Medicare Advantage Drug Cost for Olmesartan Medoxomil Amlodipine And Hydrochloroth



There are 78 Medicare Advantage Plans with additional prescription drug coverage for Olmesartan Medoxomil Amlodipine And Hydrochloroth available to residents in Ohio. The average retail unit cost (e.g. per pill) for a 30-day supply at in-area retail pharmacies is $2.51 ($75.42). Olmesartan Medoxomil, Amlodipine And Hydrochloroth 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 Olmesartan Medoxomil Amlodipine And Hydrochloroth in Ohio. 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 Cuyahoga with the best coverage and the cheapest prices for your medications in Ohio.



Proprietary Name:Olmesartan Medoxomil, Amlodipine And Hydrochloroth
Generic Name:Olmesartan Medoxomil, Amlodipine Besylate And Hydr
Drug Package:30 Tablet, Film Coated In 1 Bottle, Plastic
Drug Strength:10; 25; 40mg/1; mg/1; mg/1
Substance:Amlodipine Besylate; Hydrochlorothiazide; Olmesart
Dosage Form:Tablet, Film Coated
Route:Oral
Labeler:Sun Pharmaceutical Industries, Inc.
Pen Name:Human Prescription Drug
NDC#57664080083
RX#999991
Days Supply:30
Coverage Phase:Initial Coverage
Plan Year:2023
County:Cuyahoga





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Medicare Advantage Coverage for Olmesartan Medoxomil Amlodipine And Hydrochloroth in Ohio


