AARP MedicareRx Preferred (PDP) Formulary



Below is the 2023 Formulary, or prescription drug list, from AARP MedicareRx Preferred (PDP) by Unitedhealthcare Insurance Company. A formulary is a continually updated list of available medications and prescription drug cost information. Examining a plans formulary can help you find a In Idaho, Utah. plan that covers your prescriptions. It also helps you compare costs among Medicare Part D and Medicare Advantage plans available to you. You’ll want to make sure the medicines you are currently taking are covered under any plans you are considering enrolling in.

This AARP MedicareRx Preferred (PDP)(S5820-030) plan has a $0 drug deductible. The Initial Coverage Limit (ICL) for this plan is $4660. The Initial Coverage Period is the period after the Deductible has been met but before the Coverage Gap phase. Once you and your plan provider have spent $4660 on covered drugs. (Combined amount plus your deductible) You will enter the coverage gap. (AKA "donut hole") Once you reach the coverage gap you will be required to pay 25% of the plan's cost for covered brand-name prescription drugs unless your plan offers additional coverage. You can see if this plan offers coverage in the "donut hole" by clicking the "Coverage Gap" link above the chart.

In 2023 if you have spent $7400 in expenditures you enter the Catastrophic Phase. During the Catastrophic Period you will begin to receive significant coverage. Unitedhealthcare Insurance Company will begin paying approximately 95% of your covered medication expenses. You can see if this plan covers your drugs in the Catastrophic Phase by clicking the "Catastrophic" link above the chart.



Plan Overview

Plan Name:AARP MedicareRx Preferred (PDP)
Plan ID: S5820-030
Formulary
Provider: Unitedhealthcare Insurance Company
Plan Year:2023
Premium:$103.60
Deductible:$0
Initial Coverage Limit:$4660
Coverage Area:Idaho, Utah
Similar Plan:S5820-031


Change Table Options:

Drugs Starting Letter:
Coverage Phase:

*Tip Click the Drug name to Compare Coverage and Retail Cost for Every Plan In Your Area
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Drug
Name⇅
Tier
Level
Cost
Preferred
Cost
Non
Preferred
Cost
Mail
Limit
Amt/Days
Prior Auth
Y/N
Step
Therapy
Abacavir
440%45%NA960/30NN
Abacavir And Lamivudine
440%45%NA30/30NN
Abelcet
440%45%NAYN
Abilify Maintena
533%33%33%NN
Abiraterone
440%45%NA120/30YN
Abiraterone Acetate
440%45%NA60/30YN
Acarbose
3$47$47NA360/30NN
Accutane
440%45%NAYN
Acebutolol Hydrochloride
2$12$20NANN
Acetaminophen And Codeine Phosphate
2$12$20NA4500/30NN
Acetaminophen, Caffeine, Dihydrocodeine Bitartrate
440%45%NA300/30NN
Acetazolamide
3$47$47NANN
Acetic Acid
2$12$20NANN
Acetylcysteine
2$12$20NAYN
Acitretin
440%45%NANN
Actemra
533%33%33%3/28YN
Actemra Actpen
533%33%33%3/28YN
Acthib
3$47$47NA1/1NN
Actimmune
533%33%33%NN
Acyclovir
440%45%NANN
Acyclovir Sodium
440%45%NAYN
Adapalene
3$47$47NANN
Adempas
533%33%33%YN
Advair
3$47$47NA60/30NN
Advair Hfa
3$47$47NA12/30NN
Aimovig
440%45%NA1/30YN
Alacort
2$12$20NANN
Albendazole
440%45%NA480/30NN
Albuterol Sulfate
2$12$20NANN
Alclometasone Dipropionate
3$47$47NANN
Alecensa
533%33%33%240/30YN
Alendronate Sodium
1$7$15NA4/28NN
Aliskiren
440%45%NA30/30NN
Alocril
440%45%NANN
Alomide
440%45%NANN
Alosetron Hydrochloride
533%33%33%YN
Alprazolam
2$12$20NA150/30NN
Altavera
440%45%NANN
Alunbrig
533%33%33%60/365YN
Alyacen 1/35
440%45%NANN
Alyq
440%45%NA60/30YN
Amabelz
3$47$47NANN
Amantadine Hydrochloride
3$47$47NANN
Ambisome
440%45%NAYN
Amethia
440%45%NANN
Amikacin Sulfate
440%45%NANN
Amiloride Hydrochloride And Hydrochlorothiazide
2$12$20NANN
Amiloride Hydrocloride
2$12$20NANN
Amiodarone Hydrochloride
2$12$20NANN
Amitriptyline Hydrochloride
3$47$47NANN
Amlodipine And Benazepril Hydrochloride
2$12$20NA30/30NN
Amlodipine And Olmesartan Medoxomil
3$47$47NA30/30NN
Amlodipine And Valsartan
3$47$47NA30/30NN
Amlodipine Besylate
1$7$15NANN
Amlodipine Besylate And Benazepril Hydrochloride
2$12$20NA30/30NN
Ammonium Lactate
3$47$47NANN
Amnesteem
440%45%NAYN
Amoxapine
3$47$47NANN
Amoxicillin
2$12$20NANN
Amoxicillin And Clavulanate Potassium
2$12$20NANN
Amphotericin B
440%45%NAYN
Ampicillin
440%45%NANN
Ampicillin And Sulbactam
440%45%NANN
Ampicillin Sodium And Sulbactam Sodium
440%45%NANN
Anagrelide
3$47$47NANN
Anastrozole
1$7$15NANN
Androderm
3$47$47NA30/30NN
Apraclonidine Ophthalmic
3$47$47NANN
Aprepitant
440%45%NA6/28YN
Apri
440%45%NANN
Aptivus
533%33%33%120/30NN
Aralast
533%33%33%YN
Aranelle
440%45%NANN
Aranesp
533%33%33%YN
Aripiprazole
440%45%NA60/30NN
Aristada
533%33%33%NN
Aristada Initio
533%33%33%NN
Armodafinil
440%45%NA30/30YN
Arnuity Ellipta
3$47$47NA30/30NN
Asenapine
440%45%NA60/30NN
Ashlyna
440%45%NANN
Atenolol And Chlorthalidone
1$7$15NANN
Atomoxetine
440%45%NA30/30NN
Atovaquone
533%33%33%420/30NN
Atovaquone And Proguanil Hydrochloride Pediatric
3$47$47NANN
Atrovent
440%45%NANN
Aubra Eq
440%45%NANN
Auryxia
440%45%NAYN
Austedo
533%33%33%120/30YN
Aviane
440%45%NANN
Avonex
533%33%33%1/28NN
Ayvakit
533%33%33%30/30YN
Azathioprine
2$12$20NAYN
Azelaic Acid
440%45%NA50/30NN
Azelastine Hcl Nasal
3$47$47NANN
Azelastine Hydrochloride
3$47$47NANN
Azelastine Hydrochloride And Fluticasone Propionat
440%45%NANN
Azithromycin
440%45%NANN
Aztreonam
440%45%NANN

* Drug Prices and Coverage is for a 30 Day Supply



Additional Notes by Medicare Help:

Coverage Levels for S5820-030

Most plans have 4 levels of coverage. The exception is the $0 Deductible Plans.
1. Pre-Deductable: Before you reach the plans deductible of $0. Some plans offer select Pre-deductible drug Coverage
2. Initial Coverage: (ICL) After you reach the plans deductible but before the Initial Coverage limit of $4660
3. Coverage Gap: (AKA Donut Hole) After you reach the plans ICL but before the Catastrophic of $7400 in 2023.
4. Catastrophic: Anything over $7400 you will receive a significant increase in coverage.

Definitions:

Premium: A monthly flat fee that varies by plan.
Deductible: The amount you must pay each year for your prescriptions before your plan begins to pay its share of your covered drugs. The max in 2022 is $320. Some plans have a $0 Deductible.
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.
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 to be covered. Usually just an additional form. If you dont get approval, the plan may not cover the drug.
Does the Deduct Apply: Some drugs do not require that the deductible is met before you receive coverage.
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.
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.


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 plan's 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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MedicareHelp.org is a privately-owned Non-governmental agency operated by Mark Spencer. The government website can be found at HealthCare.gov.

HealthCompare Insurance Services, HealthPlanOne, LLC, ClearMatch Medicare and Medicare Solutions does not offer every plan available in your area. Currently HealthCompare Insurance Services represent 18 organizations, which offers 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. HealthCompare Insurance Services, HealthPlanOne, LLC, ClearMatch Medicare and Medicare Solutions represents Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan’s contract renewal.

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