Medicare Advantage Drug Cost for Iressa



There are 56 Medicare Advantage Plans with additional prescription drug coverage for Iressa available to residents in Illinois. The average retail unit cost (e.g. per pill) for a 30-day supply at in-area retail pharmacies is $273.53 ($8,205.92). Iressa is typically listed as a Tier 5 drug on the formulary and does not require prior authorization.

Below is the average retail cost and your co-pay for Iressa in Illinois. 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 Cook with the best coverage and the cheapest prices for your medications in Illinois.



Proprietary Name:Iressa
Generic Name:Gefitinib
Drug Package:30 Tablet, Coated In 1 Bottle
Drug Strength:250mg/1
Substance:Gefitinib
Dosage Form:Tablet, Coated
Route:Oral
Labeler:Astrazeneca Pharmaceuticals Lp
Pen Name:Human Prescription Drug
NDC#00310048230
RX#402091
Days Supply:30
Coverage Phase:Initial Coverage
Plan Year:2023
County:Cook





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Medicare Advantage Coverage for Iressa in Illinois


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 Access

5NA33%33%/YN$276.91
($8,307.36)
AARP Medicare Advantage Choice

5NA33%33%/YN$276.91
($8,307.36)
AARP Medicare Advantage Plan 2

5NA33%33%/YN$276.91
($8,307.36)
AARP Medicare Advantage Walgreens

530%30%30%/YN$264.62
($7,938.57)
Aetna Medicare Premier Plus

533%33%33%/YN$292.08
($8,762.49)
Aetna Medicare Prime

533%33%33%/YN$292.08
($8,762.49)
Aetna Medicare Value

533%33%33%/YN$292.08
($8,762.49)
Ascension Complete Illinois Reward

525%25%25%/YN$298.97
($8,969.05)
Ascension Complete Illinois Secure

533%33%33%/YN$298.97
($8,969.05)
Blue Cross Medicare Advantage Basic

533%33%33%/YN$260.33
($7,809.87)
Blue Cross Medicare Advantage Basic Plus

533%33%33%/YN$260.33
($7,809.87)
Blue Cross Medicare Advantage Choice Plus

533%33%33%/YN$260.33
($7,809.87)
Blue Cross Medicare Advantage Choice Premier

533%33%33%/YN$260.33
($7,809.87)
Blue Cross Medicare Advantage Classic

529%29%29%/YN$260.33
($7,809.87)
Blue Cross Medicare Advantage Flex

525%25%25%/YN$264.83
($7,944.95)
Blue Cross Medicare Advantage Premier Plus

533%33%33%/YN$260.33
($7,809.87)
Blue Medicare Advocate Health

533%33%33%/YN$260.33
($7,809.87)
Cigna Preferred Medicare

533%33%33%/YN$267.26
($8,017.86)
Cigna Premier Medicare

533%33%33%/YN$267.26
($8,017.86)
Cigna True Choice Medicare

533%33%33%/YN$267.26
($8,017.86)
Clear Spring Health Community Advantage Plan

533%33%33%/YN$267.95
($8,038.50)
Clear Spring Health Essential

533%33%33%/YN$267.95
($8,038.50)
Devoted CORE Illinois

5NA33%NA/YN$246.30
($7,388.87)
Devoted GIVEBACK Illinois

5NA33%NA/YN$246.30
($7,388.87)
Humana Gold Choice H8145-008

5NA27%27%/YN$279.05
($8,371.35)
Humana Gold Plus H1468-013

5NA33%33%/YN$279.05
($8,371.35)
HumanaChoice H5216-013

5NA33%33%/YN$279.05
($8,371.35)
HumanaChoice H5216-251

5NA33%33%/YN$279.05
($8,371.35)
HumanaChoice H5216-283

5NA33%33%/YN$279.05
($8,371.35)
HumanaChoice R5361-002

5NA25%25%/YN$279.05
($8,371.35)
Wellcare Assist

525%25%25%/YN$292.39
($8,771.84)
Wellcare Assist Compass

525%25%25%/YN$292.39
($8,771.84)
Wellcare Giveback Open

533%33%33%/YN$298.97
($8,969.05)
Wellcare No Premium

533%33%33%/YN$298.97
($8,969.05)
Wellcare No Premium Essential

533%33%33%/YN$291.71
($8,751.25)
Wellcare No Premium Exclusive

533%33%33%/YN$298.97
($8,969.05)
Wellcare No Premium Open

533%33%33%/YN$298.97
($8,969.05)
Zing Choice IL

5NA33%NA/YN$270.03
($8,100.90)
Zing Open Access IL

5NA33%NA/YN$270.03
($8,100.90)
Zing Signature Care IL

5NA33%NA/YN$270.03
($8,100.90)


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SNP Prescription Drug Cost for Iressa

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)
Humana Community HMO Diabetes and Heart

5NA33%33%/YN$279.05
($8,371.35)
Humana Senior Living Plan

5NA29%29%/YN$279.05
($8,371.35)
Humana Together in Health

5NA29%29%/YN$279.05
($8,371.35)
Longevity Health Plan

1NA25%NA/YN$251.12
($7,533.56)
Provider Partners Illinois Advantage Plan

1NA25%NA/YN$262.18
($7,865.52)
Provider Partners Illinois Community Plan

1NA25%NA/YN$262.18
($7,865.52)
UnitedHealthcare Assisted Living Plan

5NA33%33%/YN$276.91
($8,307.36)
UnitedHealthcare Chronic Complete Assure (PPO C-SNP)

5NA25%NA/YN$276.91
($8,307.36)
UnitedHealthcare Nursing Home Plan 1

5NA25%NA/YN$276.91
($8,307.36)
UnitedHealthcare Nursing Home Plan 2

5NA25%NA/YN$276.91
($8,307.36)
Zing Essential Wellness Diabetes and Heart IL

5NA33%NA/YN$270.03
($8,100.90)


Do any Medicare Advantage Plans Cover Iressa? Yes, 56 Medicare Advantage Plans cover this drug in Illinois.

How much does Iressa Cost? $273.53, the average retail cost in Illinois is $273.53 per unit or $8,205.92 for a 30-day supply at in-area pharmacies.

What Tier is Iressa? Tier 5, most Advantage Plans list Iressa on Tier 5 on their formulary. Usually, the higher the tier, the more you have to pay for the medication.

Do I need Prior Authorization for Iressa? Yes, the majority of Medicare Prescription Plans do require prior authorization from your doctor for Iressa.



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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