$6.20/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2751$1.656 units
  • Quantity limit 6 per 30 days
SilverScript Choice (PDP)$103.60/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2252$1.356 units
  • Prior authorization
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$104.60/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3018—None
AARP Medicare Rx Saver from UHC (PDP)$109.40/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2863—None
Humana Basic Rx Plan (PDP)$132.20/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2975—None
AARP Medicare Rx Preferred from UHC (PDP)$165.40/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4723—None
Humana Premier Rx Plan (PDP)$172.90/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2975—None
Blue Shield Rx Plus (PDP)$199.70/mo premium · $615.00 deductible2Generic$7.00$17.50$0.4357—None

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 — 11 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0754$0.456 units
  • Prior authorization
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$8.40/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3200—None
Wellcare Value Script (PDP)$16.40/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1149$0.696 units
  • Quantity limit 6 per 30 days
Blue MedicareRx Value Plus (PDP)$20.70/mo premium · $615.00 deductible2Generic$3.00$6.00$0.2171—
  • Prior authorization
Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.3008$1.806 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible2Generic$8.00$24.00$0.3056—None
Humana Value Rx Plan (PDP)$73.60/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3229—None
Humana Premier Rx Plan (PDP)$138.60/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3200—None
HealthSpring Assurance Rx (PDP)$139.30/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1681$1.016 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4976—None
Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible2Generic$7.00$14.00$0.2171—
  • 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.

South Carolina — 11 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1361$0.826 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$4.80/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1213$0.736 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$9.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2680$1.616 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$10.10/mo premium · $615.00 deductible2Generic$2.00$0.00$0.3009—None
Humana Value Rx Plan (PDP)$65.60/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3094—None
SilverScript Choice (PDP)$98.40/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2206$1.326 units
  • Prior authorization
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$122.10/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2682—None
AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4311—None
BlueCross Rx Value (PDP)$139.70/mo premium · $615.00 deductible2Generic$17.00$42.50$0.9247—None
Humana Premier Rx Plan (PDP)$145.60/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3009—None
HealthSpring Assurance Rx (PDP)$152.50/mo premium · $615.00 deductible2Generic$2.00$2.00$0.2013$1.216 units
  • Quantity limit 6 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 — 11 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$65.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1589$0.956 units
  • Quantity limit 6 per 30 days
Blue Cross MedicareRx Basic (PDP)$0.00/mo premium · $615.00 deductible2Generic$5.00$15.00$0.2871$1.726 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$2.00$0.00$0.2726—None
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1412$0.856 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2227$1.346 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible2Generic$0.00$0.00$0.2841—None
AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2396—None
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2726—None
AARP Medicare Rx Preferred from UHC (PDP)$121.00/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3935—None
HealthSpring Assurance Rx (PDP)$126.50/mo premium · $615.00 deductible2Generic$2.00$2.00$0.2271$1.366 units
  • Quantity limit 6 per 30 days
Blue Cross MedicareRx Value (PDP)$167.30/mo premium · $615.00 deductible2Generic$1.00$3.00$0.3382$2.036 units
  • Quantity limit 6 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.

Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming — 11 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0777$0.476 units
  • Prior authorization
  • Quantity limit 6 per 30 days
HealthSpring Extra Rx (PDP)$66.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1301$0.786 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$4.70/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2604—None
AARP Medicare Rx Saver from UHC (PDP)$5.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2486—None
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1378$0.836 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$12.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2791$1.676 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$20.80/mo premium · $601.00 deductible2Generic$0.00$0.00$0.2670—None
MedicareBlue Rx Standard (PDP)$101.00/mo premium · $615.00 deductible2Generic$1.00$3.00$0.2822$1.696 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$103.70/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2604—None
HealthSpring Assurance Rx (PDP)$125.90/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1791$1.076 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$140.20/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3874—None

