VERAPAMIL HYDROCHLORIDE 240 mg Tablet, Film Coated, Extended Release
Package: 100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (68462-260-01). NDC 68462026001.
- Plans covering it
- 367
- across 39 regions checked
- Lowest tier
- 1
- lower tiers cost less
- Plans with restrictions
- 0
- prior auth, step therapy or quantity limit
Coverage by region
Covered by at least one plan in 39 of 39 CMS regions.
| Region | Plans covering | Tiers | Lowest 30-day cost | Restrictions |
|---|---|---|---|---|
| New Jersey | 12 of 12 | 2 | $0.00 | none |
| Pennsylvania and West Virginia | 12 of 12 | 1–2 | $0.00 | none |
| North Carolina | 12 of 12 | 2 | $0.00 | none |
| Alabama and Tennessee | 12 of 12 | 2 | $0.00 | none |
| Michigan | 12 of 12 | 2–4 | $0.00 | none |
| Illinois | 12 of 12 | 2 | $0.00 | none |
| Arkansas | 12 of 12 | 2 | $0.00 | none |
| Texas | 12 of 12 | 2 | $0.00 | none |
| Kansas | 12 of 12 | 2 | $0.00 | none |
| California | 12 of 12 | 2 | $0.00 | none |
| Connecticut, Massachusetts, Rhode Island and Vermont | 11 of 11 | 1–2 | $0.00 | none |
| South Carolina | 11 of 11 | 2 | $0.00 | none |
| Oklahoma | 11 of 11 | 2 | $0.00 | none |
| Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming | 11 of 11 | 1–2 | $0.00 | none |
| New Mexico | 11 of 11 | 2 | $0.00 | none |
| New York | 10 of 10 | 2 | $0.00 | none |
| Delaware, DC and Maryland | 10 of 10 | 2 | $0.00 | none |
| Georgia | 10 of 10 | 2 | $0.00 | none |
| Florida | 10 of 10 | 2 | $0.00 | none |
| Ohio | 10 of 10 | 2 | $0.00 | none |
| Indiana and Kentucky | 10 of 10 | 1–2 | $0.00 | none |
| Wisconsin | 10 of 10 | 1–2 | $0.00 | none |
| Missouri | 10 of 10 | 2 | $0.00 | none |
| Mississippi | 10 of 10 | 2 | $0.00 | none |
| Louisiana | 10 of 10 | 1–2 | $0.00 | none |
| Colorado | 10 of 10 | 2 | $0.00 | none |
| Arizona | 10 of 10 | 2 | $0.00 | none |
| Nevada | 10 of 10 | 2 | $0.00 | none |
| Oregon and Washington | 10 of 10 | 2 | $0.00 | none |
| Idaho and Utah | 10 of 10 | 1–2 | $0.00 | none |
| Maine and New Hampshire | 9 of 9 | 2 | $0.00 | none |
| Virginia | 9 of 9 | 2 | $0.00 | none |
| Alaska | 9 of 9 | 2 | $0.00 | none |
| Hawaii | 8 of 8 | 1–2 | $0.00 | none |
| Puerto Rico | 3 of 3 | 2 | $2.00 | none |
| American Samoa | 1 of 1 | 2 | — | none |
| Guam | 1 of 1 | 2 | — | none |
| Northern Mariana Islands | 1 of 1 | 2 | — | none |
| U.S. Virgin Islands | 1 of 1 | 2 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$4.40/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3677 | — | None |
| Wellcare Value Script (PDP)$22.80/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1471 | — | None |
| Wellcare Classic (PDP)$28.20/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3081 | — | None |
| Humana Value Rx Plan (PDP)$35.60/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3720 | — | None |
| HealthSpring Extra Rx (PDP)$59.90/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.3012 | — | None |
| Horizon Medicare Blue Rx Standard (PDP)$72.30/mo premium · $615.00 deductible | 2Generic | $3.00 | $4.50 | $0.1990 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$77.40/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2827 | — | None |
| SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2538 | — | None |
| HealthSpring Assurance Rx (PDP)$109.30/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.5730 | — | None |
| Humana Premier Rx Plan (PDP)$111.90/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3677 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$118.90/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.4721 | — | None |
| Horizon Medicare Blue Rx Enhanced (PDP)$139.10/mo premium · $200.00 deductible | 2Generic | $6.00 | $9.00 | $0.1990 | — | 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.
