FillMapAetna Medicare Full Dual Care (HMO D-SNP)

Does Aetna Medicare Full Dual Care (HMO D-SNP) cover cyclosporine?

Aetna Medicare Full Dual Care (HMO D-SNP)
H3146-023-0 · MA_LOCAL · Medicare Part D
cyclosporine
Your Extra Help level

Everyone on this plan has Medicare and Medicaid, which qualifies you for Extra Help automatically — so the figures below already use the statutory copays, not this plan’s published cost sharing. Nothing here is saved.

Full Extra Help: no deductible, and at most $5.10 generic or $12.65 brand-name per fill.

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.

cyclosporineunder Aetna Medicare Full Dual Care (HMO D-SNP)
Covered — some forms require prior authorization
8 of 10 covered forms have a condition attached. Your plan has to approve it first — your doctor’s office handles it.
What you'd pay
22%of the price your plan negotiates

Medicare hasn’t published this plan’s negotiated price for this drug yet — that file is updated every three months, and newly launched drugs appear in it late. Your pharmacy can quote the exact amount today. Part D caps what you pay out of pocket at $2,100 for 2026. Before that, you pay the full price until you have paid $615 this year.

This plan charges the same at every pharmacy in its network — where you fill it will not change this figure.

Amount limit applies — how much depends on the strength you are prescribed — the cap for each one is listed below. You can still fill it; more than that needs your plan's approval, which your doctor's office requests.
Tier
Tier 3
Approval first
Required
Try another first
No
Amount limit
Varies by strength
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 (10)

  • 0.4 ML cyclosporine 0.5 MG/ML Ophthalmic Suspension [Restasis]Tier 360 mL per 30 days
  • cyclosporine 0.5 MG/ML Ophthalmic Suspension [Restasis]Tier 35.5 mL per 30 days
  • cyclosporine 100 MG Oral CapsuleTier 4Approval first
  • cyclosporine 25 MG Oral CapsuleTier 4Approval first
  • cyclosporine, modified 100 MG Oral CapsuleTier 4Approval first
  • cyclosporine, modified 100 MG Oral Capsule [Gengraf]Tier 4Approval first
  • cyclosporine, modified 100 MG/ML Oral SolutionTier 4Approval first
  • cyclosporine, modified 25 MG Oral CapsuleTier 4Approval first
  • cyclosporine, modified 25 MG Oral Capsule [Gengraf]Tier 4Approval first
  • cyclosporine, modified 50 MG Oral CapsuleTier 4Approval first

← All coverage for cyclosporine