Medicare Advantage Drug Cost for Isolyte P In Dextrose



There are 44 Medicare Advantage Plans with additional prescription drug coverage for Isolyte P In Dextrose 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 $0.01 ($0.22). Isolyte P In Dextrose 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 Isolyte P In Dextrose 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:Isolyte P In Dextrose
Generic Name:Dextrose, Sodium Acetate, Potassium Chloride, Magn
Drug Package:24 Container In 1 Case > 500 Ml In 1 Container
Drug Strength:5; .031; .13; .026; .32g/100mL; g/100mL; g/100mL; g/100mL; g/100mL
Substance:Dextrose Monohydrate; Magnesium Chloride; Potassiu
Dosage Form:Injection, Solution
Route:Intravenous
Labeler:B. Braun Medical Inc.
Pen Name:Human Prescription Drug
NDC#00264773010
RX#800812
Days Supply:30
Coverage Phase:Initial Coverage
Plan Year:2023
County:Cook





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Medicare Advantage Coverage for Isolyte P In Dextrose 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$0.01
($0.18)
AARP Medicare Advantage Choice

4NA$95NA/NN$0.01
($0.18)
AARP Medicare Advantage Plan 2

4NA$100NA/NN$0.01
($0.18)
AARP Medicare Advantage Walgreens

4$100$100NA/NN$0.01
($0.18)
Aetna Medicare Premier Plus

4$100$100$100/NN$0.01
($0.18)
Aetna Medicare Prime

4$100$100$100/NN$0.01
($0.18)
Aetna Medicare Value

4$100$100$100/NN$0.01
($0.18)
Ascension Complete Illinois Reward

4$90$100$90/NN$0.01
($0.18)
Ascension Complete Illinois Secure

4$90$100$90/NN$0.01
($0.18)
Clear Spring Health Community Advantage Plan

4$95$100$95/NN$0.02
($0.60)
Clear Spring Health Essential

4$95$100$95/NN$0.02
($0.60)
Devoted CORE Illinois

4NA$100NA/NN$0.01
($0.18)
Devoted GIVEBACK Illinois

4NA$100NA/NN$0.01
($0.18)
Humana Gold Choice H8145-008

4NA$100$100/NN$0.01
($0.17)
Humana Gold Plus H1468-013

4NA$100$100/NN$0.01
($0.17)
HumanaChoice H5216-013

4NA$100$100/NN$0.01
($0.17)
HumanaChoice H5216-251

4NA$100$100/NN$0.01
($0.17)
HumanaChoice H5216-283

4NA$100$100/NN$0.01
($0.17)
HumanaChoice R5361-002

4NA$100$100/NN$0.01
($0.17)
Wellcare Assist

442%42%42%/NN$0.01
($0.18)
Wellcare Assist Compass

450%50%50%/NN$0.01
($0.18)
Wellcare Giveback Open

4$90$100$90/NN$0.01
($0.18)
Wellcare No Premium

448%50%48%/NN$0.01
($0.18)
Wellcare No Premium Essential

447%49%47%/NN$0.01
($0.18)
Wellcare No Premium Exclusive

448%50%48%/NN$0.01
($0.18)
Wellcare No Premium Open

4$90$100$90/NN$0.01
($0.18)
Zing Choice IL

4NA$100NA/YN$0.01
($0.30)
Zing Open Access IL

4NA$100NA/YN$0.01
($0.30)
Zing Signature Care IL

4NA$100NA/YN$0.01
($0.30)


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SNP Prescription Drug Cost for Isolyte P In Dextrose

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

4NA$99$99/NN$0.01
($0.17)
Humana Senior Living Plan

4NA$100$100/NN$0.01
($0.17)
Humana Together in Health

4NA$100$100/NN$0.01
($0.17)
Longevity Health Plan

1NA25%NA/NN$0.02
($0.60)
Provider Partners Illinois Advantage Plan

1NA25%NA/YN$0.01
($0.17)
Provider Partners Illinois Community Plan

1NA25%NA/YN$0.01
($0.17)
UnitedHealthcare Assisted Living Plan

4NA$100NA/NN$0.01
($0.18)
UnitedHealthcare Chronic Complete Assure (PPO C-SNP)

4NA25%NA/NN$0.01
($0.18)
UnitedHealthcare Nursing Home Plan 1

4NA25%NA/NN$0.01
($0.18)
UnitedHealthcare Nursing Home Plan 2

4NA25%NA/NN$0.01
($0.18)
Zing Essential Wellness Diabetes and Heart IL

4NA$100NA/YN$0.01
($0.30)


Do any Medicare Advantage Plans Cover Isolyte P In Dextrose? Yes, 44 Medicare Advantage Plans cover this drug in Illinois.

How much does Isolyte P In Dextrose Cost? $0.01, the average retail cost in Illinois is $0.01 per unit or $0.22 for a 30-day supply at in-area pharmacies.

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



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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