Does SummaCare Gold 1000 with 3 Free PCP Visits + Adult Vision cover everolimus?
SummaCare Gold 1000 with 3 Free PCP Visits + Adult Vision
52664-52664OH1540013-0 · ACA · ACA Marketplace
everolimus
everolimusunder SummaCare Gold 1000 with 3 Free PCP Visits + Adult Vision
Covered — some forms require prior authorization
16 of 20 covered forms have a condition attached. Your plan has to approve it first — your doctor’s office handles it.
What you'd pay
50%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. Your plan’s deductible comes first — you pay the full price until it is met.
This is the standard amount. If you qualified for a cost-sharing reduction when you enrolled, set your level above and this will follow it.
Amount limit applies — you can still fill it, but your plan caps how much you get at a time. This plan's drug list records the cap without stating the amount — your pharmacy can tell you when they fill it.
- Tier
- Specialty drugs
- Approval first
- Required
- Try another first
- No
- Amount limit
- Yes
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 14, 2026 · CMS QHP machine-readable. Reference information, not medical advice and not a price.
Covered forms and strengths (20)
- everolimus 0.25 MG Oral Tablet
- everolimus 0.5 MG Oral Tablet
- everolimus 0.75 MG Oral Tablet
- everolimus 1 MG Oral Tablet
- everolimus 10 MG Oral TabletApproval first
- everolimus 10 MG Oral Tablet [Torpenz]Approval firstAmount limit
- everolimus 10 MG Oral Tablet [Yulithira]Approval firstAmount limit
- everolimus 2 MG Tablet for Oral SuspensionApproval first
- everolimus 2.5 MG Oral TabletApproval firstAmount limit
- everolimus 2.5 MG Oral Tablet [Torpenz]Approval firstAmount limit
- everolimus 2.5 MG Oral Tablet [Yulithira]Approval firstAmount limit
- everolimus 3 MG Tablet for Oral SuspensionApproval first
- everolimus 3 MG Tablet for Oral Suspension [Afinitor]Approval first
- everolimus 5 MG Oral TabletApproval firstAmount limit
- everolimus 5 MG Oral Tablet [Torpenz]Approval firstAmount limit
- everolimus 5 MG Oral Tablet [Yulithira]Approval firstAmount limit
- everolimus 5 MG Tablet for Oral SuspensionApproval first
- everolimus 7.5 MG Oral TabletApproval firstAmount limit
- everolimus 7.5 MG Oral Tablet [Torpenz]Approval firstAmount limit
- everolimus 7.5 MG Oral Tablet [Yulithira]Approval firstAmount limit