FUROSEMIDE 40 mg Tablet
Package: 1000 TABLET in 1 BOTTLE (69315-117-10). NDC 69315011710.
- 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 | 1 | $0.00 | none |
| Pennsylvania and West Virginia | 12 of 12 | 1 | $0.00 | none |
| North Carolina | 12 of 12 | 1 | $0.00 | none |
| Alabama and Tennessee | 12 of 12 | 1 | $0.00 | none |
| Michigan | 12 of 12 | 1 | $0.00 | none |
| Illinois | 12 of 12 | 1 | $0.00 | none |
| Arkansas | 12 of 12 | 1 | $0.00 | none |
| Texas | 12 of 12 | 1 | $0.00 | none |
| Kansas | 12 of 12 | 1 | $0.00 | none |
| California | 12 of 12 | 1 | $0.00 | none |
| Connecticut, Massachusetts, Rhode Island and Vermont | 11 of 11 | 1 | $0.00 | none |
| South Carolina | 11 of 11 | 1 | $0.00 | none |
| Oklahoma | 11 of 11 | 1 | $0.00 | none |
| Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming | 11 of 11 | 1 | $0.00 | none |
| New Mexico | 11 of 11 | 1 | $0.00 | none |
| New York | 10 of 10 | 1 | $0.00 | none |
| Delaware, DC and Maryland | 10 of 10 | 1 | $0.00 | none |
| Georgia | 10 of 10 | 1 | $0.00 | none |
| Florida | 10 of 10 | 1 | $0.00 | none |
| Ohio | 10 of 10 | 1 | $0.00 | none |
| Indiana and Kentucky | 10 of 10 | 1 | $0.00 | none |
| Wisconsin | 10 of 10 | 1 | $0.00 | none |
| Missouri | 10 of 10 | 1 | $0.00 | none |
| Mississippi | 10 of 10 | 1 | $0.00 | none |
| Louisiana | 10 of 10 | 1 | $0.00 | none |
| Colorado | 10 of 10 | 1 | $0.00 | none |
| Arizona | 10 of 10 | 1 | $0.00 | none |
| Nevada | 10 of 10 | 1 | $0.00 | none |
| Oregon and Washington | 10 of 10 | 1 | $0.00 | none |
| Idaho and Utah | 10 of 10 | 1 | $0.00 | none |
| Maine and New Hampshire | 9 of 9 | 1 | $0.00 | none |
| Virginia | 9 of 9 | 1 | $0.00 | none |
| Alaska | 9 of 9 | 1 | $0.00 | none |
| Hawaii | 8 of 8 | 1 | $0.00 | none |
| Puerto Rico | 3 of 3 | 1 | $0.00 | none |
| American Samoa | 1 of 1 | 1 | — | none |
| Guam | 1 of 1 | 1 | — | none |
| Northern Mariana Islands | 1 of 1 | 1 | — | none |
| U.S. Virgin Islands | 1 of 1 | 1 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0923 | — | None |
| Wellcare Value Script (PDP)$22.80/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0273 | — | None |
| Wellcare Classic (PDP)$28.20/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0829 | — | None |
| Humana Value Rx Plan (PDP)$35.60/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0933 | — | None |
| HealthSpring Extra Rx (PDP)$59.90/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0756 | — | None |
| Horizon Medicare Blue Rx Standard (PDP)$72.30/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1276 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$77.40/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1260 | — | None |
| SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0738 | — | None |
| HealthSpring Assurance Rx (PDP)$109.30/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0698 | — | None |
| Humana Premier Rx Plan (PDP)$111.90/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0923 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$118.90/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1365 | — | None |
| Horizon Medicare Blue Rx Enhanced (PDP)$139.10/mo premium · $200.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1276 | — | 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 |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$6.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0852 | — | None |
| Wellcare Value Script (PDP)$8.20/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0344 | — | None |
| Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0767 | — | None |
| Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0873 | — | None |
| SilverScript Choice (PDP)$22.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0931 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$43.50/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1256 | — | None |
| HealthSpring Extra Rx (PDP)$62.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0798 | — | None |
| HealthSpring Assurance Rx (PDP)$74.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0680 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$121.90/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1427 | — | None |
| Humana Premier Rx Plan (PDP)$123.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0852 | — | None |
| Blue Rx PDP Complete (PDP)$164.80/mo premium · $200.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0569 | — | None |
| Blue Rx PDP Plus (PDP)$193.20/mo premium · $615.00 deductible | 1Preferred Generic | 25% | 25% | $0.0569 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0375 | — | None |
| Wellcare Classic (PDP)$4.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0900 | — | None |
| Humana Basic Rx Plan (PDP)$6.80/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0906 | — | None |
| Humana Value Rx Plan (PDP)$32.00/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0933 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$56.90/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1166 | — | None |
| HealthSpring Extra Rx (PDP)$78.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0835 | — | None |
| Blue Medicare Rx Standard (PDP)$83.90/mo premium · $615.00 deductible | 1Preferred Generic | $5.00 | $15.00 | $0.1526 | — | None |
| SilverScript Choice (PDP)$90.20/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0797 | — | None |
| HealthSpring Assurance Rx (PDP)$110.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0825 | — | None |
| Humana Premier Rx Plan (PDP)$110.90/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0906 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$119.80/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1293 | — | None |
| Blue Medicare Rx Enhanced (PDP)$163.20/mo premium · $0.00 deductible | 1Preferred Generic | $3.00 | $9.00 | $0.1526 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0880 | — | None |
| Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0388 | — | None |
| Wellcare Classic (PDP)$3.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0849 | — | None |
| Humana Value Rx Plan (PDP)$37.70/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0907 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$63.20/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1116 | — | None |
| BlueRx Essential (PDP)$76.20/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $4.00 | $0.1260 | — | None |
| HealthSpring Extra Rx (PDP)$77.50/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0802 | — | None |
| HealthSpring Assurance Rx (PDP)$87.20/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0816 | — | None |
| SilverScript Choice (PDP)$97.30/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0863 | — | None |
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0880 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$119.30/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1289 | — | None |
| BlueRx Enhanced Plus (PDP)$129.50/mo premium · $150.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1260 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0766 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0322 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | 5% | 5% | $0.0707 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0845 | — | None |
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0861 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$14.10/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1228 | — | None |
