Medicare Advantage Drug Cost for Coartem



There are 41 Medicare Advantage Plans with additional prescription drug coverage for Coartem available to residents in California. The average retail unit cost (e.g. per pill) for a 30-day supply at in-area retail pharmacies is $5.28 ($158.41). Coartem is typically listed as a Tier 4 drug on the formulary and does not require prior authorization.

Below is the average retail cost and your co-pay for Coartem in California. You can also see if each plan requires prior authorization, step therapy or has drug quantity limits. Please check the formulary for different brand and generic drug names. Every Medicare Advantage Plan will vary in coverage, co-pays, costs and premiums. This chart can help you sort through different plan details to find a Medicare Advantage Plan in Alameda with the best coverage and the cheapest prices for your medications in California.



Proprietary Name:Coartem
Generic Name:Artemether And Lumefantrine
Drug Package:24 Tablet In 1 Bottle
Drug Strength:20; 120mg/1; mg/1
Substance:Artemether; Lumefantrine
Dosage Form:Tablet
Route:Oral
Labeler:Novartis Pharmaceuticals Corporation
Pen Name:Human Prescription Drug
NDC#00078056845
RX#847734
Days Supply:30
Coverage Phase:Initial Coverage
Plan Year:2023
County:Alameda





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Medicare Advantage Coverage for Coartem in California


Click the Plan Name for More Details
Click the header to sort
Plan
Name ⇅
Tier
Level
Your
Cost
Preferred
Cost
Non
Preferred
Cost
Mail
Limit
Amt/
Days
Prior
Auth
Y/N
Step
Therapy
Y/N
Avg
Unit
Cost
(x30)
AARP Medicare Advantage Choice Plan 1

4NA$100NA/NN$5.47
($164.14)
AARP Medicare Advantage SecureHorizons Plan 1

4NA$100NA/NN$5.45
($163.60)
Aetna Medicare Elite Plan

4$100$100$100/NN$5.52
($165.56)
Aetna Medicare Plus Plan

4$99$100$99/NN$5.52
($165.56)
Alignment Health Harmony

4NA$93NA/NN$5.38
($161.54)
Alignment Health My Choice CalPlus

4NA$100NA/NN$5.34
($160.28)
Anthem MediBlue Coordination Plus

4$95$100NA/NN$5.50
($165.05)
Anthem MediBlue Select

4$95$100NA/NN$5.50
($165.11)
Blue Shield Inspire

4$95$100NA/NN$4.92
($147.59)
Blue Shield Select

4$95$100NA/NN$4.92
($147.66)
Essence Advantage Gold

4NA$100NA/NN$4.96
($148.82)
Essence Advantage Platinum

4NA$100NA/NN$4.96
($148.82)
Imperial Dynamic Plan

4NA$75NA/NN$5.17
($155.05)
Imperial Strong

4NA25%NA/NN$5.18
($155.37)
Imperial Traditional

4NA$90NA/NN$5.18
($155.37)
Kaiser Permanente Senior Advantage Alam., SF, Napa

3NA$45NA/NN$5.63
($168.75)
Kaiser Permanente Senior Advantage Basic Alameda

3NA$45NA/NN$5.63
($168.75)
SCAN Classic

3$37$47$37/NN$5.04
($151.15)
UnitedHealthcare Canopy Health Medicare Advantage

4NA$100NA/NN$5.45
($163.60)
UnitedHealthcare Medicare Advantage Assure

4NA25%NA/NN$5.45
($163.56)
Wellcare No Premium

4$90$100$90/NN$5.38
($161.54)
Wellcare Premium Ultra

4$90$100$90/NN$5.38
($161.54)


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SNP Prescription Drug Cost for Coartem

Click the Plan Name for More Details about that Plan
Click the header to sort
Plan
Name ⇅
Tier
Level
Cost
Preferred
Cost
Non
Preferred
Cost
Amt
Mail
Limit
Days/
Amt
Prior
Auth
Y/N
Step
Therapy
Y/N
Avg
Unit
Cost
(x30)
Aetna Medicare Preferred Plan