Pennsylvania and West Virginia — 12 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| SilverScript Choice (PDP)$22.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0867 | — | None |
| Humana Basic Rx Plan (PDP)$6.60/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3218 | — | None |
| Wellcare Value Script (PDP)$8.20/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1583 | — | None |
| Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3075 | — | None |
| Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3290 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$43.50/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2868 | — | None |
| HealthSpring Extra Rx (PDP)$62.60/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.2989 | — | None |
| HealthSpring Assurance Rx (PDP)$74.00/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.5869 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$121.90/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.4636 | — | None |
| Humana Premier Rx Plan (PDP)$123.60/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3218 | — | None |
| Blue Rx PDP Complete (PDP)$164.80/mo premium · $200.00 deductible | 2Generic | $5.00 | $12.50 | $0.2288 | — | None |
| Blue Rx PDP Plus (PDP)$193.20/mo premium · $615.00 deductible | 2Generic | 25% | 25% | $0.2288 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1567 | — | None |
| Wellcare Classic (PDP)$4.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3009 | — | None |
| Humana Basic Rx Plan (PDP)$6.80/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3541 | — | None |
| Humana Value Rx Plan (PDP)$32.00/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3627 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$56.90/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2783 | — | None |
| HealthSpring Extra Rx (PDP)$78.00/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.3717 | — | None |
| Blue Medicare Rx Standard (PDP)$83.90/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.2630 | — | None |
| SilverScript Choice (PDP)$90.20/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2493 | — | None |
| HealthSpring Assurance Rx (PDP)$110.40/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.6493 | — | None |
| Humana Premier Rx Plan (PDP)$110.90/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3541 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$119.80/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.4437 | — | None |
| Blue Medicare Rx Enhanced (PDP)$163.20/mo premium · $0.00 deductible | 2Generic | $6.00 | $18.00 | $0.2630 | — | 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.
Alabama and Tennessee — 12 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3295 | — | None |
| Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1694 | — | None |
| Wellcare Classic (PDP)$3.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.2908 | — | None |
| Humana Value Rx Plan (PDP)$37.70/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3398 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$63.20/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2709 | — | None |
| BlueRx Essential (PDP)$76.20/mo premium · $615.00 deductible | 2Generic | $10.00 | $20.00 | $0.2253 | — | None |
| HealthSpring Extra Rx (PDP)$77.50/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.3941 | — | None |
| HealthSpring Assurance Rx (PDP)$87.20/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.6183 | — | None |
| SilverScript Choice (PDP)$97.30/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2520 | — | None |
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3295 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$119.30/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.4283 | — | None |
| BlueRx Enhanced Plus (PDP)$129.50/mo premium · $150.00 deductible | 2Generic | $12.00 | $24.00 | $0.2253 | — | 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.
Michigan — 12 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.2991 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1631 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | 10% | 10% | $0.5250 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3244 | — | None |
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3304 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$14.10/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2712 | — | None |
| HealthSpring Extra Rx (PDP)$50.40/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.3350 | — | None |
| SilverScript Choice (PDP)$78.30/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2576 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$78.30/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.4614 | — | None |
| Humana Premier Rx Plan (PDP)$98.10/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3244 | — | None |
| Prescription Blue Select (PDP)$78.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 25% | 25% | $0.4309 | — | None |
| Prescription Blue Premium (PDP)$106.70/mo premium · $0.00 deductible | 4Non-Preferred Drug | 27% | 27% | $0.4309 | — | 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.
Illinois — 12 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3206 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1465 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3356 | — | None |
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3407 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$40.20/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2602 | — | None |
| HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.3537 | — | None |
| Blue Cross MedicareRx Basic (PDP)$89.70/mo premium · $615.00 deductible | 2Generic | $5.00 | $15.00 | $0.2013 | — | None |
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2864 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$103.90/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3808 | — | None |
| HealthSpring Assurance Rx (PDP)$104.20/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.7049 | — | None |
| Humana Premier Rx Plan (PDP)$119.40/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3356 | — | None |
| Blue Cross MedicareRx Value (PDP)$119.70/mo premium · $615.00 deductible | 2Generic | $1.00 | $3.00 | $0.2031 | — | 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.
