MedicarePartD.guide

A non-government resource built from CMS public data

METFORMIN HYDROCHLORIDE 500 mg Tablet

Package: 1000 TABLET in 1 BOTTLE (70010-063-10). NDC 70010006310.

Plans covering it
367
across 39 regions checked
Lowest tier
1
lower tiers cost less
Plans with restrictions
260
prior auth, step therapy or quantity limit

Coverage by region

Covered by at least one plan in 39 of 39 CMS regions.

RegionPlans coveringTiersLowest 30-day costRestrictions
New Jersey12 of 121$0.009 of 12 plans
Pennsylvania and West Virginia12 of 121$0.007 of 12 plans
North Carolina12 of 121$0.009 of 12 plans
Alabama and Tennessee12 of 121$0.009 of 12 plans
Michigan12 of 121$0.009 of 12 plans
Illinois12 of 121$0.009 of 12 plans
Arkansas12 of 121$0.009 of 12 plans
Texas12 of 121$0.009 of 12 plans
Kansas12 of 121$0.009 of 12 plans
California12 of 121$0.007 of 12 plans
Connecticut, Massachusetts, Rhode Island and Vermont11 of 111$0.008 of 11 plans
South Carolina11 of 111–6$0.007 of 11 plans
Oklahoma11 of 111$0.008 of 11 plans
Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming11 of 111$0.008 of 11 plans
New Mexico11 of 111$0.008 of 11 plans
New York10 of 101$0.007 of 10 plans
Delaware, DC and Maryland10 of 101$0.007 of 10 plans
Georgia10 of 101$0.007 of 10 plans
Florida10 of 101–6$0.007 of 10 plans
Ohio10 of 101$0.007 of 10 plans
Indiana and Kentucky10 of 101$0.007 of 10 plans
Wisconsin10 of 101$0.007 of 10 plans
Missouri10 of 101$0.007 of 10 plans
Mississippi10 of 101$0.007 of 10 plans
Louisiana10 of 101$0.007 of 10 plans
Colorado10 of 101$0.007 of 10 plans
Arizona10 of 101$0.007 of 10 plans
Nevada10 of 101$0.007 of 10 plans
Oregon and Washington10 of 101$0.007 of 10 plans
Idaho and Utah10 of 101$0.007 of 10 plans
Maine and New Hampshire9 of 91$0.006 of 9 plans
Virginia9 of 91$0.006 of 9 plans
Alaska9 of 91$0.006 of 9 plans
Hawaii8 of 81$0.005 of 8 plans
Puerto Rico3 of 31$0.003 of 3 plans
American Samoa1 of 11—1 of 1 plans
Guam1 of 11—1 of 1 plans
Northern Mariana Islands1 of 11—1 of 1 plans
U.S. Virgin Islands1 of 11—1 of 1 plans

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, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$4.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0435—None
Wellcare Value Script (PDP)$22.80/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0215$0.3215 units
  • Quantity limit 15 per 30 days
Wellcare Classic (PDP)$28.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0497$0.7515 units
  • Quantity limit 15 per 30 days
Humana Value Rx Plan (PDP)$35.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0439—None
HealthSpring Extra Rx (PDP)$59.90/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0523$0.7815 units
  • Quantity limit 15 per 30 days
Horizon Medicare Blue Rx Standard (PDP)$72.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0472$0.7115 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$77.40/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1104$1.6615 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0620$0.9315 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$109.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0489$0.7315 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$111.90/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0435—None
AARP Medicare Rx Preferred from UHC (PDP)$118.90/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1299$1.9515 units
  • Quantity limit 15 per 30 days
Horizon Medicare Blue Rx Enhanced (PDP)$139.10/mo premium · $200.00 deductible1Preferred Generic$0.00$0.00$0.0472$0.7115 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

