FillMapNaviCare (HMO D-SNP)

Does NaviCare (HMO D-SNP) cover tacrolimus?

NaviCare (HMO D-SNP)
H8928-001-0 · MA_LOCAL · Medicare Part D
tacrolimus
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.

tacrolimusunder NaviCare (HMO D-SNP)
Covered — some forms require prior authorization
14 of 16 covered forms have a condition attached. Your plan has to approve it first — your doctor’s office handles it.
What you'd pay
$0per 30-day fill

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 — this plan covers 120 grams per 30 days. You can still fill it — more than that needs your plan's approval, which your doctor's office requests.
Tier
Tier 1
Approval first
Required
Try another first
No
Amount limit
120 grams per 30 days
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 (16)

  • 24 HR tacrolimus 0.5 MG Extended Release Oral CapsuleTier 1Approval first
  • 24 HR tacrolimus 0.5 MG Extended Release Oral Capsule [Astagraf]Tier 1Approval first
  • 24 HR tacrolimus 0.75 MG Extended Release Oral Tablet [Envarsus]Tier 1Approval first
  • 24 HR tacrolimus 1 MG Extended Release Oral CapsuleTier 1Approval first
  • 24 HR tacrolimus 1 MG Extended Release Oral Capsule [Astagraf]Tier 1Approval first
  • 24 HR tacrolimus 1 MG Extended Release Oral Tablet [Envarsus]Tier 1Approval first
  • 24 HR tacrolimus 4 MG Extended Release Oral Tablet [Envarsus]Tier 1Approval first
  • 24 HR tacrolimus 5 MG Extended Release Oral CapsuleTier 1Approval first
  • 24 HR tacrolimus 5 MG Extended Release Oral Capsule [Astagraf]Tier 1Approval first
  • tacrolimus 0.0003 MG/MG Topical OintmentTier 1120 grams per 30 days
  • tacrolimus 0.001 MG/MG Topical OintmentTier 1120 grams per 30 days
  • tacrolimus 0.2 MG Granules for Oral Suspension [Prograf]Tier 1Approval first
  • tacrolimus 0.5 MG Oral CapsuleTier 1Approval first
  • tacrolimus 1 MG Granules for Oral Suspension [Prograf]Tier 1Approval first
  • tacrolimus 1 MG Oral CapsuleTier 1Approval first
  • tacrolimus 5 MG Oral CapsuleTier 1Approval first

← All coverage for tacrolimus