Arkansas — 12 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.2686 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1967 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | 10% | 10% | $0.6212 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.2881 | — | None |
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3027 | — | None |
| BlueMedicare Value Rx (PDP)$52.50/mo premium · $615.00 deductible | 2Generic | $5.00 | $15.00 | $0.3357 | — | None |
| HealthSpring Extra Rx (PDP)$54.50/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.4592 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$65.10/mo premium · $615.00 deductible | 2Generic | $7.00 | $27.00 | $0.2650 | — | None |
| SilverScript Choice (PDP)$73.50/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2357 | — | None |
| Humana Premier Rx Plan (PDP)$92.40/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.2881 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$114.90/mo premium · $130.00 deductible | 2Generic | $10.00 | $54.00 | $0.4368 | — | None |
| BlueMedicare Premier Rx (PDP)$181.20/mo premium · $0.00 deductible | 2Generic | $5.00 | $15.00 | $0.3357 | — | 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.
Texas — 12 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3104 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1607 | — | None |
| Humana Value Rx Plan (PDP)$22.90/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3485 | — | None |
| Humana Basic Rx Plan (PDP)$41.70/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3384 | — | None |
| HealthSpring Extra Rx (PDP)$70.00/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.3720 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$89.20/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2669 | — | None |
| SilverScript Choice (PDP)$94.80/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2850 | — | None |
| Blue Cross MedicareRx Basic (PDP)$104.70/mo premium · $615.00 deductible | 2Generic | $5.00 | $15.00 | $0.2137 | — | None |
| HealthSpring Assurance Rx (PDP)$111.40/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.6283 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3900 | — | None |
| Humana Premier Rx Plan (PDP)$118.20/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3384 | — | None |
| Blue Cross MedicareRx Value (PDP)$167.40/mo premium · $615.00 deductible | 2Generic | $1.00 | $3.00 | $0.2259 | — | 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.
Kansas — 12 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Blue MedicareRx Essentials (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $0.00 | $0.00 | $0.2726 | — | None |
| Blue MedicareRx Value (PDP)$0.70/mo premium · $615.00 deductible | 2Generic | $2.00 | $6.00 | $0.2797 | — | None |
| HealthSpring Assurance Rx (PDP)$6.70/mo premium · $615.00 deductible | 2Generic | 10% | 10% | $0.6746 | — | None |
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1896 | — | None |
| Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible | 2Generic | $9.00 | $27.00 | $0.3223 | — | None |
| Humana Basic Rx Plan (PDP)$15.50/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.2950 | — | None |
| Humana Value Rx Plan (PDP)$55.60/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3073 | — | None |
| Blue MedicareRx Plus (PDP)$67.40/mo premium · $0.00 deductible | 2Generic | $0.00 | $0.00 | $0.2797 | — | None |
| SilverScript Choice (PDP)$88.30/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2860 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$105.40/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2758 | — | None |
| Humana Premier Rx Plan (PDP)$116.30/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.2950 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$147.00/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.4158 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | 10% | 10% | $0.6064 | — | None |
| Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1457 | — | None |
| Wellcare Classic (PDP)$6.20/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3137 | — | None |
| HealthSpring Extra Rx (PDP)$70.60/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.2852 | — | None |
| SilverScript Choice (PDP)$103.60/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2541 | — | None |
| Humana Value Rx Plan (PDP)$104.60/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3689 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$109.40/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2903 | — | None |
| Humana Basic Rx Plan (PDP)$132.20/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3645 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$165.40/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.4644 | — | None |
| Humana Premier Rx Plan (PDP)$172.90/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3645 | — | None |
| Blue Shield Rx Plus (PDP)$199.70/mo premium · $615.00 deductible | 2Generic | $7.00 | $17.50 | $0.6119 | — | None |
| Blue Shield Rx Enhanced (PDP)$227.80/mo premium · $0.00 deductible | 2Generic | $7.00 | $14.00 | $0.6119 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0792 | — | None |
| Humana Basic Rx Plan (PDP)$8.40/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3883 | — | None |
| Wellcare Value Script (PDP)$16.40/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1359 | — | None |
| Blue MedicareRx Value Plus (PDP)$20.70/mo premium · $615.00 deductible | 2Generic | $3.00 | $6.00 | $0.3976 | — | None |
| Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3212 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.3021 | — | None |
| Humana Value Rx Plan (PDP)$73.60/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3920 | — | None |
| Humana Premier Rx Plan (PDP)$138.60/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3883 | — | None |
| HealthSpring Assurance Rx (PDP)$139.30/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.6028 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.4786 | — | None |
| Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible | 2Generic | $7.00 | $14.00 | $0.3976 | — | 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.
