Does Freedom Blue PPO Select (PPO) cover somatropin?
Freedom Blue PPO Select (PPO)
H3916-022-0 · MA_LOCAL · Medicare Part D
somatropin
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.
somatropinunder Freedom Blue PPO Select (PPO)
Covered — requires prior authorization
Your plan has to approve it first — your doctor’s office handles it.
What you'd pay
$95per 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 4
- 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 (24)
- 0.25 ML somatropin 0.8 MG/ML Prefilled Syringe [Genotropin]Tier 4Approval first
- 0.25 ML somatropin 1.6 MG/ML Prefilled Syringe [Genotropin]Tier 5Approval first
- 0.25 ML somatropin 2.4 MG/ML Prefilled Syringe [Genotropin]Tier 5Approval first
- 0.25 ML somatropin 3.2 MG/ML Prefilled Syringe [Genotropin]Tier 5Approval first
- 0.25 ML somatropin 4 MG/ML Prefilled Syringe [Genotropin]Tier 5Approval first
- 0.25 ML somatropin 4.8 MG/ML Prefilled Syringe [Genotropin]Tier 5Approval first
- 0.25 ML somatropin 5.6 MG/ML Prefilled Syringe [Genotropin]Tier 5Approval first
- 0.25 ML somatropin 6.4 MG/ML Prefilled Syringe [Genotropin]Tier 5Approval first
- 0.25 ML somatropin 7.2 MG/ML Prefilled Syringe [Genotropin]Tier 5Approval first
- 0.25 ML somatropin 8 MG/ML Prefilled Syringe [Genotropin]Tier 5Approval first
- 1 ML somatropin 12 MG/ML Cartridge [Genotropin]Tier 5Approval first
- 1 ML somatropin 5 MG/ML Cartridge [Genotropin]Tier 5Approval first
- 1.5 ML somatropin 10 MG/ML Pen Injector [Norditropin]Tier 5Approval first
- 1.5 ML somatropin 3.3 MG/ML Cartridge [Omnitrope]Tier 4Approval first
- 1.5 ML somatropin 3.33 MG/ML Pen Injector [Norditropin]Tier 5Approval first
- 1.5 ML somatropin 6.67 MG/ML Cartridge [Omnitrope]Tier 5Approval first
- 1.5 ML somatropin 6.67 MG/ML Pen Injector [Norditropin]Tier 5Approval first
- somatropin 12 MG Cartridge [Humatrope]Tier 5Approval first
- somatropin 24 MG Cartridge [Humatrope]Tier 5Approval first
- somatropin 5 MG Injection [Serostim]Tier 5Approval first
- somatropin 5 MG/ML Injectable Solution [Omnitrope]Tier 5Approval first
- somatropin 6 MG Cartridge [Humatrope]Tier 5Approval first
- somatropin 6 MG Injection [Serostim]Tier 5Approval first
- somatropin 8 MG/ML Injectable Solution [Serostim]Tier 5Approval first