To all -Prescription coverage (Part D) in Delaware (each state is different) the 2026 formulary for HealthSpring EXTRA Plan lists Nuzyra in the formulary, so if that doesn't change the total out of pocket should be capped at the $2,100.00 for the year. However, the HealthSpring ASSURANCE plan DOES NOT list Nuzyra in the formulary, so if that plan did approve by exception, the $2,100.00 out of pocket cap would not apply.

I am not familiar with NJH pharmacies, maybe NJH would be able to send a script to a different pharmacy that is on the HealthSpring Extra pharmacy list.

I go to Johns Hopkins and I get some of my medications from their pharmacies and others at my local pharmacies. They don't require, but it can be more convenient, that I use their pharmacies for my treatment medications.