Pennsylvania and West Virginia — 12 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$6.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0408—None
Wellcare Value Script (PDP)$8.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0274$0.4115 units
  • Quantity limit 15 per 30 days
Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0495$0.7415 units
  • Quantity limit 15 per 30 days
Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0417—None
SilverScript Choice (PDP)$22.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0700$1.0515 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$43.50/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1072$1.6115 units
  • Quantity limit 15 per 30 days
HealthSpring Extra Rx (PDP)$62.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0529$0.7915 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$74.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0527$0.7915 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$121.90/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1273$1.9115 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$123.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0408—None
Blue Rx PDP Complete (PDP)$164.80/mo premium · $200.00 deductible1Preferred Generic$0.00$0.00$0.0428—None
Blue Rx PDP Plus (PDP)$193.20/mo premium · $615.00 deductible1Preferred Generic25%25%$0.0428—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, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0299$0.4515 units
  • Quantity limit 15 per 30 days
Wellcare Classic (PDP)$4.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0570$0.8515 units
  • Quantity limit 15 per 30 days
Humana Basic Rx Plan (PDP)$6.80/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0435—None
Humana Value Rx Plan (PDP)$32.00/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0447—None
AARP Medicare Rx Saver from UHC (PDP)$56.90/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0954$1.4315 units
  • Quantity limit 15 per 30 days
HealthSpring Extra Rx (PDP)$78.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0570$0.8515 units
  • Quantity limit 15 per 30 days
Blue Medicare Rx Standard (PDP)$83.90/mo premium · $615.00 deductible1Preferred Generic$5.00$15.00$0.0603$0.9015 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$90.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0627$0.9415 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$110.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0649$0.9715 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$110.90/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0435—None
AARP Medicare Rx Preferred from UHC (PDP)$119.80/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1177$1.7715 units
  • Quantity limit 15 per 30 days
Blue Medicare Rx Enhanced (PDP)$163.20/mo premium · $0.00 deductible1Preferred Generic$3.00$9.00$0.0603$0.9015 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

Alabama and Tennessee — 12 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0418—None
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0319$0.4815 units
  • Quantity limit 15 per 30 days
Wellcare Classic (PDP)$3.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0538$0.8115 units
  • Quantity limit 15 per 30 days
Humana Value Rx Plan (PDP)$37.70/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0431—None
AARP Medicare Rx Saver from UHC (PDP)$63.20/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0890$1.3315 units
  • Quantity limit 15 per 30 days
BlueRx Essential (PDP)$76.20/mo premium · $615.00 deductible1Preferred Generic$2.00$4.00$0.0478$0.7215 units
  • Quantity limit 15 per 30 days
HealthSpring Extra Rx (PDP)$77.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0554$0.8315 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$87.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0632$0.9515 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$97.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0655$0.9815 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0418—None
AARP Medicare Rx Preferred from UHC (PDP)$119.30/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1150$1.7315 units
  • Quantity limit 15 per 30 days
BlueRx Enhanced Plus (PDP)$129.50/mo premium · $150.00 deductible1Preferred Generic$0.00$0.00$0.0478$0.7215 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

Michigan — 12 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0468$0.7015 units
  • Quantity limit 15 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0262$0.3915 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.0504$0.7615 units
  • Quantity limit 15 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0395—None
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0401—None
AARP Medicare Rx Saver from UHC (PDP)$14.10/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1070$1.6015 units
  • Quantity limit 15 per 30 days
HealthSpring Extra Rx (PDP)$50.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0487$0.7315 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$78.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0673$1.0115 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$78.30/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1251$1.8815 units
  • Quantity limit 15 per 30 days
Prescription Blue Select (PDP)$78.40/mo premium · $615.00 deductible1Preferred Generic$1.00$3.00$0.0395$0.5915 units
  • Quantity limit 45 per 90 days
Humana Premier Rx Plan (PDP)$98.10/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0395—None
Prescription Blue Premium (PDP)$106.70/mo premium · $0.00 deductible1Preferred Generic$1.00$2.00$0.0395$0.5915 units
  • Quantity limit 45 per 90 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