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 — 11 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2785$1.676 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1409$0.856 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible2Generic10%10%$0.2719$1.636 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2930—None
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible2Generic$6.00$18.00$0.2234—None
Humana Value Rx Plan (PDP)$69.60/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3059—None
Humana Premier Rx Plan (PDP)$75.60/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2930—None
AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3348—None
SilverScript Choice (PDP)$104.00/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2428$1.466 units
  • Prior authorization
  • Quantity limit 6 per 30 days
Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible2Generic$4.00$12.00$0.3222$1.936 units
  • Quantity limit 6 per 30 days
Blue Cross MedicareRx Basic (PDP)$145.40/mo premium · $615.00 deductible2Generic$5.00$15.00$0.2734$1.646 units
  • Quantity limit 6 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 — 10 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$91.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1095$0.666 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$35.70/mo premium · $615.00 deductible2Generic10%10%$0.1568$0.946 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$42.40/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1138$0.686 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$45.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2576$1.556 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$105.80/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2792—None
SilverScript Choice (PDP)$116.00/mo premium · $615.00 deductible2Generic$6.00$18.00$0.2142$1.296 units
  • Prior authorization
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$140.90/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2806—None
Humana Value Rx Plan (PDP)$158.90/mo premium · $601.00 deductible2Generic$0.00$0.00$0.2835—None
AARP Medicare Rx Preferred from UHC (PDP)$163.70/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4743—None
Humana Premier Rx Plan (PDP)$173.60/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2806—None

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 — 10 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1123$0.676 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2922—None
Humana Value Rx Plan (PDP)$4.30/mo premium · $601.00 deductible2Generic$0.00$0.00$0.2968—None
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1132$0.686 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2835$1.706 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$32.60/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1795$1.086 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$37.80/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2708—None
AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4331—None
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2292$1.386 units
  • Prior authorization
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2922—None

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 — 10 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1444$0.876 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2610$1.576 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1232$0.746 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2806—None
Humana Value Rx Plan (PDP)$36.40/mo premium · $601.00 deductible2Generic$0.00$0.00$0.2875—None
AARP Medicare Rx Saver from UHC (PDP)$98.00/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2690—None
SilverScript Choice (PDP)$100.70/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2179$1.316 units
  • Prior authorization
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$129.50/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2806—None
AARP Medicare Rx Preferred from UHC (PDP)$139.80/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4245—None
HealthSpring Assurance Rx (PDP)$149.30/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1911$1.156 units
  • Quantity limit 6 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.

Florida — 10 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2852$1.716 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1177$0.716 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$25.90/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3197—None
Humana Basic Rx Plan (PDP)$92.70/mo premium · $615.00 deductible2Generic$1.00$0.00$0.3142—None
SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2469$1.486 units
  • Prior authorization
  • Quantity limit 6 per 30 days
BlueMedicare Premier Rx (PDP)$98.60/mo premium · $615.00 deductible2Generic$14.00$42.00$0.2270$1.366 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$98.70/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2608—None
Humana Premier Rx Plan (PDP)$115.90/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3142—None
AARP Medicare Rx Preferred from UHC (PDP)$119.10/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4040—None
BlueMedicare Complete Rx (PDP)$217.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.2270$1.366 units
  • Quantity limit 6 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.

Ohio — 10 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$65.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1387$0.836 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2713—None
Wellcare Value Script (PDP)$7.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1211$0.736 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$7.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2884$1.736 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$23.70/mo premium · $601.00 deductible2Generic$0.00$0.00$0.2783—None
AARP Medicare Rx Saver from UHC (PDP)$73.70/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2769—None
SilverScript Choice (PDP)$90.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2419$1.456 units
  • Prior authorization
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$109.50/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1947$1.176 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$117.60/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2713—None
AARP Medicare Rx Preferred from UHC (PDP)$123.40/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4742—None

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 — 10 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0752$0.456 units
  • Prior authorization
  • Quantity limit 6 per 30 days
HealthSpring Extra Rx (PDP)$78.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1512$0.916 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2764—None
Wellcare Value Script (PDP)$8.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1272$0.766 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$8.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2529$1.526 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$9.90/mo premium · $601.00 deductible2Generic$0.00$0.00$0.2843—None
AARP Medicare Rx Saver from UHC (PDP)$90.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2809—None
HealthSpring Assurance Rx (PDP)$117.80/mo premium · $615.00 deductible2Generic$2.00$2.00$0.2041$1.226 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$125.30/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2764—None
AARP Medicare Rx Preferred from UHC (PDP)$127.10/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4340—None

