MedicarePartD.guide

A non-government resource built from CMS public data

EMGALITY 100 mg/mL Injection, Solution

Also known as Galcanezumab-Gnlm. Coverage in Puerto Rico (CMS PDP Region 38).

1 of 3 stand-alone Part D plans in Puerto Rico cover this drug on tier 4.

1 of 1 plans apply a prior authorization, step therapy or quantity limit.

62 Medicare Advantage plans in PR do cover it

Medicare Advantage plans carry their own formularies, separate from stand-alone Part D. A patient on an MA-PD plan may have coverage even where no PDP lists the drug. PR: 62 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Preferred from UHC (PDP)$145.10/mo premium · $615.00 deductible4Non-Preferred Drug25%25%$653.4395$1,960.323 units
  • Prior authorization
  • Quantity limit 3 per 28 days

Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity.

See coverage in all 39 regions →