2026 HealthSpring Assurance Rx (PDP) formulary (drug list)
Contract S5617, plan 003 · Maine · 3,188 drugs on file · formulary ID 00026089. Each drug links to its cost in every CMS PDP Region 01 plan.
15 drugs starting with W.
| Drug name | Tier | 30-day preferred pharmacy | 90-day mail order | Usage management |
|---|---|---|---|---|
| WARFARIN SODIUM 1 mg Tablet | 1Preferred Generic | 5% | 5% | None |
| WARFARIN SODIUM 10 mg Tablet | 1Preferred Generic | 5% | 5% | None |
| WARFARIN SODIUM 2 mg Tablet | 1Preferred Generic | 5% | 5% | None |
| WARFARIN SODIUM 2.5 mg Tablet | 1Preferred Generic | 5% | 5% | None |
| WARFARIN SODIUM 3 mg Tablet | 1Preferred Generic | 5% | 5% | None |
| WARFARIN SODIUM 4 mg Tablet | 1Preferred Generic | 5% | 5% | None |
| WARFARIN SODIUM 5 mg Tablet | 1Preferred Generic | 5% | 5% | None |
| WARFARIN SODIUM 6 mg Tablet | 1Preferred Generic | 5% | 5% | None |
| WARFARIN SODIUM 7.5 mg Tablet | 1Preferred Generic | 5% | 5% | None |
| WELIREG 40 mg Tablet, Film CoatedBelzutifan | 5Specialty Tier | 25% | N/A |
|
| WINREVAIR KitSotatercept-Csrk | 5Specialty Tier | 25% | N/A |
|
| WINREVAIR KitSotatercept-Csrk | 5Specialty Tier | 25% | N/A |
|
| WINREVAIR KitSotatercept-Csrk | 5Specialty Tier | 25% | N/A |
|
| WINREVAIR KitSotatercept-Csrk | 5Specialty Tier | 25% | N/A |
|
| WYMZYA FE KitNorethindrone And Ethinyl Estradiol | 4Non-Preferred Drug | 30% | 30% | None |
PA = prior authorization, ST = step therapy, QL = quantity limit. Costs are the plan’s initial-coverage cost-sharing from the CMS 2026 formulary files; a drug not listed here is not on this plan’s formulary, though a formulary exception may still be possible.