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 — 10 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
SilverScript Choice (PDP)$26.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0734$0.446 units
  • Prior authorization
  • Quantity limit 6 per 30 days
HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1368$0.826 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2577$1.556 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1273$0.766 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible2Generic10%10%$0.2256$1.356 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2937—None
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3022—None
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2422—None
Humana Premier Rx Plan (PDP)$110.60/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2937—None
AARP Medicare Rx Preferred from UHC (PDP)$113.90/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3722—None

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 — 10 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1476$0.896 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1509$0.916 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$10.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2677$1.616 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$16.50/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2912—None
Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3031—None
AARP Medicare Rx Saver from UHC (PDP)$71.90/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2495—None
HealthSpring Assurance Rx (PDP)$74.30/mo premium · $615.00 deductible2Generic$2.00$2.00$0.2226$1.346 units
  • Quantity limit 6 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1996$1.206 units
  • Prior authorization
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$125.40/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4009—None
Humana Premier Rx Plan (PDP)$126.40/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2912—None

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 — 10 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$77.10/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1625$0.986 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2101$1.266 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1305$0.786 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2598—None
Humana Value Rx Plan (PDP)$37.60/mo premium · $601.00 deductible2Generic$0.00$0.00$0.2710—None
HealthSpring Assurance Rx (PDP)$59.70/mo premium · $615.00 deductible2Generic$2.00$2.00$0.2158$1.296 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$84.70/mo premium · $615.00 deductible2Generic$6.00$18.00$0.2509—None
Humana Premier Rx Plan (PDP)$89.90/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2598—None
SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible2Generic$7.00$21.00$0.1667$1.006 units
  • Prior authorization
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$140.60/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4119—None

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 — 10 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
SilverScript Choice (PDP)$44.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0727$0.446 units
  • Prior authorization
  • Quantity limit 6 per 30 days
HealthSpring Extra Rx (PDP)$60.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1507$0.906 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2866—None
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1266$0.766 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$6.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2288$1.376 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$19.30/mo premium · $601.00 deductible2Generic$0.00$0.00$0.2977—None
AARP Medicare Rx Saver from UHC (PDP)$37.00/mo premium · $615.00 deductible2Generic$6.00$18.00$0.2463—None
HealthSpring Assurance Rx (PDP)$48.40/mo premium · $615.00 deductible2Generic$2.00$2.00$0.2199$1.326 units
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$113.70/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2866—None
AARP Medicare Rx Preferred from UHC (PDP)$139.50/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3952—None

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 — 10 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1545$0.936 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1291$0.776 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2647—None
Wellcare Classic (PDP)$2.20/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2852$1.716 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$48.50/mo premium · $601.00 deductible2Generic$0.00$0.00$0.2739—None
HealthSpring Assurance Rx (PDP)$61.70/mo premium · $615.00 deductible2Generic$2.00$2.00$0.2413$1.456 units
  • Quantity limit 6 per 30 days
SilverScript Choice (PDP)$105.10/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2578$1.556 units
  • Prior authorization
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$125.00/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2462—None
Humana Premier Rx Plan (PDP)$137.10/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2647—None
AARP Medicare Rx Preferred from UHC (PDP)$151.90/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3530—None

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 — 10 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$66.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1303$0.786 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.3078$1.856 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1357$0.816 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible2Generic10%10%$0.2355$1.416 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$0.00$0.3016—None
Humana Value Rx Plan (PDP)$2.50/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3096—None
AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2699—None
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2717$1.636 units
  • Prior authorization
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$97.50/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4610—None
Humana Premier Rx Plan (PDP)$119.20/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3016—None

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 — 10 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$52.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1385$0.836 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2969—None
Wellcare Classic (PDP)$2.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2927$1.766 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$2.70/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1221$0.736 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$43.70/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3058—None
AARP Medicare Rx Saver from UHC (PDP)$76.70/mo premium · $615.00 deductible2Generic$6.00$18.00$0.2589—None
HealthSpring Assurance Rx (PDP)$95.60/mo premium · $615.00 deductible2Generic$2.00$2.00$0.2307$1.386 units
  • Quantity limit 6 per 30 days
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2637$1.586 units
  • Prior authorization
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.10/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3822—None
Humana Premier Rx Plan (PDP)$148.70/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2969—None

