MedicarePartD.guide

A non-government resource built from CMS public data

WINREVAIR Kit

Also known as Sotatercept-Csrk. Coverage in Colorado (CMS PDP Region 27).

10 of 10 stand-alone Part D plans in Colorado cover this drug on tier 5.

10 of 10 plans apply a prior authorization, step therapy or quantity limit.

96 Medicare Advantage plans in CO 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. CO: 96 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$18357.8300$18,357.831 unit
  • Prior authorization
  • Quantity limit 1 per 21 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$15352.0423—
  • Prior authorization
Wellcare Classic (PDP)$2.20/mo premium · $615.00 deductible5Specialty Tier25%—$18357.8300$18,357.831 unit
  • Prior authorization
  • Quantity limit 1 per 21 days
Humana Value Rx Plan (PDP)$48.50/mo premium · $601.00 deductible5Specialty Tier26%—$15352.0423—
  • Prior authorization
HealthSpring Assurance Rx (PDP)$61.70/mo premium · $615.00 deductible5Specialty Tier25%—$14580.1341$14,580.131 unit
  • Prior authorization
  • Quantity limit 1 per 21 days
HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible5Specialty Tier25%—$14578.1653$14,578.171 unit
  • Prior authorization
  • Quantity limit 1 per 21 days
SilverScript Choice (PDP)$105.10/mo premium · $615.00 deductible5Specialty Tier25%—$15913.5783$47,740.733 units
  • Prior authorization
  • Quantity limit 2 per 21 days
AARP Medicare Rx Saver from UHC (PDP)$125.00/mo premium · $615.00 deductible5Specialty Tier25%—$15916.2301$15,916.231 unit
  • Prior authorization
  • Quantity limit 1 per 21 days
Humana Premier Rx Plan (PDP)$137.10/mo premium · $0.00 deductible5Specialty Tier33%—$15352.0423—
  • Prior authorization
AARP Medicare Rx Preferred from UHC (PDP)$151.90/mo premium · $130.00 deductible5Specialty Tier31%—$15916.2301$15,916.231 unit
  • Prior authorization
  • Quantity limit 1 per 21 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 →