MedicarePartD.guide

A non-government resource built from CMS public data

L-GLUTAMINE 5 g Powder, For Solution

Coverage in Virginia (CMS PDP Region 07).

9 of 9 stand-alone Part D plans in Virginia cover this drug on tier 5.

9 of 9 plans apply a prior authorization, step therapy or quantity limit.

Every plan that covers it

Prior authorization
Step therapy
Quantity limit
Extra Help (LIS)

Showing 9 of 9 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help5Specialty Tier25%—$13.0606—
  • Prior authorization
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help5Specialty Tier25%—$13.0606—
  • Prior authorization
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help5Specialty Tier25%—$18.7754$337.9618 units
  • Prior authorization
  • Quantity limit 18 per 30 days
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible · $0 with full Extra Help5Specialty Tier26%—$18.7754$337.9618 units
  • Prior authorization
  • Quantity limit 18 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$39.60/mo premium · $615.00 deductible5Specialty Tier25%—$18.5269—
  • Prior authorization
SilverScript Choice (PDP)$78.20/mo premium · $615.00 deductible5Specialty Tier25%—$19.1545—
  • Prior authorization
Humana Premier Rx Plan (PDP)$87.60/mo premium · $0.00 deductible5Specialty Tier33%—$18.7754$337.9618 units
  • Prior authorization
  • Quantity limit 18 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$100.80/mo premium · $130.00 deductible5Specialty Tier31%—$17.7198—
  • Prior authorization
HealthSpring Assurance Rx (PDP)$133.80/mo premium · $615.00 deductible5Specialty Tier25%—$12.7675$229.8118 units
  • Prior authorization
  • Quantity limit 18 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.

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.

122 Medicare Advantage plans in VA do cover it

A patient on an MA-PD plan may have coverage even where no PDP lists the drug. VA: 122 plans.

See coverage in all 39 regions →