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Page Updated On 07/27/2022

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.

2023 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-dayRetail 60-DayRetail 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 costN/A N/A N/A
Tier 6 (Vaccines)$0N/AN/AN/A

Initial Coverage Gap begins at: $4,660 | Catastrophic Coverage begins at: $7,400
Formularies

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
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Medicare Advantage Drug Information

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