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Medicare Advantage Drug Cost for Gentamicin Sulfate In Sodium Chloride



There are 65 Medicare Advantage Plans with additional prescription drug coverage for Gentamicin Sulfate In Sodium Chloride available to residents in Georgia. The average retail unit cost (e.g. per pill) for a 30-day supply at in-area retail pharmacies is $0.07 ($2.23). Gentamicin Sulfate In Sodium Chloride is typically listed as a Tier 2 drug on the formulary and does not require prior authorization.

Below is the average retail cost and your co-pay for Gentamicin Sulfate In Sodium Chloride in Georgia. You can also see if each plan requires prior authorization, step therapy or has drug quantity limits. Please check the formulary for different brand and generic drug names. Every Medicare Advantage Plan will vary in coverage, co-pays, costs and premiums. This chart can help you sort through different plan details to find a Medicare Advantage Plan in Cobb with the best coverage and the cheapest prices for your medications in Georgia.



Proprietary Name:Gentamicin Sulfate In Sodium Chloride
Generic Name:Gentamicin Sulfate
Drug Package:50 Ml In 1 Bag
Drug Strength:80mg/50mL
Substance:Gentamicin Sulfate
Dosage Form:Injection, Solution
Route:Intravenous
Labeler:Baxter Healthcare Corporation
Pen Name:Human Prescription Drug
NDC#00338050941
RX#310477
Days Supply:30
Coverage Phase:Initial Coverage
Plan Year:2023
County:Cobb





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Medicare Advantage Coverage for Gentamicin Sulfate In Sodium Chloride in Georgia


Click the Plan Name for More Details
Click the header to sort
Plan
Name ⇅
Tier
Level
Your
Cost
Preferred
Cost
Non
Preferred
Cost
Mail
Limit
Amt/
Days
Prior
Auth
Y/N
Step
Therapy
Y/N
Avg
Unit
Cost
(x30)
AARP Medicare Advantage Walgreens

4$95$95NA/NN$0.07
($2.08)
Aetna Medicare Advantra Preferred Plan

4$100$100$100/NN$0.07
($2.15)
Aetna Medicare Freedom Plan

4$100$100$100/NN$0.07
($2.21)
Anthem MediBlue + Kroger

4$95$100NA/NN$0.07
($2.02)
Anthem MediBlue + Kroger Access

4$95$100NA/NN$0.07
($2.02)
Anthem MediBlue Access

4$95$100NA/NN$0.07
($2.02)
Anthem MediBlue Access Basic

4$95$100NA/NN$0.07
($2.02)
Anthem MediBlue Essential

4$95$100NA/NN$0.07
($2.02)
Anthem MediBlue Extra

4$95$100NA/NN$0.07
($2.02)
Anthem MediBlue Plus

4$95$100NA/NN$0.07
($2.02)
Cigna Preferred GA Medicare

438%38%38%/YN$0.09
($2.70)
Cigna Preferred Medicare

4$95$100$95/YN$0.09
($2.55)
Cigna Preferred Plus Medicare

4$95$100$95/YN$0.09
($2.70)
Cigna True Choice Medicare

4$95$100$95/YN$0.09
($2.55)
Clover Health LiveHealthy

3$37$47NA/NN$0.07
($2.25)
Clover Health LiveHealthy Value

322%25%NA/NN$0.07
($2.25)
Humana Care Extra

2NA$12$12/NN$0.08
($2.34)
Humana Gold Plus H4141-017

2NA$0$0/NN$0.08
($2.34)
HumanaChoice H5216-073

2NA$17$17/NN$0.08
($2.34)
HumanaChoice H5216-154

2NA$15$15/NN$0.08
($2.34)
HumanaChoice H5216-203

2NA$0$0/NN$0.08
($2.34)
HumanaChoice H5216-279

2NA$0$0/NN$0.08
($2.34)
HumanaChoice H5216-280

2NA$20$20/NN$0.08
($2.34)
HumanaChoice R3392-002

2NA$17$17/NN$0.08
($2.34)
Kaiser Permanente Senior Advantage Basic 1

2NA$0NA/NN$0.08
($2.37)
Kaiser Permanente Senior Advantage Enhanced 1

2NA$0NA/NN$0.08
($2.37)
Sonder Complete Health Medicare Advantage

2NA$10NA/NN$0.08
($2.29)
UnitedHealthcare Medicare Advantage Choice

4NA$100NA/NN$0.07
($2.08)
Wellcare Assist

3$47$47$47/NN$0.07
($2.02)
Wellcare Giveback

2$5$15$5/NN$0.07
($2.02)
Wellcare Low Premium Open

2$0$10$0/NN$0.07
($2.02)
Wellcare No Premium

2$5$15$5/NN$0.07
($2.02)
Wellcare No Premium Open

2$0$15$0/NN$0.07
($2.02)
Wellcare Premium Enhanced Open

2$0$10$0/NN$0.07
($2.02)


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SNP Prescription Drug Cost for Gentamicin Sulfate In Sodium Chloride

Click the Plan Name for More Details about that Plan
Click the header to sort
Plan
Name ⇅
Tier
Level
Cost
Preferred
Cost
Non
Preferred
Cost
Amt
Mail
Limit
Days/
Amt
Prior
Auth
Y/N
Step
Therapy
Y/N
Avg
Unit
Cost
(x30)
Aetna Medicare Dual Preferred Plan

