DULERA 200/5 ug Aerosol

Also known as Mometasone Furoate And Formoterol Fumarate Dihydrate. Coverage in Arkansas (CMS PDP Region 19).

5 of 12 stand-alone Part D plans in Arkansas cover this drug on tier 4.

5 of 5 plans apply a prior authorization, step therapy or quantity limit.

38 Medicare Advantage plans in AR do cover it

Medicare Advantage plans carry their own formularies, separate from stand-alone Part D. A patient on an MA-PD plan may have coverage even where no PDP lists the drug. AR: 38 plans.

Every plan that covers it

Plan	Tier	30-day preferred	90-day mail	Unit cost	Est. 30-day fill	Restrictions
BlueMedicare Value Rx (PDP)$52.50/mo premium · $615.00 deductible	4Non-Preferred Drug	34%	34%	$25.6053	$998.6139 units	Quantity limit 39 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$65.10/mo premium · $615.00 deductible	4Non-Preferred Drug	32%	—	$27.0097	$351.1313 units	Quantity limit 13 per 30 days
SilverScript Choice (PDP)$73.50/mo premium · $615.00 deductible	4Non-Preferred Drug	33%	33%	$25.9463	$337.3013 units	Quantity limit 13 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$114.90/mo premium · $130.00 deductible	4Non-Preferred Drug	29%	—	$27.0097	$351.1313 units	Quantity limit 13 per 30 days
BlueMedicare Premier Rx (PDP)$181.20/mo premium · $0.00 deductible	4Non-Preferred Drug	34%	34%	$25.6053	$998.6139 units	Quantity limit 39 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.

See coverage in all 39 regions →