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Drug Coverage Check · Plan Year 2026

Does this plan cover
Lupron Depot?

Verified · CMS.gov Plan ID: H2172-025 Cross-check on Medicare.gov →
Verified · CMS 2026

YES — Covered

Lupron Depot is covered on Tier 4

30-day copay: $90.00 at a preferred pharmacy

Cost Details

30-Day Supply

Preferred Pharmacy
$90.00
Standard Pharmacy
$100.00

90-Day / Mail Order

Preferred / Mail Order
$0.00
Standard Pharmacy
$90.00

Deductible

Applies to This Drug?
Yes — deductible applies before copay
Plan Deductible
$0.00 / year

Lower-Cost Plans for Lupron Depot

These plans may offer a lower copay for Lupron Depot. Compare total annual costs including premium.

# Plan Name Tier 30-Day Copay Monthly Premium Rating
1 Anthem Medicare Advantage (HMO-POS) Tier 5 See Plan $0.00/mo View
2 The Health Plan SecureCare - Option II (HMO) Tier 5 See Plan $0.00/mo View
3 SCAN Classic (HMO) Tier 5 See Plan $0.00/mo View
4 Medicare Plus Blue + Meijer (PPO) Tier 5 See Plan $0.00/mo View
5 HealthSpring Achieve (HMO C-SNP) Tier 5 See Plan $0.00/mo View