South Carolina — 11 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$4.80/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1549 | — | None |
| Wellcare Classic (PDP)$9.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3028 | — | None |
| Humana Basic Rx Plan (PDP)$10.10/mo premium · $615.00 deductible | 2Generic | $2.00 | $0.00 | $0.3557 | — | None |
| Humana Value Rx Plan (PDP)$65.60/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3656 | — | None |
| HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.3604 | — | None |
| SilverScript Choice (PDP)$98.40/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2629 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$122.10/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2830 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.4433 | — | None |
| BlueCross Rx Value (PDP)$139.70/mo premium · $615.00 deductible | 2Generic | $17.00 | $42.50 | $0.6765 | — | None |
| Humana Premier Rx Plan (PDP)$145.60/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3557 | — | None |
| HealthSpring Assurance Rx (PDP)$152.50/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.6401 | — | 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.
Oklahoma — 11 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Blue Cross MedicareRx Basic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $5.00 | $15.00 | $0.2305 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $2.00 | $0.00 | $0.3102 | — | None |
| Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.2094 | — | None |
| Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.2823 | — | None |
| Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3264 | — | None |
| HealthSpring Extra Rx (PDP)$65.40/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.4661 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2641 | — | None |
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3102 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$121.00/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.4321 | — | None |
| HealthSpring Assurance Rx (PDP)$126.50/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.6532 | — | None |
| Blue Cross MedicareRx Value (PDP)$167.30/mo premium · $615.00 deductible | 2Generic | $1.00 | $3.00 | $0.2743 | — | 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.
Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming — 11 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1040 | — | None |
| Humana Basic Rx Plan (PDP)$4.70/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.2871 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$5.30/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2585 | — | None |
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1974 | — | None |
| Wellcare Classic (PDP)$12.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3106 | — | None |
| Humana Value Rx Plan (PDP)$20.80/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.2949 | — | None |
| HealthSpring Extra Rx (PDP)$66.50/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.3455 | — | None |
| MedicareBlue Rx Standard (PDP)$101.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $3.00 | $0.2526 | — | None |
| Humana Premier Rx Plan (PDP)$103.70/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.2871 | — | None |
| HealthSpring Assurance Rx (PDP)$125.90/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.4891 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$140.20/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.4176 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3152 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1715 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | 10% | 10% | $0.7614 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3554 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $6.00 | $18.00 | $0.2509 | — | None |
| Humana Value Rx Plan (PDP)$69.60/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3691 | — | None |
| Humana Premier Rx Plan (PDP)$75.60/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3554 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3512 | — | None |
| SilverScript Choice (PDP)$104.00/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.3014 | — | None |
| Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible | 2Generic | $4.00 | $12.00 | $0.2141 | — | None |
| Blue Cross MedicareRx Basic (PDP)$145.40/mo premium · $615.00 deductible | 2Generic | $5.00 | $15.00 | $0.2079 | — | 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 York — 10 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| HealthSpring Assurance Rx (PDP)$35.70/mo premium · $615.00 deductible | 2Generic | 10% | 10% | $0.5075 | — | None |
| Wellcare Value Script (PDP)$42.40/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1550 | — | None |
| Wellcare Classic (PDP)$45.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.2984 | — | None |
| HealthSpring Extra Rx (PDP)$91.60/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.2844 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$105.80/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2770 | — | None |
| SilverScript Choice (PDP)$116.00/mo premium · $615.00 deductible | 2Generic | $6.00 | $18.00 | $0.2402 | — | None |
| Humana Basic Rx Plan (PDP)$140.90/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3407 | — | None |
| Humana Value Rx Plan (PDP)$158.90/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3446 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$163.70/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.4667 | — | None |
| Humana Premier Rx Plan (PDP)$173.60/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3407 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3549 | — | None |
| Humana Value Rx Plan (PDP)$4.30/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3605 | — | None |
| Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1467 | — | None |
| Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3112 | — | None |
| HealthSpring Assurance Rx (PDP)$32.60/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.5871 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$37.80/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2742 | — | None |
| HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.3075 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.4279 | — | None |
| SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2510 | — | None |
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3549 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3018 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1621 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3267 | — | None |
| Humana Value Rx Plan (PDP)$36.40/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3355 | — | None |
| HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.3679 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$98.00/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2786 | — | None |
| SilverScript Choice (PDP)$100.70/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2644 | — | None |
| Humana Premier Rx Plan (PDP)$129.50/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3267 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$139.80/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.4311 | — | None |
| HealthSpring Assurance Rx (PDP)$149.30/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.5945 | — | 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.
