FillMapHAP Member Assist (PPO)

Does HAP Member Assist (PPO) cover leuprolide?

HAP Member Assist (PPO)
H2322-017-0 · MA_LOCAL · Medicare Part D
leuprolide
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.

leuprolideunder HAP Member Assist (PPO)
Covered — some forms require prior authorization
3 of 18 covered forms have a condition attached. Your plan has to approve it first — your doctor’s office handles it.
What you'd pay
18%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.

Tier
Tier 3
Approval first
Required
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 (18)

  • 0.25 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Eligard]Tier 3
  • 0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard]Tier 3
  • 0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Vabrinty]Tier 5Approval first
  • 0.375 ML leuprolide acetate 60 MG/ML Prefilled Syringe [Eligard]Tier 3
  • 0.375 ML leuprolide acetate 60 MG/ML Prefilled Syringe [Vabrinty]Tier 5Approval first
  • 0.5 ML leuprolide acetate 60 MG/ML Prefilled Syringe [Eligard]Tier 3
  • 0.5 ML leuprolide acetate 60 MG/ML Prefilled Syringe [Vabrinty]Tier 5Approval first
  • 1 ML leuprolide acetate 3.75 MG/ML Prefilled Syringe [Lupron]Tier 5
  • 1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron]Tier 5
  • 1.5 ML leuprolide acetate 15 MG/ML Prefilled Syringe [Lupron]Tier 5
  • 1.5 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Lupron]Tier 5
  • 1.5 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron]Tier 5
  • 4-Month 1.5 ML leuprolide acetate 20 MG/ML Prefilled Syringe [Lupron]Tier 5
  • leuprolide acetate 22.5 MG Injection [Lutrate]Tier 4
  • leuprolide acetate 5 MG/ML Injectable SolutionTier 4
  • Pediatric 1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron]Tier 5
  • Pediatric 1.5 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Lupron]Tier 5
  • Pediatric 1.5 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron]Tier 5

← All coverage for leuprolide