2022 Part D Prescription Drug Coverage
Available with Quartz Medicare Advantage (HMO) Core D, Value D, and Elite D plans.
| 30-day | Retail 60-Day | 90-Day | Mail 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 cost | 40% of cost | 40% of cost | 40% of cost |
| Tier 5 (Specialty) | 30% of cost | N/A | N/A | N/A |
| Tier 6 (Vaccines) | $0 | $0 | $0 | $0 |