Gundersen Quartz Medicare Advantage

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

You won’t pay more than $35 for a one-month supply of covered insulin, no matter what cost-sharing tier it’s on.

2024 Copayment table, Formulary, Drug prices, and Pharmacy network

View the 2024 Formulary, Drug prices, and Pharmacy network

Retail 30-dayRetail 60-dayRetail 90-day Mail Order
 Tier 1 (Preferred Generic) $5 $10 $15 $12.50
 Tier 2 (Generic) $15$30 $45$38
 Tier 3 (Preferred Brand)$47 $94 $141 $117.50
 Tier 4 (Non-Preferred Drugs)   $100 $200 $300 $300
 Tier 5 (Specialty Tier) Core D = 28%
Value D = 29%
Elite D = 30%
Tier 6 (Vaccines)$0N/AN/AN/A

Initial Coverage Gap begins at: $5,330 | Catastrophic Coverage begins at: $8,000

Note: Part D vaccines (e.g. Tetanus (Tdap), shingles, etc.) are covered at no cost to you. You will need to submit a reimbursement request form for vaccines received in a clinic.

There is a deductible for Tiers 3, 4, and 5. Deductible is: Core D $300; Value D $250; Elite D $200.

Enroll in Quartz Medicare Advantage

Get personal support and real value with a Quartz Medicare Advantage plan. Our plan options start at $0 per month. Enroll today for quality coverage you can count on.