MedicarePartD.guide

A non-government resource built from CMS public data

DUPIXENT 200 mg/1.14mL Injection, Solution

Also known as Dupilumab. Coverage in Virginia (CMS PDP Region 07).

9 of 9 stand-alone Part D plans in Virginia cover this drug on tier 5.

9 of 9 plans apply a prior authorization, step therapy or quantity limit.

128 Medicare Advantage plans in VA 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. VA: 128 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%—$1607.7238$8,038.625 units
  • Prior authorization
  • Quantity limit 4.56 per 28 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$1607.7238$8,038.625 units
  • Prior authorization
  • Quantity limit 4.56 per 28 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$1732.3834$6,929.534 units
  • Prior authorization
  • Quantity limit 3.42 per 28 days
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible5Specialty Tier26%—$1732.3834$6,929.534 units
  • Prior authorization
  • Quantity limit 3.42 per 28 days
AARP Medicare Rx Saver from UHC (PDP)$39.60/mo premium · $615.00 deductible5Specialty Tier25%—$1744.2521$8,721.265 units
  • Prior authorization
  • Quantity limit 4.56 per 28 days
SilverScript Choice (PDP)$78.20/mo premium · $615.00 deductible5Specialty Tier25%—$1809.6250$9,048.125 units
  • Prior authorization
  • Quantity limit 4.56 per 28 days
Humana Premier Rx Plan (PDP)$87.60/mo premium · $0.00 deductible5Specialty Tier33%—$1732.3834$6,929.534 units
  • Prior authorization
  • Quantity limit 3.42 per 28 days
AARP Medicare Rx Preferred from UHC (PDP)$100.80/mo premium · $130.00 deductible5Specialty Tier31%—$1744.2521$8,721.265 units
  • Prior authorization
  • Quantity limit 4.56 per 28 days
HealthSpring Assurance Rx (PDP)$133.80/mo premium · $615.00 deductible5Specialty Tier25%—$1637.0225$8,185.115 units
  • Prior authorization
  • Quantity limit 4.56 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 →