| HealthSpring Extra Rx (PDP)$50.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0729 | — | None |
| SilverScript Choice (PDP)$78.30/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0868 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$78.30/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1328 | — | None |
| Prescription Blue Select (PDP)$78.40/mo premium · $615.00 deductible | 1Preferred Generic | $1.00 | $3.00 | $0.0769 | — | None |
| Humana Premier Rx Plan (PDP)$98.10/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0845 | — | None |
| Prescription Blue Premium (PDP)$106.70/mo premium · $0.00 deductible | 1Preferred Generic | $1.00 | $2.00 | $0.0769 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0916 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0309 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0889 | — | None |
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0906 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$40.20/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0935 | — | None |
| HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0709 | — | None |
| Blue Cross MedicareRx Basic (PDP)$89.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1524 | — | None |
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0870 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$103.90/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1257 | — | None |
| HealthSpring Assurance Rx (PDP)$104.20/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0906 | — | None |
| Humana Premier Rx Plan (PDP)$119.40/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0889 | — | None |
| Blue Cross MedicareRx Value (PDP)$119.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1457 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0785 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0559 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | 5% | 5% | $0.0833 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0780 | — | None |
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0824 | — | None |
| BlueMedicare Value Rx (PDP)$52.50/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1070 | — | None |
| HealthSpring Extra Rx (PDP)$54.50/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0913 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$65.10/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $24.00 | $0.1190 | — | None |
| SilverScript Choice (PDP)$73.50/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0927 | — | None |
| Humana Premier Rx Plan (PDP)$92.40/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0780 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$114.90/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $39.00 | $0.1290 | — | None |
| BlueMedicare Premier Rx (PDP)$181.20/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1070 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0825 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0374 | — | None |
| Humana Value Rx Plan (PDP)$22.90/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0912 | — | None |
| Humana Basic Rx Plan (PDP)$41.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0883 | — | None |
| HealthSpring Extra Rx (PDP)$70.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0787 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$89.20/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1012 | — | None |
| SilverScript Choice (PDP)$94.80/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0883 | — | None |
| Blue Cross MedicareRx Basic (PDP)$104.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1348 | — | None |
| HealthSpring Assurance Rx (PDP)$111.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0810 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1318 | — | None |
| Humana Premier Rx Plan (PDP)$118.20/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0883 | — | None |
| Blue Cross MedicareRx Value (PDP)$167.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1356 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.1494 | — | None |
| Blue MedicareRx Value (PDP)$0.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1465 | — | None |
| HealthSpring Assurance Rx (PDP)$6.70/mo premium · $615.00 deductible | 1Preferred Generic | 5% | 5% | $0.0867 | — | None |
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0513 | — | None |
| Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0965 | — | None |
| Humana Basic Rx Plan (PDP)$15.50/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0790 | — | None |
| Humana Value Rx Plan (PDP)$55.60/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0826 | — | None |
| Blue MedicareRx Plus (PDP)$67.40/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1465 | — | None |
| SilverScript Choice (PDP)$88.30/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0966 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$105.40/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1229 | — | None |
| Humana Premier Rx Plan (PDP)$116.30/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0790 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$147.00/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1342 | — | 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 | 1Preferred Generic | 5% | 5% | $0.0721 | — | None |
| Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0277 | — | None |
| Wellcare Classic (PDP)$6.20/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0860 | — | None |
| HealthSpring Extra Rx (PDP)$70.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0786 | — | None |
| SilverScript Choice (PDP)$103.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0714 | — | None |
| Humana Value Rx Plan (PDP)$104.60/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0942 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$109.40/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1244 | — | None |
| Humana Basic Rx Plan (PDP)$132.20/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0929 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$165.40/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1375 | — | None |
| Humana Premier Rx Plan (PDP)$172.90/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0929 | — | None |
| Blue Shield Rx Plus (PDP)$199.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0972 | — | None |
| Blue Shield Rx Enhanced (PDP)$227.80/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0972 | — | 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 |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$8.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0981 | — | None |
| Wellcare Value Script (PDP)$16.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0235 | — | None |
| Blue MedicareRx Value Plus (PDP)$20.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1102 | — | None |
| Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0918 | — | None |
| SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0968 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1250 | — | None |
| Humana Value Rx Plan (PDP)$73.60/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0991 | — | None |
| Humana Premier Rx Plan (PDP)$138.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0981 | — | None |
| HealthSpring Assurance Rx (PDP)$139.30/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0704 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1369 | — | None |
| Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible | 1Preferred Generic | $1.00 | $1.00 | $0.1102 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0362 | — | None |
| Wellcare Classic (PDP)$9.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0885 | — | None |
| Humana Basic Rx Plan (PDP)$10.10/mo premium · $615.00 deductible | 1Preferred Generic | $1.00 | $0.00 | $0.0927 | — | None |
| Humana Value Rx Plan (PDP)$65.60/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0955 | — | None |
| HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0854 | — | None |
| SilverScript Choice (PDP)$98.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0781 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$122.10/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1200 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1340 | — | None |
| BlueCross Rx Value (PDP)$139.70/mo premium · $615.00 deductible | 1Preferred Generic | $12.00 | $30.00 | $0.1543 | — | None |
| Humana Premier Rx Plan (PDP)$145.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0927 | — | None |
| HealthSpring Assurance Rx (PDP)$152.50/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0783 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.1408 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $1.00 | $0.00 | $0.0830 | — | None |
| Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0560 | — | None |
| Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0843 | — | None |
| Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0872 | — | None |
| HealthSpring Extra Rx (PDP)$65.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0950 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1136 | — | None |
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0830 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$121.00/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1274 | — | None |
| HealthSpring Assurance Rx (PDP)$126.50/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0855 | — | None |
| Blue Cross MedicareRx Value (PDP)$167.30/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1451 | — | 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 |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$4.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0768 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$5.30/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1058 | — | None |
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0449 | — | None |
| Wellcare Classic (PDP)$12.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0666 | — | None |
| Humana Value Rx Plan (PDP)$20.80/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0790 | — | None |
| SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0966 | — | None |
| HealthSpring Extra Rx (PDP)$66.50/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0760 | — | None |
| MedicareBlue Rx Standard (PDP)$101.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1406 | — | None |
| Humana Premier Rx Plan (PDP)$103.70/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0768 | — | None |
| HealthSpring Assurance Rx (PDP)$125.90/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0677 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$140.20/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1396 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0912 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0446 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | 5% | 5% | $0.0990 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0892 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0918 | — | None |
| Humana Value Rx Plan (PDP)$69.60/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0929 | — | None |
| Humana Premier Rx Plan (PDP)$75.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0892 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1226 | — | None |
| SilverScript Choice (PDP)$104.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0978 | — | None |
| Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1427 | — | None |
| Blue Cross MedicareRx Basic (PDP)$145.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1472 | — | 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 | 1Preferred Generic | 5% | 5% | $0.0637 | — | None |
| Wellcare Value Script (PDP)$42.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0286 | — | None |
| Wellcare Classic (PDP)$45.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0726 | — | None |
| HealthSpring Extra Rx (PDP)$91.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0697 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$105.80/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1283 | — | None |
| SilverScript Choice (PDP)$116.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0767 | — | None |
| Humana Basic Rx Plan (PDP)$140.90/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0868 | — | None |
| Humana Value Rx Plan (PDP)$158.90/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0875 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$163.70/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1386 | — | None |
| Humana Premier Rx Plan (PDP)$173.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0868 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0915 | — | None |
| Humana Value Rx Plan (PDP)$4.30/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0931 | — | None |
| Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0281 | — | None |
| Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0819 | — | None |
| HealthSpring Assurance Rx (PDP)$32.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0746 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$37.80/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1109 | — | None |
| HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0708 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1350 | — | None |
| SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0806 | — | None |
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0915 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0836 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0376 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0870 | — | None |
| Humana Value Rx Plan (PDP)$36.40/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0895 | — | None |
| HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0883 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$98.00/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1192 | — | None |
| SilverScript Choice (PDP)$100.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0835 | — | None |
| Humana Premier Rx Plan (PDP)$129.50/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0870 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$139.80/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1355 | — | None |
| HealthSpring Assurance Rx (PDP)$149.30/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0766 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0815 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0290 | — | None |
| Humana Value Rx Plan (PDP)$25.90/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0987 | — | None |
| Humana Basic Rx Plan (PDP)$92.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0970 | — | None |
| SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0833 | — | None |
