VOQUEZNA TRIPLE PAK Kit
Also known as Vonoprazan Fumarate, Amoxicillin And Clarithromycin. Coverage in Connecticut, Massachusetts, Rhode Island and Vermont (CMS PDP Region 02).
5 of 11 stand-alone Part D plans in Connecticut, Massachusetts, Rhode Island and Vermont cover this drug on tier 3–4.
Lowest 30-day cost $30.00 at a preferred pharmacy. 5 of 5 plans apply a prior authorization, step therapy or quantity limit.
Every plan that covers it
Showing 5 of 5 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Blue MedicareRx Value Plus (PDP)$20.70/mo premium · $615.00 deductible · $0 with full Extra Help | 3Preferred Brand | 17% | 17% | $7.4848 | $134.7318 units |
|
| SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible · $0 with full Extra Help | 4Non-Preferred Drug | 35% | 35% | $7.7162 | $138.8918 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | — | $8.0803 | — |
|
| AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible | 4Non-Preferred Drug | 30% | — | $8.0803 | — |
|
| Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible | 3Preferred Brand | $30.00 | $60.00 | $7.4848 | $134.7318 units |
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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.
113 Medicare Advantage plans in CT, MA, RI do cover it
A patient on an MA-PD plan may have coverage even where no PDP lists the drug. CT: 24 plans · MA: 74 plans · RI: 15 plans.