Florida — 10 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3185 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1469 | — | None |
| Humana Value Rx Plan (PDP)$25.90/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3884 | — | None |
| Humana Basic Rx Plan (PDP)$92.70/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3827 | — | None |
| SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2773 | — | None |
| BlueMedicare Premier Rx (PDP)$98.60/mo premium · $615.00 deductible | 2Generic | $14.00 | $42.00 | $0.1966 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$98.70/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2646 | — | None |
| Humana Premier Rx Plan (PDP)$115.90/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3827 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$119.10/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3947 | — | None |
| BlueMedicare Complete Rx (PDP)$217.00/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1966 | — | 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.
Ohio — 10 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3226 | — | None |
| Wellcare Value Script (PDP)$7.60/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1488 | — | None |
| Wellcare Classic (PDP)$7.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3177 | — | None |
| Humana Value Rx Plan (PDP)$23.70/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3298 | — | None |
| HealthSpring Extra Rx (PDP)$65.70/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.3467 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$73.70/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2771 | — | None |
| SilverScript Choice (PDP)$90.30/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2825 | — | None |
| HealthSpring Assurance Rx (PDP)$109.50/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.6429 | — | None |
| Humana Premier Rx Plan (PDP)$117.60/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3226 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$123.40/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.5111 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0845 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3354 | — | None |
| Wellcare Value Script (PDP)$8.60/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1573 | — | None |
| Wellcare Classic (PDP)$8.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3073 | — | None |
| Humana Value Rx Plan (PDP)$9.90/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3444 | — | None |
| HealthSpring Extra Rx (PDP)$78.20/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.3787 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$90.30/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2896 | — | None |
| HealthSpring Assurance Rx (PDP)$117.80/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.6551 | — | None |
| Humana Premier Rx Plan (PDP)$125.30/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3354 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$127.10/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.4427 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| SilverScript Choice (PDP)$26.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0935 | — | None |
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3011 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1653 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | 10% | 10% | $0.6785 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3659 | — | None |
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3759 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2542 | — | None |
| HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.4244 | — | None |
| Humana Premier Rx Plan (PDP)$110.60/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3659 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$113.90/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3870 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1830 | — | None |
| Wellcare Classic (PDP)$10.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3125 | — | None |
| Humana Basic Rx Plan (PDP)$16.50/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3538 | — | None |
| Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3672 | — | None |
| HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.4117 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$71.90/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2744 | — | None |
| HealthSpring Assurance Rx (PDP)$74.30/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.6869 | — | None |
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2711 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$125.40/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.4219 | — | None |
| Humana Premier Rx Plan (PDP)$126.40/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3538 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.2799 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1853 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3124 | — | None |
| Humana Value Rx Plan (PDP)$37.60/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3244 | — | None |
| HealthSpring Assurance Rx (PDP)$59.70/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.6190 | — | None |
| HealthSpring Extra Rx (PDP)$77.10/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.4215 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$84.70/mo premium · $615.00 deductible | 2Generic | $6.00 | $18.00 | $0.2705 | — | None |
| Humana Premier Rx Plan (PDP)$89.90/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3124 | — | None |
| SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2471 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$140.60/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.4379 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| SilverScript Choice (PDP)$44.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0921 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3396 | — | None |
| Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1783 | — | None |
| Wellcare Classic (PDP)$6.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.2809 | — | None |
| Humana Value Rx Plan (PDP)$19.30/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3533 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$37.00/mo premium · $615.00 deductible | 2Generic | $6.00 | $18.00 | $0.2698 | — | None |
| HealthSpring Assurance Rx (PDP)$48.40/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.6517 | — | None |
| HealthSpring Extra Rx (PDP)$60.60/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.4193 | — | None |
| Humana Premier Rx Plan (PDP)$113.70/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3396 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$139.50/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.4301 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1589 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3029 | — | None |
| Wellcare Classic (PDP)$2.20/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3169 | — | None |
| Humana Value Rx Plan (PDP)$48.50/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3121 | — | None |
| HealthSpring Assurance Rx (PDP)$61.70/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.7049 | — | None |
| HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.4177 | — | None |
| SilverScript Choice (PDP)$105.10/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.3053 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$125.00/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2640 | — | None |
| Humana Premier Rx Plan (PDP)$137.10/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3029 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$151.90/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3603 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3286 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1518 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | 10% | 10% | $0.7393 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $3.00 | $0.00 | $0.3741 | — | None |