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

1NA$0NA/NN$2.47
($74.10)
AARP Medicare Advantage Flex Plan 8

1NA$0NA/NN$2.70
($81.01)
AARP Medicare Advantage Plan 1

1NA$0NA/NN$2.70
($81.01)
AARP Medicare Advantage Plan 3

1NA$0NA/NN$2.73
($81.89)
AARP Medicare Advantage Plan 7

1NA$0NA/NN$2.70
($81.01)
Aetna Medicare Advantra Silver

1$0$15$0/NN$0.33
($10.04)
Aetna Medicare Premier

1$0$15$0/NN$0.43
($12.89)
Aetna Medicare Premier 1

1$0$15$0/NN$0.32
($9.59)
Aetna Medicare Premier 2

1$0$15$0/NN$0.31
($9.20)
Aetna Medicare Premier Plus 1

1$0$15$0/NN$0.39
($11.60)
Aetna Medicare Premier Plus 2

1$0$19$0/NN$0.47
($14.06)
Aetna Medicare Value Plan

1$0$15$0/NN$0.35
($10.51)
Aetna Medicare Value Plan

1$0$15$0/NN$0.32
($9.59)
Anthem MediBlue Access

3$42$47NA/NN$3.19
($95.57)
Anthem MediBlue Access Basic

3$42$47NA/NN$3.19
($95.57)
Anthem MediBlue Access Plus

3$42$47NA/NN$3.19
($95.80)
Anthem MediBlue Extra

3$47$47NA/NN$3.19
($95.57)
Anthem MediBlue Preferred

3$42$47NA/NN$3.11
($93.44)
Anthem MediBlue Preferred Plus

3$42$47NA/NN$3.18
($95.26)
Anthem MediBlue Prime Select

3$42$47NA/NN$3.20
($95.86)
Devoted CORE Ohio

1NA$0NA/NN$3.65
($109.65)
Devoted GIVEBACK Ohio

1NA$0NA/NN$3.65
($109.65)
Devoted PRIME Ohio

1NA$0NA/NN$3.65
($109.65)
Humana Cleveland Clinic Preferred

4NA$100$100/NN$4.12
($123.59)
Humana Gold Plus H6622-019

4NA$97$97/NN$4.12
($123.65)
Humana Gold Plus H6622-022

4NA$100$100/NN$4.12
($123.62)
Humana Value Plus H5525-041

4NA$97$97/NN$4.13
($123.84)
HumanaChoice H5216-024

4NA$100$100/NN$4.12
($123.59)
HumanaChoice H5216-106

4NA$100$100/NN$4.12
($123.63)
HumanaChoice H5216-285

4NA$100$100/NN$4.12
($123.70)
HumanaChoice H5525-030

4NA$97$97/NN$4.12
($123.70)
HumanaChoice H5525-042

4NA$100$100/NN$4.12
($123.70)
HumanaChoice R5495-002

4NA21%21%/NN$4.12
($123.70)
MedMutual Advantage Access

2$8$16$0/NN$2.63
($78.90)
MedMutual Advantage Choice

2$5$12$4/NN$2.63
($78.90)
MedMutual Advantage Classic

2$5$12$0/NN$2.63
($78.90)
MedMutual Advantage Plus

2$5$12$4/NN$2.63
($78.90)
MedMutual Advantage Preferred

2$5$12$4/NN$2.63
($78.90)
MedMutual Advantage Premium

2$5$12$4/NN$2.63
($78.90)
MedMutual Advantage Secure

2$5$12$4/NN$2.63
($78.90)
MedMutual Advantage Select

2$5$12$4/NN$2.63
($78.90)
MedMutual Advantage Signature

2$8$16$0/NN$2.63
($78.90)
Molina Medicare Choice Care

1NA$3NA/NN$3.12
($93.46)
SummaCare Medicare Emerald

2NA$8NA/NN$2.48
($74.40)
SummaCare Medicare Garnet

2NA$8NA/NN$2.48
($74.40)
SummaCare Medicare Ruby

2NA$8NA/NN$2.48
($74.40)
SummaCare Medicare Sapphire

2NA$8NA/NN$2.48
($74.40)
SummaCare Medicare Topaz

2NA$9NA/NN$2.48
($74.40)
The Health Plan SecureCare - Option II

2$0$20$0/NN$2.80
($83.96)
The Health Plan SecureChoice - Option II

2$10$20$10/NN$2.80
($83.96)
Wellcare Assist

6$0$0$0/NN$1.67
($50.21)
Wellcare Assist Complement

6$0$0$0/NN$1.67
($50.24)
Wellcare Dividend Giveback

6$0$0$0/NN$0.56
($16.80)
Wellcare Giveback

6$0$0$0/NN$0.74
($22.14)
Wellcare Giveback Boost

6$0$0$0/NN$0.72
($21.68)
Wellcare No Premium

6$0$0$0/NN$0.74
($22.14)
Wellcare No Premium Essential

6$0$0$0/NN$0.56
($16.72)
Wellcare No Premium Medicare

6$0$0$0/NN$0.72
($21.68)
Wellcare No Premium Open

6$0$0$0/NN$0.72
($21.68)


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SNP Prescription Drug Cost for Olmesartan Medoxomil Amlodipine And Hydrochloroth

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

1NA$0NA/NN$0.31
($9.26)
Anthem MediBlue Dual Advantage

3$47$47NA/NN$3.19
($95.57)
CareSource Dual Advantage

2NA25%NA/NN$2.59
($77.71)
CommuniCare Advantage CSNP

1NA$6NA/NN$2.99
($89.84)
CommuniCare Advantage ISNP

1NA25%NA/NN$2.99
($89.84)
Humana Gold Plus - Diabetes and Heart

6NA$7$7/NN$4.12
($123.65)
Humana Gold Plus SNP-DE H6622-015

4NA$0NA/NN$4.12
($123.65)
Molina Medicare Complete Care

1NA$0NA/NN$3.12
($93.46)
The Health Plan SecureCare SNP

1NA15%NA/NN$2.80
($83.96)
UnitedHealthcare Assisted Living Plan

1NA$2NA/NN$2.73
($81.88)
UnitedHealthcare Dual Complete LP

1NA15%NA/NN$2.73
($81.90)
UnitedHealthcare Nursing Home Plan 1

1NA25%NA/NN$2.73
($81.87)
UnitedHealthcare Nursing Home Plan 2

1NA25%NA/NN$2.73
($81.83)
Valor Health Plan

1NA25%NA/NN$2.99
($89.84)
Wellcare Dual Access

1NA$0NA/NN$1.69
($50.57)
Wellcare Dual Access Extra

1NA$0NA/NN$1.22
($36.74)


Do any Medicare Advantage Plans Cover Olmesartan Medoxomil Amlodipine And Hydrochloroth? Yes, 78 Medicare Advantage Plans cover this drug in Ohio.

How much does Olmesartan Medoxomil Amlodipine And Hydrochloroth Cost? $2.51, the average retail cost in Ohio is $2.51 per unit or $75.42 for a 30-day supply at in-area pharmacies.

What Tier is Olmesartan Medoxomil Amlodipine And Hydrochloroth? Tier 4, most Advantage Plans list Olmesartan Medoxomil Amlodipine And Hydrochloroth 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 Olmesartan Medoxomil Amlodipine And Hydrochloroth? No, the majority of Medicare Prescription Plans do not require prior authorization from your doctor for Olmesartan Medoxomil Amlodipine And Hydrochloroth.



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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