Illinois — 12 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0555$0.8315 units
  • Quantity limit 15 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0246$0.3715 units
  • Quantity limit 15 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0414—None
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0420—None
AARP Medicare Rx Saver from UHC (PDP)$40.20/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0705$1.0615 units
  • Quantity limit 15 per 30 days
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0461$0.6915 units
  • Quantity limit 15 per 30 days
Blue Cross MedicareRx Basic (PDP)$89.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0467$0.7015 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0671$1.0115 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$103.90/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1035$1.5515 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$104.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0662$0.9915 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$119.40/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0414—None
Blue Cross MedicareRx Value (PDP)$119.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0578$0.8715 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

Arkansas — 12 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0563$0.8415 units
  • Quantity limit 15 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0460$0.6915 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.0724$1.0915 units
  • Quantity limit 15 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0375—None
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0397—None
BlueMedicare Value Rx (PDP)$52.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0799$1.2015 units
  • Quantity limit 15 per 30 days
HealthSpring Extra Rx (PDP)$54.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0664$1.0015 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$65.10/mo premium · $615.00 deductible1Preferred Generic$2.00$24.00$0.0928$1.3915 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$73.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0660$0.9915 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$92.40/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0375—None
AARP Medicare Rx Preferred from UHC (PDP)$114.90/mo premium · $130.00 deductible1Preferred Generic$5.00$39.00$0.1173$1.7615 units
  • Quantity limit 15 per 30 days
BlueMedicare Premier Rx (PDP)$181.20/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0799$1.2015 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

Texas — 12 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0533$0.8015 units
  • Quantity limit 15 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0315$0.4715 units
  • Quantity limit 15 per 30 days
Humana Value Rx Plan (PDP)$22.90/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0431—None
Humana Basic Rx Plan (PDP)$41.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0417—None
HealthSpring Extra Rx (PDP)$70.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0528$0.7915 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$89.20/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0777$1.1715 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$94.80/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0660$0.9915 units
  • Quantity limit 15 per 30 days
Blue Cross MedicareRx Basic (PDP)$104.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0481$0.7215 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$111.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0630$0.9515 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1093$1.6415 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$118.20/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0417—None
Blue Cross MedicareRx Value (PDP)$167.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0644$0.9715 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

Kansas — 12 plans, 9 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Blue MedicareRx Essentials (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0762$1.1415 units
  • Quantity limit 15 per 30 days
Blue MedicareRx Value (PDP)$0.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0672$1.0115 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$6.70/mo premium · $615.00 deductible1Preferred Generic5%5%$0.0697$1.0515 units
  • Quantity limit 15 per 30 days
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0445$0.6715 units
  • Quantity limit 15 per 30 days
Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0631$0.9515 units
  • Quantity limit 15 per 30 days
Humana Basic Rx Plan (PDP)$15.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0386—None
Humana Value Rx Plan (PDP)$55.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0403—None
Blue MedicareRx Plus (PDP)$67.40/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0672$1.0115 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$88.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0730$1.0915 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$105.40/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0876$1.3115 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$116.30/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0386—None
AARP Medicare Rx Preferred from UHC (PDP)$147.00/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1180$1.7715 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

