Medicare Advantage Drug Cost for Tobramycin



There are 77 Medicare Advantage Plans with additional prescription drug coverage for Tobramycin available to residents in Texas. The average retail unit cost (e.g. per pill) for a 30-day supply at in-area retail pharmacies is $1.13 ($33.81). Tobramycin 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 Tobramycin in Texas. 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 Bexar with the best coverage and the cheapest prices for your medications in Texas.



Proprietary Name:Tobramycin
Generic Name:Tobramycin Sulfate
Drug Package:25 Vial, Multi-dose In 1 Tray > 2 Ml In 1 Vial, Multi-dose
Drug Strength:40mg/mL
Substance:Tobramycin Sulfate
Dosage Form:Injection, Solution
Route:Intramuscular; Intravenous
Labeler:Fresenius Kabi Usa, Llc
Pen Name:Human Prescription Drug
NDC#63323030602
RX#597823
Days Supply:30
Coverage Phase:Initial Coverage
Plan Year:2023
County:Bexar





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Medicare Advantage Coverage for Tobramycin in Texas


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

4NA$100NA/NN$1.05
($31.52)
AARP Medicare Advantage Choice

4NA$100NA/NN$1.05
($31.52)
AARP Medicare Advantage SecureHorizons

4NA$100NA/NN$1.05
($31.52)
Aetna Medicare Choice Plan

4$100$100$100/NN$1.62
($48.48)
Aetna Medicare Premier Plan

4$100$100$100/NN$1.61
($48.37)
Aetna Medicare Prime Plan

4$100$100$100/NN$1.62
($48.48)
Aetna Medicare Value Plan

4$100$100$100/NN$1.62
($48.48)
Amerivantage Choice

4$95$100NA/NN$0.60
($17.91)
Amerivantage Classic

4$95$100NA/NN$0.58
($17.38)
Amerivantage Classic Plus

4$95$100NA/NN$0.59
($17.61)
Amerivantage Select Plus

4$95$100NA/NN$0.60
($17.91)
Blue Cross Medicare Advantage Choice Plus

3$47$47$47/NN$0.71
($21.26)
Blue Cross Medicare Advantage Classic

4$85$100$85/NN$0.71
($21.20)
Blue Cross Medicare Advantage Flex

4$85$100$85/NN$1.06
($31.80)
Blue Cross Medicare Advantage Value

3$47$47$47/NN$0.71
($21.29)
Cigna Preferred Medicare

4$100$100$100/YN$0.85
($25.56)
Cigna Preferred Savings Medicare

4$100$100$100/YN$1.29
($38.56)
Cigna True Choice Medicare

4$100$100$100/YN$1.31
($39.17)
Cigna True Choice Plus Medicare

4$100$100$100/YN$1.31
($39.17)
Clover Health Choice

3$37$47NA/NN$1.53
($45.77)
Community First Medicare Advantage Alamo Plan

2NA$7NA/NN$0.94
($28.20)
Devoted CORE San Antonio

3NA$40NA/NN$1.53
($45.77)
Devoted PRIME San Antonio

3NA25%NA/NN$1.53
($45.77)
Humana Gold Choice H8145-084

2NA$12$12/NN$1.52
($45.68)
Humana Gold Plus H0028-030

2NA$0$0/NN$1.53
($45.77)
HumanaChoice H5216-042

2NA$12$12/NN$1.52
($45.70)
HumanaChoice H5216-043

2NA$5$5/NN$1.53
($45.75)
HumanaChoice R4182-003

2NA$10$10/NN$1.52
($45.70)
HumanaChoice R4182-004

2NA$13$13/NN$1.52
($45.70)
Imperial Insurance Company Traditional

4NA$90NA/YN$1.61
($48.42)
Imperial Insurance Traditional Plus

4NA25%NA/YN$1.61
($48.42)
Molina Medicare Choice Care

2NA$12NA/NN$1.53
($45.77)
Molina Medicare Choice Care Select

2NA$20NA/NN$1.53
($45.77)
UnitedHealthcare Medicare Advantage Choice

4NA$100NA/NN$0.94
($28.27)
Wellcare Assist

3$47$47$47/NN$1.53
($45.77)
Wellcare Complement Assist

3$47$47$47/NN$1.53
($45.77)
Wellcare No Premium

3$37$47$37/NN$1.53
($45.77)
Wellcare No Premium Rx Plus Open

3$35$45$35/NN$1.53
($45.77)