| BlueMedicare Premier Rx (PDP)$98.60/mo premium · $615.00 deductible | 1Preferred Generic | $3.00 | $9.00 | $0.1325 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$98.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0993 | — | None |
| Humana Premier Rx Plan (PDP)$115.90/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0970 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$119.10/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1327 | — | None |
| BlueMedicare Complete Rx (PDP)$217.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1325 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0844 | — | None |
| Wellcare Value Script (PDP)$7.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0330 | — | None |
| Wellcare Classic (PDP)$7.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0863 | — | None |
| Humana Value Rx Plan (PDP)$23.70/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0866 | — | None |
| HealthSpring Extra Rx (PDP)$65.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0863 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$73.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1394 | — | None |
| SilverScript Choice (PDP)$90.30/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0853 | — | None |
| HealthSpring Assurance Rx (PDP)$109.50/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0778 | — | None |
| Humana Premier Rx Plan (PDP)$117.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0844 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$123.40/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1427 | — | 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 |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0867 | — | None |
| Wellcare Value Script (PDP)$8.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0363 | — | None |
| Wellcare Classic (PDP)$8.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0888 | — | None |
| Humana Value Rx Plan (PDP)$9.90/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0890 | — | None |
| SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0939 | — | None |
| HealthSpring Extra Rx (PDP)$78.20/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0901 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$90.30/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1252 | — | None |
| HealthSpring Assurance Rx (PDP)$117.80/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0798 | — | None |
| Humana Premier Rx Plan (PDP)$125.30/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0867 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$127.10/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1339 | — | 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 |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0901 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0394 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | 5% | 5% | $0.0877 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0898 | — | None |
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0924 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1007 | — | None |
| SilverScript Choice (PDP)$26.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0966 | — | None |
| HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0780 | — | None |
| Humana Premier Rx Plan (PDP)$110.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0898 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$113.90/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1208 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0492 | — | None |
| Wellcare Classic (PDP)$10.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0906 | — | None |
| Humana Basic Rx Plan (PDP)$16.50/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0881 | — | None |
| Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0920 | — | None |
| HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0864 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$71.90/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1128 | — | None |
| HealthSpring Assurance Rx (PDP)$74.30/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0844 | — | None |
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0870 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$125.40/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1286 | — | None |
| Humana Premier Rx Plan (PDP)$126.40/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0881 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0830 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0471 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0826 | — | None |
| Humana Value Rx Plan (PDP)$37.60/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0861 | — | None |
| HealthSpring Assurance Rx (PDP)$59.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0813 | — | None |
| HealthSpring Extra Rx (PDP)$77.10/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0874 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$84.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1184 | — | None |
| Humana Premier Rx Plan (PDP)$89.90/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0826 | — | None |
| SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0873 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$140.60/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1290 | — | 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 |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0880 | — | None |
| Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0456 | — | None |
| Wellcare Classic (PDP)$6.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0835 | — | None |
| Humana Value Rx Plan (PDP)$19.30/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0915 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$37.00/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1122 | — | None |
| SilverScript Choice (PDP)$44.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0960 | — | None |
| HealthSpring Assurance Rx (PDP)$48.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0821 | — | None |
| HealthSpring Extra Rx (PDP)$60.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0843 | — | None |
| Humana Premier Rx Plan (PDP)$113.70/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0880 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$139.50/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1263 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0362 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0797 | — | None |
| Wellcare Classic (PDP)$2.20/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0897 | — | None |
| Humana Value Rx Plan (PDP)$48.50/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0824 | — | None |
| HealthSpring Assurance Rx (PDP)$61.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0943 | — | None |
| HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0931 | — | None |
| SilverScript Choice (PDP)$105.10/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1001 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$125.00/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1044 | — | None |
| Humana Premier Rx Plan (PDP)$137.10/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0797 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$151.90/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1319 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0979 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0349 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | 5% | 5% | $0.0949 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $0.00 | $0.0935 | — | None |