California — 12 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.0511$0.7715 units
  • Quantity limit 15 per 30 days
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0225$0.3415 units
  • Quantity limit 15 per 30 days
Wellcare Classic (PDP)$6.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0508$0.7615 units
  • Quantity limit 15 per 30 days
HealthSpring Extra Rx (PDP)$70.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0530$0.7915 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$103.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0608$0.9115 units
  • Quantity limit 15 per 30 days
Humana Value Rx Plan (PDP)$104.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0438—None
AARP Medicare Rx Saver from UHC (PDP)$109.40/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1108$1.6615 units
  • Quantity limit 15 per 30 days
Humana Basic Rx Plan (PDP)$132.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0433—None
AARP Medicare Rx Preferred from UHC (PDP)$165.40/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1277$1.9215 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$172.90/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0433—None
Blue Shield Rx Plus (PDP)$199.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0588—None
Blue Shield Rx Enhanced (PDP)$227.80/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0588—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, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$8.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0466—None
Wellcare Value Script (PDP)$16.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0188$0.2815 units
  • Quantity limit 15 per 30 days
Blue MedicareRx Value Plus (PDP)$20.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.1375$2.0615 units
  • Quantity limit 15 per 30 days
Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0542$0.8115 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0722$1.0815 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1122$1.6815 units
  • Quantity limit 15 per 30 days
Humana Value Rx Plan (PDP)$73.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0470—None
Humana Premier Rx Plan (PDP)$138.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0466—None
HealthSpring Assurance Rx (PDP)$139.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0500$0.7515 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1282$1.9215 units
  • Quantity limit 15 per 30 days
Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible1Preferred Generic$1.00$1.00$0.1375$2.0615 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

South Carolina — 11 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$4.80/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0285$0.4315 units
  • Quantity limit 15 per 30 days
Wellcare Classic (PDP)$9.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0540$0.8115 units
  • Quantity limit 15 per 30 days
Humana Basic Rx Plan (PDP)$10.10/mo premium · $615.00 deductible1Preferred Generic$1.00$0.00$0.0442—None
Humana Value Rx Plan (PDP)$65.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0454—None
HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0553$0.8315 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$98.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0623$0.9315 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$122.10/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0974$1.4615 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1203$1.8015 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$145.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0442—None
HealthSpring Assurance Rx (PDP)$152.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0600$0.9015 units
  • Quantity limit 15 per 30 days
BlueCross Rx Value (PDP)$139.70/mo premium · $615.00 deductible6Select Care Drugs$5.00$12.50$0.1760—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, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Blue Cross MedicareRx Basic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0674$1.0115 units
  • Quantity limit 15 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$1.00$0.00$0.0406—None
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0467$0.7015 units
  • Quantity limit 15 per 30 days
Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0600$0.9015 units
  • Quantity limit 15 per 30 days
Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0427—None
HealthSpring Extra Rx (PDP)$65.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0640$0.9615 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0891$1.3415 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0406—None
AARP Medicare Rx Preferred from UHC (PDP)$121.00/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1138$1.7115 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$126.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0742$1.1115 units
  • Quantity limit 15 per 30 days
Blue Cross MedicareRx Value (PDP)$167.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0822$1.2315 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming — 11 plans, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$4.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0377—None
AARP Medicare Rx Saver from UHC (PDP)$5.30/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0838$1.2615 units
  • Quantity limit 15 per 30 days
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0379$0.5715 units
  • Quantity limit 15 per 30 days
Wellcare Classic (PDP)$12.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0480$0.7215 units
  • Quantity limit 15 per 30 days
Humana Value Rx Plan (PDP)$20.80/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0387—None
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0731$1.1015 units
  • Quantity limit 15 per 30 days
HealthSpring Extra Rx (PDP)$66.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0516$0.7715 units
  • Quantity limit 15 per 30 days
MedicareBlue Rx Standard (PDP)$101.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0731$1.1015 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$103.70/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0377—None
HealthSpring Assurance Rx (PDP)$125.90/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0545$0.8215 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$140.20/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1129$1.6915 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

New Mexico — 11 plans, 8 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0599$0.9015 units
  • Quantity limit 15 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0367$0.5515 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.0783$1.1715 units
  • Quantity limit 15 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0429—None
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0650$0.9815 units
  • Quantity limit 15 per 30 days
Humana Value Rx Plan (PDP)$69.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0446—None
Humana Premier Rx Plan (PDP)$75.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0429—None
AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1012$1.5215 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$104.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0684$1.0315 units
  • Quantity limit 15 per 30 days
Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0705$1.0615 units
  • Quantity limit 15 per 30 days
Blue Cross MedicareRx Basic (PDP)$145.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0510$0.7615 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

