Medicare Advantage
Gundersen health system 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.
You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter its cost-sharing tier.
| | 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
You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter its cost-sharing tier.