4NA$0NA/NN$5.52
($165.56)
Align Connect

3NA$45NA/NN$5.32
($159.50)
Align Premier

1NA25%NA/NN$5.32
($159.50)
Align Thrive

3NA$45NA/NN$5.32
($159.50)
Alignment Health Heart & Diabetes

4NA$75NA/NN$5.47
($164.10)
Anthem MediBlue Dual Advantage

4$95$100NA/NN$5.50
($165.11)
Brand New Day Dual Access Plan

4NA25%NA/NN$5.01
($150.20)
Brand New Day Embrace Care Plan

4NA$90NA/NN$5.01
($150.20)
Brand New Day Embrace Choice Plan

4NA25%NA/NN$5.01
($150.20)
Brand New Day Select Care II Plan

4NA$100NA/NN$5.01
($150.20)
Brand New Day Select Choice II Plan

4NA25%NA/NN$5.01
($150.20)
Central Health Focus Plan

4NA$75NA/NN$5.16
($154.76)
Imperial Dual Plan

4NA25%NA/NN$5.18
($155.49)
Imperial Senior Value

4NA$90NA/NN$5.18
($155.37)
Kaiser Permanente Sr Adv Medicare Medi-Cal

3NA15%NA/NN$5.63
($168.75)
SCAN Balance

3$40$47$40/NN$5.04
($151.15)
SCAN Heart First

3$40$47$40/NN$5.04
($151.15)
UnitedHealthcare Dual Complete

4NA$0NA/NN$5.45
($163.60)
Wellcare Dual Liberty Amber

1NA$0NA/NN$5.40
($161.87)


Do any Medicare Advantage Plans Cover Coartem? Yes, 41 Medicare Advantage Plans cover this drug in California.

How much does Coartem Cost? $5.28, the average retail cost in California is $5.28 per unit or $158.41 for a 30-day supply at in-area pharmacies.

What Tier is Coartem? Tier 4, most Advantage Plans list Coartem on Tier 4 on their formulary. Usually, the higher the tier, the more you have to pay for the medication.

Do I need Prior Authorization for Coartem? No, the majority of Medicare Prescription Plans do not require prior authorization from your doctor for Coartem.



Additional Notes by Medicare Help:

Most plans have 4 levels of coverage. The exception is the $0 Deductible Plans.
1.Pre-Deductable: Before you reach the plans deductible. Some plans offer select Pre-deductible drug Coverage
2.Initial Coverage: (ICL) After you reach the plans deductible but before the Initial Coverage limit.
3.Coverage Gap: (AKA Donut Hole) After you reach the plans ICL but before the Catastrophic of $7550 in 2022.
4.Catastrophic: Anything over $7550 you will receive a significant increase in coverage.

Formulary Definitions:

Tier Level: Medicare drug plans place drugs into different "tiers" on their formularies. Drugs in each tier have a different cost. A drug in a lower tier will generally cost you less.
Cost Preferred: Your Cost for the Drug at the Providers In Network Preferred Pharmacy. As a Percent of the total drug cost or a flat rate.
Cost Non Preferred: Your Cost for the Prescription Drug at a Non-Preferred Pharmacy. As a Percent of the total drug cost or a flat rate.
Cost Mail: Your Cost for Prescription Drugs through a Mail Order Pharmacy. As a Percent of the total drug cost or a flat rate.
Quantity Limit Amount/Days: Certain drugs have a Quantity Limit. That means the plan will only cover the drug up to a designated quantity or amount. If your prescribing doctor feels it is necessary to exceed the set limit, he or she must get prior approval before the higher quantity will be covered.
Prior Authorization: Certain Drugs require you or your doctor to get prior authorization in order to be covered. Usually just an additional form. If you dont get approval, the plan may not cover the drug.
Step Therapy: Means you must first try one drug to treat your medical condition before the plan will cover another drug for the same condition. If you have already tried other drugs or your doctor thinks they are not right for you, you and your doctor can ask the plan to cover this drug.
Avg Unit Cost: Average unit cost (e.g. per pill) for specified days supply at in-area retail pharmacies. A pharmacy is considered in-area when it is geographically located in the service area.




What if a drug I need is not listed?

Please check the formulary for different brand and generic names. If you still cannot locate your drugs, your plan may not offer coverage. Talk to your doctor first about changing your prescription to a drug on your plans formulary. If this is not an option, you can request an exception to have the plan review its coverage decision based on your individual circumstances.

Last updated on
Source:CMS Formulary Data Q4 2022
Source:NDC Directory by FDA.gov

**We make every attempt to keep our information accurate. But please check with the plan providers to verify all information.

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*Licensed Agent Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options.

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