New York — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$35.70/mo premium · $615.00 deductible1Preferred Generic5%5%$0.0437$0.6615 units
  • Quantity limit 15 per 30 days
Wellcare Value Script (PDP)$42.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0238$0.3615 units
  • Quantity limit 15 per 30 days
Wellcare Classic (PDP)$45.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0444$0.6715 units
  • Quantity limit 15 per 30 days
HealthSpring Extra Rx (PDP)$91.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0506$0.7615 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$105.80/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1161$1.7415 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$116.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0624$0.9415 units
  • Quantity limit 15 per 30 days
Humana Basic Rx Plan (PDP)$140.90/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0401—None
Humana Value Rx Plan (PDP)$158.90/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0405—None
AARP Medicare Rx Preferred from UHC (PDP)$163.70/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1306$1.9615 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$173.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0401—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, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0438—None
Humana Value Rx Plan (PDP)$4.30/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0445—None
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0219$0.3315 units
  • Quantity limit 15 per 30 days
Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0507$0.7615 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$32.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0542$0.8115 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$37.80/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0941$1.4115 units
  • Quantity limit 15 per 30 days
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0473$0.7115 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1184$1.7815 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0632$0.9515 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0438—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, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0522$0.7815 units
  • Quantity limit 15 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0299$0.4515 units
  • Quantity limit 15 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0418—None
Humana Value Rx Plan (PDP)$36.40/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0429—None
HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0588$0.8815 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$98.00/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0909$1.3615 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$100.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0656$0.9815 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$129.50/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0418—None
AARP Medicare Rx Preferred from UHC (PDP)$139.80/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1180$1.7715 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$149.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0587$0.8815 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

Florida — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0482$0.7215 units
  • Quantity limit 15 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0239$0.3615 units
  • Quantity limit 15 per 30 days
Humana Value Rx Plan (PDP)$25.90/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0462—None
Humana Basic Rx Plan (PDP)$92.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0455—None
SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0659$0.9915 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$98.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0803$1.2015 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$115.90/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0455—None
AARP Medicare Rx Preferred from UHC (PDP)$119.10/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1105$1.6615 units
  • Quantity limit 15 per 30 days
BlueMedicare Premier Rx (PDP)$98.60/mo premium · $615.00 deductible6Select Care Drugs$3.00$9.00$0.0380$0.5715 units
  • Quantity limit 15 per 30 days
BlueMedicare Complete Rx (PDP)$217.00/mo premium · $615.00 deductible6Select Care Drugs$0.00$0.00$0.0380$0.5715 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

Ohio — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0399—None
Wellcare Value Script (PDP)$7.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0261$0.3915 units
  • Quantity limit 15 per 30 days
Wellcare Classic (PDP)$7.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0527$0.7915 units
  • Quantity limit 15 per 30 days
Humana Value Rx Plan (PDP)$23.70/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0408—None
HealthSpring Extra Rx (PDP)$65.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0562$0.8415 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$73.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1246$1.8715 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$90.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0661$0.9915 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$109.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0579$0.8715 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$117.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0399—None
AARP Medicare Rx Preferred from UHC (PDP)$123.40/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1362$2.0415 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

Indiana and Kentucky — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0412—None
Wellcare Value Script (PDP)$8.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0308$0.4615 units
  • Quantity limit 15 per 30 days
Wellcare Classic (PDP)$8.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0565$0.8515 units
  • Quantity limit 15 per 30 days
Humana Value Rx Plan (PDP)$9.90/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0423—None
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0703$1.0515 units
  • Quantity limit 15 per 30 days
HealthSpring Extra Rx (PDP)$78.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0607$0.9115 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$90.30/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1044$1.5715 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$117.80/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0611$0.9215 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$125.30/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0412—None
AARP Medicare Rx Preferred from UHC (PDP)$127.10/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1252$1.8815 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

