FillMapGeisinger Gold Value Rx (HMO)

Does Geisinger Gold Value Rx (HMO) cover epoetin alfa?

Geisinger Gold Value Rx (HMO)
H3954-163-0 · MA_LOCAL · Medicare Part D
epoetin alfa
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.

epoetin alfaunder Geisinger Gold Value Rx (HMO)
Covered — requires prior authorization
Your plan has to approve it first — your doctor’s office handles it.
What you'd pay
25%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. 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.

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 (18)

  • 1 ML epoetin alfa 10000 UNT/ML Injection [Procrit]Tier 4Approval first12 mL per 28 days
  • 1 ML epoetin alfa 2000 UNT/ML Injection [Epogen]Tier 3Approval first12 mL per 28 days
  • 1 ML epoetin alfa 2000 UNT/ML Injection [Procrit]Tier 4Approval first12 mL per 28 days
  • 1 ML epoetin alfa 3000 UNT/ML Injection [Epogen]Tier 3Approval first12 mL per 28 days
  • 1 ML epoetin alfa 3000 UNT/ML Injection [Procrit]Tier 4Approval first12 mL per 28 days
  • 1 ML epoetin alfa 4000 UNT/ML Injection [Epogen]Tier 3Approval first12 mL per 28 days
  • 1 ML epoetin alfa 4000 UNT/ML Injection [Procrit]Tier 4Approval first12 mL per 28 days
  • 1 ML epoetin alfa 40000 UNT/ML Injection [Procrit]Tier 4Approval first6 mL per 28 days
  • 1 ML epoetin alfa-epbx 10000 UNT/ML Injection [Retacrit]Tier 3Approval first12 mL per 28 days
  • 1 ML epoetin alfa-epbx 2000 UNT/ML Injection [Retacrit]Tier 3Approval first12 mL per 28 days
  • 1 ML epoetin alfa-epbx 3000 UNT/ML Injection [Retacrit]Tier 3Approval first12 mL per 28 days
  • 1 ML epoetin alfa-epbx 4000 UNT/ML Injection [Retacrit]Tier 3Approval first12 mL per 28 days
  • 1 ML epoetin alfa-epbx 40000 UNT/ML Injection [Retacrit]Tier 3Approval first6 mL per 28 days
  • epoetin alfa 10000 UNT/ML Injectable Solution [Epogen]Tier 3Approval first12 mL per 28 days
  • epoetin alfa 20000 UNT/ML Injectable Solution [Epogen]Tier 3Approval first12 mL per 28 days
  • epoetin alfa 20000 UNT/ML Injectable Solution [Procrit]Tier 4Approval first12 mL per 28 days
  • epoetin alfa-epbx 10000 UNT/ML Injectable Solution [Retacrit]Tier 3Approval first12 mL per 28 days
  • epoetin alfa-epbx 20000 UNT/ML Injectable Solution [Retacrit]Tier 3Approval first12 mL per 28 days

← All coverage for epoetin alfa