GATIFLOXACIN 5 mg/mL Solution
Coverage in Idaho and Utah (CMS PDP Region 31).
4 of 10 stand-alone Part D plans in Idaho and Utah cover this drug on tier 2–4.
Lowest 30-day cost $3.00 at a preferred pharmacy. 1 of 4 plans apply a prior authorization, step therapy or quantity limit.
Every plan that covers it
Showing 4 of 4 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 | $7.6305 | — | None |
| Wellcare Classic (PDP)$23.70/mo premium · $615.00 deductible · $0 with full Extra Help | 4Non-Preferred Drug | 27% | 27% | $29.8627 | — | None |
| SilverScript Choice (PDP)$27.70/mo premium · $615.00 deductible · $0 with full Extra Help | 2Generic | $10.00 | $30.00 | $8.6752 | $17.352 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$132.60/mo premium · $130.00 deductible | 3Preferred Brand | 17% | 17% | $17.1535 | — | 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.
Medicare Advantage plans
Medicare Advantage plans carry their own formularies, separate from stand-alone Part D, and are sold county by county. Pick a county to see every Medicare Advantage drug plan there that covers this drug.
78 Medicare Advantage plans in ID, UT do cover it
A patient on an MA-PD plan may have coverage even where no PDP lists the drug. ID: 33 plans · UT: 45 plans.