MedicarePartD.guide

A non-government resource built from CMS public data

SOMAVERT Kit

Also known as Pegvisomant. Coverage in Mississippi (CMS PDP Region 20).

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

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

85 Medicare Advantage plans in MS 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. MS: 85 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$442.1941—
  • Prior authorization
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$442.1941—
  • Prior authorization
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$461.4691$2,768.816 units
  • Prior authorization
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$37.60/mo premium · $601.00 deductible5Specialty Tier26%—$461.4691$2,768.816 units
  • Prior authorization
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$59.70/mo premium · $615.00 deductible5Specialty Tier25%—$438.2756$1,314.833 units
  • Prior authorization
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$77.10/mo premium · $615.00 deductible5Specialty Tier25%—$438.2163$1,314.653 units
  • Prior authorization
  • Quantity limit 3 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$84.70/mo premium · $615.00 deductible5Specialty Tier25%—$478.4281$1,435.283 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$89.90/mo premium · $0.00 deductible5Specialty Tier33%—$461.4691$2,768.816 units
  • Prior authorization
  • Quantity limit 6 per 30 days
SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible5Specialty Tier25%—$483.2533—
  • Prior authorization
AARP Medicare Rx Preferred from UHC (PDP)$140.60/mo premium · $130.00 deductible5Specialty Tier31%—$478.4281$1,435.283 units
  • Prior authorization
  • Quantity limit 3 per 30 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 →