FillMapPlatino Blindao (HMO D-SNP)

Does Platino Blindao (HMO D-SNP) cover leuprolide?

Platino Blindao (HMO D-SNP)
H5774-028-0 · MA_LOCAL · Medicare Part D
leuprolide
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.

leuprolideunder Platino Blindao (HMO D-SNP)
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. 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 — 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 1
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 (14)

  • 0.25 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Eligard]Tier 1Approval first1 syringe per 28 days
  • 0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard]Tier 1Approval first1 syringe per 180 days
  • 0.375 ML leuprolide acetate 60 MG/ML Prefilled Syringe [Eligard]Tier 1Approval first1 syringe per 84 days
  • 0.5 ML leuprolide acetate 60 MG/ML Prefilled Syringe [Eligard]Tier 1Approval first1 syringe per 120 days
  • 1 ML leuprolide acetate 3.75 MG/ML Prefilled Syringe [Lupron]Tier 1Approval first1 syringe per 28 days
  • 1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron]Tier 1Approval first1 syringe per 28 days
  • 1.5 ML leuprolide acetate 15 MG/ML Prefilled Syringe [Lupron]Tier 1Approval first1 syringe per 84 days
  • 1.5 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Lupron]Tier 1Approval first1 syringe per 168 days
  • 1.5 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron]Tier 1Approval first1 syringe per 84 days
  • 4-Month 1.5 ML leuprolide acetate 20 MG/ML Prefilled Syringe [Lupron]Tier 1Approval first1 syringe per 90 days
  • leuprolide acetate 5 MG/ML Injectable SolutionTier 1Approval first
  • Pediatric 1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron]Tier 1Approval first1 syringe per 30 days
  • Pediatric 1.5 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Lupron]Tier 1Approval first1 syringe per 180 days
  • Pediatric 1.5 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron]Tier 1Approval first1 syringe per 90 days

← All coverage for leuprolide