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Sylatron Medicare Coverage


Does Medicare cover Sylatron?

100% of Medicare Part D and Medicare Advantage plans cover this drug.

How much is my Sylatron co-pay with Medicare?

It depends. Which coverage stage are you in? Click on a tab below…

Donut Hole
Post-Donut Hole
Co-Pay Range
$1517 – $1698
In the Deductible co-pay stage, you are responsible for the full cost of your prescriptions. Your Medicare deductible cannot exceed $360 in 2016.
Co-Pay Range
$90 – $560
In the Typical co-pay stage, your deductible has been satisfied, and Medicare pays the majority of your drug costs.
Co-Pay Range
$683 – $764
In the Donut Hole (also called the Coverage Gap) stage, you’ll pay more for your prescriptions. In 2016, the Donut Hole begins once you’ve spent $3,310 in one year.
Co-Pay Range
$15 – $85
In the Post-Donut Hole (also called Catastrophic Coverage) stage, Medicare will cover most of your drug costs. In 2016, this stage begins once you have spent $4,850.
Want an exact price for your co-pay?

Ways to Save on Sylatron

Here are some ways that may lower the cost of your Sylatron prescription.

Patient Assistance Program
Receive your prescription at no charge if you are eligible.
Patient Assistance Program
Save at least $5 per month on your prescription.
Patient Assistance Program
Save up to $2,500 on your prescription.

Find Your Sylatron Medicare Co-Pay

Here are average co-pays for some of the most popular Medicare plans. Be sure to add your plan to see your specific co-pay. If a price is shown in red, GoodRx has found discount prices that are lower than your Medicare co-pay.

Average Co-Pay for 4 cartons (1 vial) of Sylatron 200mcg

Medicare Plan Name Average Co-Pay
AARP MedicareComplete (HMO) $433
AARP MedicareComplete Plan 1 (HMO) $456
AARP MedicareComplete SecureHorizons (HMO) $423
AARP MedicareRx Preferred (PDP) $508
AARP MedicareRx Saver Plus (PDP) $396
Aetna Medicare Rx Saver (PDP) $400
Cigna-HealthSpring Preferred (HMO) $486
Cigna-HealthSpring Rx Secure (PDP) $392
Cigna-HealthSpring Rx Secure-Extra (PDP) $423
EnvisionRxPlus Silver (PDP) $392
Express Scripts Medicare - Value (PDP) $397
First Health Part D Value Plus (PDP) $528
Humana Enhanced (PDP) $521
Humana Preferred Rx Plan (PDP) $395
Humana Walmart Rx Plan (PDP) $394
Kaiser Permanente Senior Advantage (HMO) $90
MedicareBlue Rx Standard (PDP) $392
SilverScript Choice (PDP) $539
Symphonix Value Rx (PDP) $397
WellCare Classic (PDP) $411
Don't see your Medicare plan above?

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Sylatron Medicare Formulary Information & Restrictions

Are there any restrictions on coverage?

Some Medicare plans have restrictions on coverage of Sylatron that may include:

Prior Authorization

Most Medicare plans will require you to obtain their authorization before they will provide coverage for this prescription. You’ll need to contact your plan and they may require you to have your doctor fill out paperwork indicating why you need this prescription. If you do not receive authorization or don’t want to go through this process, you may want to consider using a GoodRx discount instead of Medicare to find the best price for this prescription.

What drug tier is Sylatron typically on?

Tier 5

Medicare plans typically list Sylatron in Tier 5 of their formulary. Tier 5 drugs are usually non-preferred brand-name drugs. Tier 5 drugs cost more than Tier 1, 2, 3 and 4 drugs.

Does your plan have restrictions?

See discount prices that can save you money when your Medicare plan doesn't work for you.

Medicare prices are provided by the Centers for Medicare and Medicaid Services (CMS). If you encounter any issues, please let us know.
GoodRx is not sponsored by or affiliated with any of the pharmacies identified in its price comparisons. All trademarks, brands, logos and copyright images are property of their respective owners and rights holders and are used solely to represent the products of these rights holders. This information is for informational purposes only and is not meant to be a substitute for professional medical advice, diagnosis or treatment. GoodRx is not offering advice, recommending or endorsing any specific prescription drug, pharmacy or other information on the site. GoodRx provides no warranty for any of the pricing data or other information. Please seek medical advice before starting, changing or terminating any medical treatment.