Medicare Advantage Drug Cost for Kelnor 1 35



There are 34 Medicare Advantage Plans with additional prescription drug coverage for Kelnor 1 35 available to residents in Kentucky. The average retail unit cost (e.g. per pill) for a 30-day supply at in-area retail pharmacies is $0.53 ($15.87). Kelnor 1/35 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 Kelnor 1 35 in Kentucky. 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 Jefferson with the best coverage and the cheapest prices for your medications in Kentucky.



Proprietary Name:Kelnor 1/35
Generic Name:Ethynodiol Diacetate And Ethinyl Estradiol
Drug Package:6 Pouch In 1 Carton > 1 Kit In 1 Blister Pack
Drug Strength:
Substance:
Dosage Form:Kit
Route:
Labeler:Teva Pharmaceuticals Usa, Inc.
Pen Name:Human Prescription Drug
NDC#00555906458
RX#753483
Days Supply:30
Coverage Phase:Initial Coverage
Plan Year:2023
County:Jefferson





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Medicare Advantage Coverage for Kelnor 1 35 in Kentucky


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

4NA$100NA/NN$0.75
($22.42)
AARP Medicare Advantage Flex Plan 1

4NA$100NA/NN$0.75
($22.42)
AARP Medicare Advantage Flex Plan 2

4NA$95NA/NN$0.75
($22.42)
Aetna Medicare Premier

2$0$20$0/NN$0.21
($6.19)
Aetna Medicare Value Plan

2$10$20$10/NN$0.25
($7.40)
Anthem MediBlue + Kroger Access

3$42$47NA/NN$0.48
($14.28)
Anthem MediBlue Access Basic

3$37$47NA/NN$0.49
($14.75)
Anthem MediBlue Access Plus

3$42$47NA/NN$0.47
($14.06)
Anthem MediBlue Plus

3$42$47NA/NN$0.45
($13.43)
Humana Community

4NA$100$100/NN$0.71
($21.38)
Humana Gold Plus H5619-071

4NA$100$100/NN$0.72
($21.63)
HumanaChoice H5216-019

4NA$100$100/NN$0.71
($21.38)
HumanaChoice H5216-107

4NA$97$97/NN$0.71
($21.38)
HumanaChoice H5216-188

4NA$100$100/NN$0.71
($21.38)
HumanaChoice H5216-226

4NA$100$100/NN$0.71
($21.38)
HumanaChoice R0865-003

4NA$100$100/NN$0.71
($21.38)
Passport Medicare Choice Care

2NA$12NA/NN$0.32
($9.62)
Wellcare Assist

2$20$20$20/NN$0.56
($16.73)
Wellcare Giveback

2$5$10$5/NN$0.25
($7.60)
Wellcare No Premium

2$1$3$1/NN$0.25
($7.60)
Wellcare No Premium Essential

2$2$7$2/NN$0.25
($7.60)
Wellcare No Premium Open

2$3$8$3/NN$0.25
($7.60)


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SNP Prescription Drug Cost for Kelnor 1 35

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 Assure 1

2NA$0NA/NN$0.26
($7.76)
Anthem MediBlue + Kroger Dual Advantage

3$47$47NA/NN$0.48
($14.28)
Anthem MediBlue Dual Advantage

3$47$47NA/NN$0.47
($14.06)
Anthem MediBlue ESRD Care

3$42$47NA/NN$0.47
($14.06)
Humana Community HMO Diabetes and Heart

4NA$100$100/NN$0.71
($21.38)
Humana Community HMO SNP-DE

4NA$0NA/NN$0.71
($21.38)
Humana Gold Plus SNP-DE H5619-075

4NA$0NA/NN$0.71
($21.38)
Passport Advantage

2NA$0NA/NN$0.32
($9.62)
Signature Advantage Community

1NA25%NA/NN$0.75
($22.43)
Signature Advantage Plan

1NA25%NA/NN$0.75
($22.43)
Wellcare Dual Access

1NA$0NA/NN$0.56
($16.73)
Wellcare Dual Liberty

1NA$0NA/NN$0.56
($16.73)


Do any Medicare Advantage Plans Cover Kelnor 1 35? Yes, 34 Medicare Advantage Plans cover this drug in Kentucky.

How much does Kelnor 1 35 Cost? $0.53, the average retail cost in Kentucky is $0.53 per unit or $15.87 for a 30-day supply at in-area pharmacies.

What Tier is Kelnor 1 35? Tier 4, most Advantage Plans list Kelnor 1 35 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 Kelnor 1 35? No, the majority of Medicare Prescription Plans do not require prior authorization from your doctor for Kelnor 1 35.



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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