Medicare Advantage Drug Cost for Icosapent Ethyl



There are 16 Medicare Advantage Plans with additional prescription drug coverage for Icosapent Ethyl 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 $2.22 ($66.59). Icosapent Ethyl 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 Icosapent Ethyl 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:Icosapent Ethyl
Generic Name:Icosapent Ethyl
Drug Package:120 Capsule In 1 Bottle
Drug Strength:1g/1
Substance:Icosapent Ethyl
Dosage Form:Capsule
Route:Oral
Labeler:Hikma Pharmaceuticals Usa Inc.
Pen Name:Human Prescription Drug
NDC#00054050823
RX#1304979
Days Supply:30
Coverage Phase:Initial Coverage
Plan Year:2023
County:Cook





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Medicare Advantage Coverage for Icosapent Ethyl 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

4NA$100NA/NN$2.20
($66.04)
AARP Medicare Advantage Choice

4NA$95NA/NN$2.20
($66.04)
AARP Medicare Advantage Plan 2

4NA$100NA/NN$2.20
($66.04)
AARP Medicare Advantage Walgreens

4$100$100NA/NN$2.20
($66.04)
Blue Cross Medicare Advantage Basic

3$47$47$47/NN$2.24
($67.06)
Blue Cross Medicare Advantage Basic Plus

3$47$47$47/NN$2.24
($67.06)
Blue Cross Medicare Advantage Choice Plus

3$47$47$47/NN$2.24
($67.12)
Blue Cross Medicare Advantage Choice Premier

3$47$47$47/NN$2.24
($67.12)
Blue Cross Medicare Advantage Classic

4$85$100$85/NN$2.23
($67.04)
Blue Cross Medicare Advantage Flex

4$85$100$85/NN$2.25
($67.59)
Blue Cross Medicare Advantage Premier Plus

3$47$47$47/NN$2.24
($67.06)
Blue Medicare Advocate Health

3$47$47$47/NN$2.24
($67.10)


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SNP Prescription Drug Cost for Icosapent Ethyl

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)
UnitedHealthcare Assisted Living Plan

4NA$100NA/NN$2.20
($66.04)
UnitedHealthcare Chronic Complete Assure (PPO C-SNP)

4NA25%NA/NN$2.20
($66.04)
UnitedHealthcare Nursing Home Plan 1

4NA25%NA/NN$2.20
($66.04)
UnitedHealthcare Nursing Home Plan 2

4NA25%NA/NN$2.20
($66.04)


Do any Medicare Advantage Plans Cover Icosapent Ethyl? Yes, 16 Medicare Advantage Plans cover this drug in Illinois.

How much does Icosapent Ethyl Cost? $2.22, the average retail cost in Illinois is $2.22 per unit or $66.59 for a 30-day supply at in-area pharmacies.

What Tier is Icosapent Ethyl? Tier 4, most Advantage Plans list Icosapent Ethyl 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 Icosapent Ethyl? No, the majority of Medicare Prescription Plans do not require prior authorization from your doctor for Icosapent Ethyl.



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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