Wisconsin — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0583$0.8715 units
  • Quantity limit 15 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0333$0.5015 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.0682$1.0215 units
  • Quantity limit 15 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0433—None
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0445—None
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0766$1.1515 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$26.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0712$1.0715 units
  • Quantity limit 15 per 30 days
HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0550$0.8215 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$110.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0433—None
AARP Medicare Rx Preferred from UHC (PDP)$113.90/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1055$1.5815 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

Missouri — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0420$0.6315 units
  • Quantity limit 15 per 30 days
Wellcare Classic (PDP)$10.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0607$0.9115 units
  • Quantity limit 15 per 30 days
Humana Basic Rx Plan (PDP)$16.50/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0428—None
Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0444—None
HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0575$0.8615 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$71.90/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0914$1.3715 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$74.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0671$1.0115 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0653$0.9815 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$125.40/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1164$1.7515 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$126.40/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0428—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, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0567$0.8515 units
  • Quantity limit 15 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0391$0.5915 units
  • Quantity limit 15 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0397—None
Humana Value Rx Plan (PDP)$37.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0413—None
HealthSpring Assurance Rx (PDP)$59.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0670$1.0115 units
  • Quantity limit 15 per 30 days
HealthSpring Extra Rx (PDP)$77.10/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0632$0.9515 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$84.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0943$1.4115 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$89.90/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0397—None
SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0653$0.9815 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$140.60/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1181$1.7715 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

Louisiana — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0423—None
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0369$0.5515 units
  • Quantity limit 15 per 30 days
Wellcare Classic (PDP)$6.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0558$0.8415 units
  • Quantity limit 15 per 30 days
Humana Value Rx Plan (PDP)$19.30/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0440—None
AARP Medicare Rx Saver from UHC (PDP)$37.00/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0912$1.3715 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$44.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0690$1.0415 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$48.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0669$1.0015 units
  • Quantity limit 15 per 30 days
HealthSpring Extra Rx (PDP)$60.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0598$0.9015 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$113.70/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0423—None
AARP Medicare Rx Preferred from UHC (PDP)$139.50/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1148$1.7215 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

Colorado — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0306$0.4615 units
  • Quantity limit 15 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0381—None
Wellcare Classic (PDP)$2.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0568$0.8515 units
  • Quantity limit 15 per 30 days
Humana Value Rx Plan (PDP)$48.50/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0394—None
HealthSpring Assurance Rx (PDP)$61.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0722$1.0815 units
  • Quantity limit 15 per 30 days
HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0642$0.9615 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$105.10/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0711$1.0715 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$125.00/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0693$1.0415 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$137.10/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0381—None
AARP Medicare Rx Preferred from UHC (PDP)$151.90/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1075$1.6115 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

Arizona — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0599$0.9015 units
  • Quantity limit 15 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0308$0.4615 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.0690$1.0415 units
  • Quantity limit 15 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$2.00$0.00$0.0439—None
Humana Value Rx Plan (PDP)$2.50/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0450—None
AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1167$1.7515 units
  • Quantity limit 15 per 30 days
HealthSpring Extra Rx (PDP)$66.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0541$0.8115 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0675$1.0115 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$97.50/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1308$1.9615 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$119.20/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0439—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, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0451—None
Wellcare Classic (PDP)$2.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0583$0.8715 units
  • Quantity limit 15 per 30 days
Wellcare Value Script (PDP)$2.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0245$0.3715 units
  • Quantity limit 15 per 30 days
Humana Value Rx Plan (PDP)$43.70/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0461—None
HealthSpring Extra Rx (PDP)$52.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0544$0.8215 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$76.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0791$1.1915 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$95.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0661$0.9915 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0659$0.9915 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$139.10/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1091$1.6415 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$148.70/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0451—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, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0492$0.7415 units
  • Quantity limit 15 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0300$0.4515 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.0652$0.9815 units
  • Quantity limit 15 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0372—None
Humana Value Rx Plan (PDP)$22.10/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0381—None
AARP Medicare Rx Saver from UHC (PDP)$38.40/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0741$1.1115 units
  • Quantity limit 15 per 30 days
HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0554$0.8315 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$85.90/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0710$1.0615 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0372—None
AARP Medicare Rx Preferred from UHC (PDP)$110.00/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1102$1.6515 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

