Medicare Advantage
Gundersen health system MN Pharmacy Benefits
Get more from your Medicare plan.
Choose Quartz Medicare Advantage for more support, more benefits, more extras, more doctors, and more experience.
Part D Prescription Drug Coverage
Available with Quartz Medicare Advantage (HMO) Code D, Value D, and Elite D plans. Part D vaccines are covered at no cost to you.
You won’t pay more than $35 for a one-month supply of covered insulin, no matter what cost-sharing tier it’s on.
| Retail 30-day | Retail 60-Day | Retail 90-Day | Mail Order 90-Day | |
|---|---|---|---|---|
| Tier 1 (Preferred Generic) | $2 | $4 | $6 | $5 |
| Tier 2 (Generic) | $15 | $30 | $45 | $38 |
| Tier 3 (Preferred Brand) | $45 | $90 | $135 | $113 |
| Tier 4 (Non-Preferred Drug) | $100 | $200 | $300 | $300 |
| Tier 5 (Specialty) | 33% of cost | N/A | N/A | N/A |
| Tier 6 (Vaccines) | $0 | N/A | N/A | N/A |
Initial Coverage Gap begins at: $4,660 | Catastrophic Coverage begins at: $7,400