Does Aetna Medicare Chronic Care Total (HMO C-SNP) cover GaviLyte-N?
Aetna Medicare Chronic Care Total (HMO C-SNP)
H3146-036-0 · MA_LOCAL · Medicare Part D
GaviLyte-N
Do you get help with your Medicare drug costs?None of these
Optional. Some plans charge less at a preferred pharmacy. Enter your ZIP to see which pharmacies near you take this plan — pick yours and the price above is re-worked for it. Until you do, we show what a standard pharmacy costs. Nothing here is saved.
GaviLyte-Nunder Aetna Medicare Chronic Care Total (HMO C-SNP)
Covered — just walk in
Nothing to clear first — take the prescription to an in-network pharmacy.
What you'd pay
$0per 30-day fill
Part D caps what you pay out of pocket at $2,100 for 2026. From the first fill — no deductible on this drug.
This plan charges the same at every pharmacy in its network — where you fill it will not change this figure.
- Tier
- Tier 2
- Approval first
- Not needed
- Try another first
- No
- Amount limit
- None
Talk to your pharmacist or doctor before acting on anything here. They can see your full history and this page cannot. Never start, stop, or switch a medication based on it. Coverage rules change and plans make exceptions — your pharmacy can check your exact benefit in seconds.As of Sep 16, 2026 · CMS Part D monthly PUF. Reference information, not medical advice and not a price.
Covered forms and strengths (2)
- polyethylene glycol 3350 420000 MG / potassium chloride 1480 MG / sodium bicarbonate 5720 MG / sodium chloride 11200 MG Powder for Oral SolutionTier 2
- polyethylene glycol 3350 420000 MG / potassium chloride 1480 MG / sodium bicarbonate 5720 MG / sodium chloride 11200 MG Powder for Oral Solution [GaviLyte-N]Tier 2