| Humana Value Rx Plan (PDP)$2.50/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3828 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2703 | — | None |
| HealthSpring Extra Rx (PDP)$66.40/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.3842 | — | None |
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.3027 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$97.50/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.5045 | — | None |
| Humana Premier Rx Plan (PDP)$119.20/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3741 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3745 | — | None |
| Wellcare Classic (PDP)$2.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3194 | — | None |
| Wellcare Value Script (PDP)$2.70/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1481 | — | None |
| Humana Value Rx Plan (PDP)$43.70/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3835 | — | None |
| HealthSpring Extra Rx (PDP)$52.60/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.3872 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$76.70/mo premium · $615.00 deductible | 2Generic | $6.00 | $18.00 | $0.2707 | — | None |
| HealthSpring Assurance Rx (PDP)$95.60/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.7085 | — | None |
| SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2974 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$139.10/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3909 | — | None |
| Humana Premier Rx Plan (PDP)$148.70/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3745 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3148 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1680 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | 10% | 10% | $0.6506 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.2930 | — | None |
| Humana Value Rx Plan (PDP)$22.10/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3004 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$38.40/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2594 | — | None |
| HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.3689 | — | None |
| SilverScript Choice (PDP)$85.90/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2902 | — | None |
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.2930 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$110.00/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3733 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| SilverScript Choice (PDP)$27.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0930 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.2821 | — | None |
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1786 | — | None |
| Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.2924 | — | None |
| Wellcare Classic (PDP)$23.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.2900 | — | None |
| HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.4113 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$56.50/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2636 | — | None |
| Humana Premier Rx Plan (PDP)$115.50/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.2821 | — | None |
| HealthSpring Assurance Rx (PDP)$128.60/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.6113 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$132.60/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.4041 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3261 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1725 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | 10% | 10% | $0.5885 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3359 | — | None |
| Humana Value Rx Plan (PDP)$54.40/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3448 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2626 | — | None |
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2479 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$104.30/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.3800 | — | None |
| Humana Premier Rx Plan (PDP)$150.20/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3359 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3135 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1576 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $1.00 | $0.00 | $0.3522 | — | None |
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3633 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$39.60/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2858 | — | None |
| SilverScript Choice (PDP)$78.20/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2698 | — | None |
| Humana Premier Rx Plan (PDP)$87.60/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3522 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$100.80/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.4236 | — | None |
| HealthSpring Assurance Rx (PDP)$133.80/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.6786 | — | 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.
Alaska — 9 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.2998 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | 10% | 10% | $0.5828 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $3.00 | $0.00 | $0.2614 | — | None |
| Humana Value Rx Plan (PDP)$10.60/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.2682 | — | None |
| Wellcare Value Script (PDP)$19.70/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1983 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$53.20/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.2810 | — | None |
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 2Generic | $7.00 | $21.00 | $0.2838 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$100.20/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.4387 | — | None |
| Humana Premier Rx Plan (PDP)$112.40/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.2614 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| SilverScript Choice (PDP)$14.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0888 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | $8.00 | $24.00 | $0.3065 | — | None |
| Humana Basic Rx Plan (PDP)$0.40/mo premium · $615.00 deductible | 2Generic | $4.00 | $0.00 | $0.3782 | — | None |
| Wellcare Value Script (PDP)$21.60/mo premium · $615.00 deductible | 2Generic | $3.00 | $9.00 | $0.1468 | — | None |
| Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible | 2Generic | $10.00 | $30.00 | $0.3181 | — | None |
| Humana Value Rx Plan (PDP)$51.60/mo premium · $601.00 deductible | 2Generic | $0.00 | $0.00 | $0.3811 | — | None |
| Humana Premier Rx Plan (PDP)$90.20/mo premium · $0.00 deductible | 2Generic | $4.00 | $0.00 | $0.3782 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible | 2Generic | $10.00 | $0.00 | $0.5051 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible | 2Generic | $5.00 | $3.00 | $0.3337 | — | None |
| HealthSpring Assurance Rx (PDP)$65.70/mo premium · $615.00 deductible | 2Generic | $2.00 | $2.00 | $0.4344 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$145.10/mo premium · $615.00 deductible | 2Generic | 25% | 25% | $0.5254 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | 25% | 25% | $0.5658 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible | 2Generic | 25% | 25% | $0.5810 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP)$32.10/mo premium · $615.00 deductible | 2Generic | 25% | 25% | $0.5658 | — | 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
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $615.00 deductible | 2Generic | 25% | 25% | $0.5500 | — | 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.