4NA$0NA/NN$0.07
($2.21)
Anthem MediBlue + Kroger Dual Advantage

4$95$100NA/NN$0.07
($2.02)
Anthem MediBlue Dual Access

4$95$100NA/NN$0.07
($2.02)
Anthem MediBlue Dual Advantage

4$95$100NA/NN$0.07
($2.02)
Anthem MediBlue ESRD Care

4$95$100NA/NN$0.07
($2.13)
CareSource Dual Advantage

4NA25%NA/YN$0.09
($2.70)
Cigna TotalCare

4NA15%NA/YN$0.09
($2.70)
Cigna TotalCare Plus

4NA$0NA/YN$0.09
($2.70)
Humana Care Extra

2NA$20$20/NN$0.08
($2.34)
Humana Gold Plus SNP-DE H4141-003

2NA$0NA/NN$0.08
($2.34)
Humana Together in Health

2NA$12$12/NN$0.08
($2.34)
HumanaChoice - Diabetes and Heart (PPO C-SNP)

2NA$0$0/NN$0.08
($2.34)
HumanaChoice SNP-DE H5216-205

2NA$0NA/NN$0.08
($2.34)
HumanaChoice SNP-DE H5216-206

2NA15%NA/NN$0.08
($2.34)
PruittHealth Premier

1NA25%NA/NN$0.08
($2.40)
Senior Advantage Medicare Medicaid Plan 1

2NA$14NA/NN$0.08
($2.37)
Sonder Diabetes Wellness

2NA$15NA/NN$0.08
($2.29)
Sonder Dual Complete

2NA$20NA/NN$0.08
($2.29)
Sonder Heart Healthy

2NA$15NA/NN$0.08
($2.29)
UnitedHealthcare Assisted Living Plan

4NA$100NA/NN$0.07
($2.08)
UnitedHealthcare Dual Complete

4NA15%NA/NN$0.07
($2.08)
UnitedHealthcare Dual Complete

4NA15%NA/NN$0.07
($2.08)
UnitedHealthcare Dual Complete Choice LP

4NA$0NA/NN$0.07
($2.08)
UnitedHealthcare Dual Complete Choice Select LP

4NA15%NA/NN$0.07
($2.08)
UnitedHealthcare Medicare Gold

4NA$100NA/NN$0.07
($2.08)
UnitedHealthcare Medicare Silver

4NA25%NA/NN$0.07
($2.08)
UnitedHealthcare Nursing Home Plan 1

4NA25%NA/NN$0.07
($2.08)
UnitedHealthcare Nursing Home Plan 2

4NA25%NA/NN$0.07
($2.08)
Wellcare Dual Access

1NA$0NA/NN$0.07
($2.02)
Wellcare Dual Access Open

1NA$0NA/NN$0.07
($2.02)
Wellcare Dual Liberty

1NA$0NA/NN$0.07
($2.02)


Do any Medicare Advantage Plans Cover Gentamicin Sulfate In Sodium Chloride? Yes, 65 Medicare Advantage Plans cover this drug in Georgia.

How much does Gentamicin Sulfate In Sodium Chloride Cost? $0.07, the average retail cost in Georgia is $0.07 per unit or $2.23 for a 30-day supply at in-area pharmacies.

What Tier is Gentamicin Sulfate In Sodium Chloride? Tier 2, most Advantage Plans list Gentamicin Sulfate In Sodium Chloride on Tier 2 on their formulary. Usually, the higher the tier, the more you have to pay for the medication.

Do I need Prior Authorization for Gentamicin Sulfate In Sodium Chloride? No, the majority of Medicare Prescription Plans do not require prior authorization from your doctor for Gentamicin Sulfate In Sodium Chloride.



Additional Notes by Medicare Help:

Most plans have 4 levels of coverage. The exception is the $0 Deductible Plans.
1.Pre-Deductable: Before you reach the plans deductible. Some plans offer select Pre-deductible drug Coverage
2.Initial Coverage: (ICL) After you reach the plans deductible but before the Initial Coverage limit.
3.Coverage Gap: (AKA Donut Hole) After you reach the plans ICL but before the Catastrophic of $7550 in 2022.
4.Catastrophic: Anything over $7550 you will receive a significant increase in coverage.

Formulary Definitions:

Tier Level: Medicare drug plans place drugs into different "tiers" on their formularies. Drugs in each tier have a different cost. A drug in a lower tier will generally cost you less.
Cost Preferred: Your Cost for the Drug at the Providers In Network Preferred Pharmacy. As a Percent of the total drug cost or a flat rate.
Cost Non Preferred: Your Cost for the Prescription Drug at a Non-Preferred Pharmacy. As a Percent of the total drug cost or a flat rate.
Cost Mail: Your Cost for Prescription Drugs through a Mail Order Pharmacy. As a Percent of the total drug cost or a flat rate.
Quantity Limit Amount/Days: Certain drugs have a Quantity Limit. That means the plan will only cover the drug up to a designated quantity or amount. If your prescribing doctor feels it is necessary to exceed the set limit, he or she must get prior approval before the higher quantity will be covered.
Prior Authorization: Certain Drugs require you or your doctor to get prior authorization in order to be covered. Usually just an additional form. If you dont get approval, the plan may not cover the drug.
Step Therapy: Means you must first try one drug to treat your medical condition before the plan will cover another drug for the same condition. If you have already tried other drugs or your doctor thinks they are not right for you, you and your doctor can ask the plan to cover this drug.
Avg Unit Cost: Average unit cost (e.g. per pill) for specified days supply at in-area retail pharmacies. A pharmacy is considered in-area when it is geographically located in the service area.




What if a drug I need is not listed?

Please check the formulary for different brand and generic names. If you still cannot locate your drugs, your plan may not offer coverage. Talk to your doctor first about changing your prescription to a drug on your plans formulary. If this is not an option, you can request an exception to have the plan review its coverage decision based on your individual circumstances.

Last updated on
Source:CMS Formulary Data Q4 2022
Source:NDC Directory by FDA.gov

**We make every attempt to keep our information accurate. But please check with the plan providers to verify all information.

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