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Page Updated On 10/13/2021

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.

2022 Part D Prescription Drug Coverage

Available with Quartz Medicare Advantage (HMO) Core D, Value D, and Elite D plans.

30-DayRetail
60-Day
90-DayMail Order
90-Day
Yearly Deductible$0$0$0$0
Tier 1 (Preferred Generic)$3$6$9$7
Tier 2 (Generic)$15$30$45$38
Tier 3 (Preferred Brand)$45
$35 for select insulins
$90
$70 for select insulins
$135
$105 for select insulins
$113
$87 for select insulins
Tier 4 (Non-preferred Drug)40% of cost40% of cost40% of cost40% of cost
Tier 5 (Specialty)30% of costN/AN/AN/A
Tier 6 (Vaccines)$0$0$0$0
Initial Coverage Gap begins at: $4,430 | Catastrophic Coverage begins at: $7,050

Formularies

2021 Part D Prescription Drug Coverage

Available with Quartz Medicare Advantage (HMO) Core D, Value D, and Elite D plans.

30-DayRetail
60-Day
90-DayMail Order
90-Day
Yearly Deductible$0$0$0$0
Tier 1 (Preferred Generic)$3$6$9$7
Tier 2 (Generic)$15$30$45$38
Tier 3 (Preferred Brand)$45$90$135$113
Tier 4 (Non-preferred Drug)40% of cost40% of cost40% of cost40% of cost
Tier 5 (Specialty)30% of costN/AN/AN/A
Initial Coverage Gap begins at: $4,130 | Catastrophic Coverage begins at: $6,550

Check Drug Prices and Pharmacy Network

Core D

Value D

Elite D

Medicare Advantage Drug Information

Looking for information on your drug plan? Find answers to your questions and view the drug list.