Idaho and Utah — 10 plans, 7 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0365—None
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0328$0.4915 units
  • Quantity limit 15 per 30 days
Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0378—None
Wellcare Classic (PDP)$23.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0506$0.7615 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$27.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0700$1.0515 units
  • Quantity limit 15 per 30 days
HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0642$0.9615 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$56.50/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0819$1.2315 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$115.50/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0365—None
HealthSpring Assurance Rx (PDP)$128.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0651$0.9815 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$132.60/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1137$1.7115 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

Maine and New Hampshire — 9 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0516$0.7715 units
  • Quantity limit 15 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0344$0.5215 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.0600$0.9015 units
  • Quantity limit 15 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0414—None
Humana Value Rx Plan (PDP)$54.40/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0425—None
AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0749$1.1215 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0670$1.0115 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$104.30/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1082$1.6215 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$150.20/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0414—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, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0578$0.8715 units
  • Quantity limit 15 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0291$0.4415 units
  • Quantity limit 15 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0437—None
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0450—None
AARP Medicare Rx Saver from UHC (PDP)$39.60/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0950$1.4315 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$78.20/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0624$0.9415 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$87.60/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0437—None
AARP Medicare Rx Preferred from UHC (PDP)$100.80/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1193$1.7915 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$133.80/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0636$0.9515 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

Alaska — 9 plans, 6 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0567$0.8515 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic5%5%$0.0771$1.1615 units
  • Quantity limit 15 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$2.00$0.00$0.0333—None
Humana Value Rx Plan (PDP)$10.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0342—None
Wellcare Value Script (PDP)$19.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0412$0.6215 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$53.20/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0970$1.4615 units
  • Quantity limit 15 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0753$1.1315 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$100.20/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1338$2.0115 units
  • Quantity limit 15 per 30 days
Humana Premier Rx Plan (PDP)$112.40/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0333—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, 5 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.1247$1.8715 units
  • Quantity limit 15 per 30 days
Humana Basic Rx Plan (PDP)$0.40/mo premium · $615.00 deductible1Preferred Generic$3.00$0.00$0.0472—None
SilverScript Choice (PDP)$14.70/mo premium · $615.00 deductible1Preferred Generic$2.00$6.00$0.0747$1.1215 units
  • Quantity limit 15 per 30 days
Wellcare Value Script (PDP)$21.60/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0214$0.3215 units
  • Quantity limit 15 per 30 days
Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0564$0.8515 units
  • Quantity limit 15 per 30 days
Humana Value Rx Plan (PDP)$51.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$0.0476—None
Humana Premier Rx Plan (PDP)$90.20/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$0.0472—None
AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible1Preferred Generic$5.00$0.00$0.1355$2.0315 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

Puerto Rico — 3 plans, 3 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0563$0.8415 units
  • Quantity limit 15 per 30 days
HealthSpring Assurance Rx (PDP)$65.70/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$0.0504$0.7615 units
  • Quantity limit 15 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$145.10/mo premium · $615.00 deductible1Preferred Generic25%25%$0.1221$1.8315 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

American Samoa — 1 plan, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic25%25%$0.1687$2.5315 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

Guam — 1 plan, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$0.00/mo premium · $615.00 deductible1Preferred Generic25%25%$0.1488$2.2315 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

Northern Mariana Islands — 1 plan, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$32.10/mo premium · $615.00 deductible1Preferred Generic25%25%$0.1488$2.2315 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.

U.S. Virgin Islands — 1 plan, 1 with restrictions
PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $615.00 deductible1Preferred Generic25%25%$0.1348$2.0215 units
  • Quantity limit 15 per 30 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity — elsewhere it depends on what is prescribed.