| Humana Value Rx Plan (PDP)$2.50/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0961 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1352 | — | None |
| HealthSpring Extra Rx (PDP)$66.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0806 | — | None |
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0913 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$97.50/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1400 | — | None |
| Humana Premier Rx Plan (PDP)$119.20/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0935 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0943 | — | None |
| Wellcare Classic (PDP)$2.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0979 | — | None |
| Wellcare Value Script (PDP)$2.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0314 | — | None |
| Humana Value Rx Plan (PDP)$43.70/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0969 | — | None |
| HealthSpring Extra Rx (PDP)$52.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0849 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$76.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1035 | — | None |
| HealthSpring Assurance Rx (PDP)$95.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0904 | — | None |
| SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0868 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$139.10/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1268 | — | None |
| Humana Premier Rx Plan (PDP)$148.70/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0943 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0762 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0366 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | 5% | 5% | $0.0890 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0784 | — | None |
| Humana Value Rx Plan (PDP)$22.10/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0806 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$38.40/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1025 | — | None |
| HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0781 | — | None |
| SilverScript Choice (PDP)$85.90/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0961 | — | None |
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0784 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$110.00/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1375 | — | 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 |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0766 | — | None |
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0405 | — | None |
| Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0792 | — | None |
| Wellcare Classic (PDP)$23.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0761 | — | None |
| SilverScript Choice (PDP)$27.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0927 | — | None |
| HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0879 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$56.50/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1127 | — | None |
| Humana Premier Rx Plan (PDP)$115.50/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0766 | — | None |
| HealthSpring Assurance Rx (PDP)$128.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0821 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$132.60/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1350 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0773 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0400 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | 5% | 5% | $0.0786 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0869 | — | None |
| Humana Value Rx Plan (PDP)$54.40/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0895 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.0935 | — | None |
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0971 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$104.30/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1361 | — | None |
| Humana Premier Rx Plan (PDP)$150.20/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0869 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0943 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0386 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0917 | — | None |
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0949 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$39.60/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1176 | — | None |
| SilverScript Choice (PDP)$78.20/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0820 | — | None |
| Humana Premier Rx Plan (PDP)$87.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0917 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$100.80/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1325 | — | None |
| HealthSpring Assurance Rx (PDP)$133.80/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0836 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0720 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | 5% | 5% | $0.0886 | — | None |
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $0.00 | $0.0716 | — | None |
| Humana Value Rx Plan (PDP)$10.60/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0734 | — | None |
| Wellcare Value Script (PDP)$19.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0357 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$53.20/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1119 | — | None |
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1011 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$100.20/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1458 | — | None |
| Humana Premier Rx Plan (PDP)$112.40/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0716 | — | 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 |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1398 | — | None |
| Humana Basic Rx Plan (PDP)$0.40/mo premium · $615.00 deductible | 1Preferred Generic | $3.00 | $0.00 | $0.1008 | — | None |
| SilverScript Choice (PDP)$14.70/mo premium · $615.00 deductible | 1Preferred Generic | $2.00 | $6.00 | $0.1000 | — | None |
| Wellcare Value Script (PDP)$21.60/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0296 | — | None |
| Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0987 | — | None |
| Humana Value Rx Plan (PDP)$51.60/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1019 | — | None |
| Humana Premier Rx Plan (PDP)$90.20/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.1008 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible | 1Preferred Generic | $5.00 | $0.00 | $0.1439 | — | 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 | 1Preferred Generic | $0.00 | $0.00 | $0.0679 | — | None |
| HealthSpring Assurance Rx (PDP)$65.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $0.0712 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$145.10/mo premium · $615.00 deductible | 1Preferred Generic | 25% | 25% | $0.1250 | — | 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 | 1Preferred Generic | 25% | 25% | $0.1431 | — | 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 | 1Preferred Generic | 25% | 25% | $0.1485 | — | 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 | 1Preferred Generic | 25% | 25% | $0.1485 | — | 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 | 1Preferred Generic | 25% | 25% | $0.1397 | — | 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.