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 — 10 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1323$0.796 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2869$1.726 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1336$0.806 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible2Generic10%10%$0.2204$1.326 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2549—None
Humana Value Rx Plan (PDP)$22.10/mo premium · $601.00 deductible2Generic$0.00$0.00$0.2616—None
AARP Medicare Rx Saver from UHC (PDP)$38.40/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2511—None
SilverScript Choice (PDP)$85.90/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2464$1.486 units
  • Prior authorization
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2549—None
AARP Medicare Rx Preferred from UHC (PDP)$110.00/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3808—None

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 — 10 plans, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
SilverScript Choice (PDP)$27.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0752$0.456 units
  • Prior authorization
  • Quantity limit 6 per 30 days
HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1555$0.936 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2451—None
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1221$0.736 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible2Generic$0.00$0.00$0.2532—None
Wellcare Classic (PDP)$23.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2322$1.396 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$56.50/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2532—None
Humana Premier Rx Plan (PDP)$115.50/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2451—None
HealthSpring Assurance Rx (PDP)$128.60/mo premium · $615.00 deductible2Generic$2.00$2.00$0.2100$1.266 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$132.60/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3920—None

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 — 9 plans, 4 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.3019$1.816 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1394$0.846 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible2Generic10%10%$0.2026$1.226 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2852—None
Humana Value Rx Plan (PDP)$54.40/mo premium · $601.00 deductible2Generic$0.00$0.00$0.2927—None
AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2497—None
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2477$1.496 units
  • Prior authorization
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$104.30/mo premium · $130.00 deductible2Generic$10.00$0.00$0.3680—None
Humana Premier Rx Plan (PDP)$150.20/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2852—None

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 — 9 plans, 4 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.2816$1.696 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1280$0.776 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$1.00$0.00$0.2954—None
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3041—None
AARP Medicare Rx Saver from UHC (PDP)$39.60/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2703—None
SilverScript Choice (PDP)$78.20/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2312$1.396 units
  • Prior authorization
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$87.60/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2954—None
AARP Medicare Rx Preferred from UHC (PDP)$100.80/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4157—None
HealthSpring Assurance Rx (PDP)$133.80/mo premium · $615.00 deductible2Generic$2.00$2.00$0.2137$1.286 units
  • Quantity limit 6 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.

Alaska — 9 plans, 4 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible2Generic$10.00$30.00$0.3155$1.896 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible2Generic10%10%$0.2769$1.666 units
  • Quantity limit 6 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible2Generic$3.00$0.00$0.2260—None
Humana Value Rx Plan (PDP)$10.60/mo premium · $601.00 deductible2Generic$0.00$0.00$0.2319—None
Wellcare Value Script (PDP)$19.70/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1832$1.106 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$53.20/mo premium · $615.00 deductible2Generic$8.00$24.00$0.2983—None
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible2Generic$7.00$21.00$0.2527$1.526 units
  • Prior authorization
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$100.20/mo premium · $130.00 deductible2Generic$10.00$0.00$0.4074—None
Humana Premier Rx Plan (PDP)$112.40/mo premium · $0.00 deductible2Generic$4.00$0.00$0.2260—None

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 — 8 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
SilverScript Choice (PDP)$14.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1139$0.686 units
  • Prior authorization
  • Quantity limit 6 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible2Generic$8.00$24.00$0.3008—None
Humana Basic Rx Plan (PDP)$0.40/mo premium · $615.00 deductible2Generic$4.00$0.00$0.3132—None
Wellcare Value Script (PDP)$21.60/mo premium · $615.00 deductible2Generic$3.00$9.00$0.1363$0.826 units
  • Quantity limit 6 per 30 days
Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible2Generic$10.00$30.00$0.3043$1.836 units
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$51.60/mo premium · $601.00 deductible2Generic$0.00$0.00$0.3178—None
Humana Premier Rx Plan (PDP)$90.20/mo premium · $0.00 deductible2Generic$4.00$0.00$0.3132—None
AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible2Generic$10.00$0.00$0.5147—None

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, 2 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1243$0.756 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$65.70/mo premium · $615.00 deductible2Generic$2.00$2.00$0.1691$1.016 units
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$145.10/mo premium · $615.00 deductible2Generic25%25%$0.4913—None

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
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible2Generic25%25%$0.5448—None

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
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible2Generic25%25%$0.5448—None

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
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$32.10/mo premium · $615.00 deductible2Generic25%25%$0.5448—None

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
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $615.00 deductible2Generic25%25%$0.5391—None

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.