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SNP Prescription Drug Cost for Tobramycin

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 Dual Complete Plan

4NA$0NA/NN$1.59
($47.66)
American Health Advantage of Texas

1NA25%NA/NN$1.58
($47.48)
Amerivantage Comfort Plus

2NA$7.5NA/NN$0.68
($20.39)
Amerivantage Diabetes Care Plus

2$7.5$12.5NA/NN$0.57
($17.09)
Amerivantage Dual Coordination

4$95$100NA/NN$0.58
($17.38)
Amerivantage Dual Coordination Plus

4$95$100NA/NN$0.58
($17.35)
Amerivantage Dual Secure Plus

4$95$100NA/NN$0.55
($16.38)
Amerivantage ESRD Care

4$93$98NA/NN$0.60
($17.85)
Amerivantage Heart Care Plus

2$7.5$12.5NA/NN$0.57
($17.09)
Amerivantage Lung Care Plus

2$7.5$12.5NA/NN$0.57
($17.09)
Blue Cross Medicare Advantage Dual Care Plus

1NA$0NA/NN$1.22
($36.48)
Cigna TotalCare

4NA15%NA/YN$1.29
($38.56)
Community First Medicare Advantage D-SNP

2NA25%NA/NN$0.94
($28.20)
Devoted BEWELL San Antonio - D

3NA$40NA/NN$1.53
($45.77)
Humana Gold Plus - Diabetes and Heart

2NA$0$0/NN$1.53
($45.77)
Humana Gold Plus SNP-DE H0028-036

2NA$13$13/NN$1.53
($45.77)
Imperial Insurance Company Dual

4NA25%NA/YN$1.61
($48.29)
Imperial Insurance Value

4NA$90NA/YN$1.61
($48.42)
Molina Medicare Complete Care

3NA$42NA/NN$1.53
($45.77)
ProCare Advantage

1NA25%NA/NN$1.22
($36.48)
Provider Partners Texas Advantage Plan

1NA25%NA/NN$1.58
($47.28)
Provider Partners Texas Community Plan

1NA25%NA/NN$1.58
($47.28)
Texas Independence Health Plan, Inc.

1NA25%NA/NN$1.58
($47.50)
UnitedHealthcare Assisted Living Plan

4NA$100NA/NN$0.86
($25.81)
UnitedHealthcare Chronic Complete

4NA$100NA/NN$1.05
($31.52)
UnitedHealthcare Dual Complete

4NA15%NA/NN$1.05
($31.52)
UnitedHealthcare Dual Complete Choice

4NA$0NA/NN$0.94
($28.27)
UnitedHealthcare Medicare Gold

4NA$100NA/NN$0.94
($28.27)
UnitedHealthcare Medicare Silver

4NA25%NA/NN$0.94
($28.27)
UnitedHealthcare Nursing Home Plan

4NA25%NA/NN$0.88
($26.51)
Wellcare Dual Access

1NA$0NA/NN$1.53
($45.77)
Wellcare Dual Access Harmony

1NA$0NA/NN$1.53
($45.77)
Wellcare Dual Access Open

1NA$0NA/NN$1.53
($45.77)
Wellcare Dual Liberty

1NA$0NA/NN$1.53
($45.77)
Wellcare Dual Liberty Nurture

1NA$0NA/NN$1.53
($45.77)
Wellcare Specialty No Premium

2$0$10$0/NN$1.53
($45.77)


Do any Medicare Advantage Plans Cover Tobramycin? Yes, 77 Medicare Advantage Plans cover this drug in Texas.

How much does Tobramycin Cost? $1.13, the average retail cost in Texas is $1.13 per unit or $33.81 for a 30-day supply at in-area pharmacies.

What Tier is Tobramycin? Tier 4, most Advantage Plans list Tobramycin 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 Tobramycin? Yes, the majority of Medicare Prescription Plans do require prior authorization from your doctor for Tobramycin.



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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