MedicarePartD.guide

A non-government resource built from CMS public data

XELJANZ 1 mg/mL Solution

Also known as Tofacitinib. Coverage in Michigan (CMS PDP Region 13).

6 of 12 stand-alone Part D plans in Michigan cover this drug on tier 5.

6 of 6 plans apply a prior authorization, step therapy or quantity limit.

149 Medicare Advantage plans in MI 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. MI: 149 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%—$20.4396$1,226.3860 units
  • Prior authorization
  • Quantity limit 48 per 24 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$20.4396$1,226.3860 units
  • Prior authorization
  • Quantity limit 48 per 24 days
AARP Medicare Rx Saver from UHC (PDP)$14.10/mo premium · $615.00 deductible5Specialty Tier25%—$22.2203$66.663 units
  • Prior authorization
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$78.30/mo premium · $130.00 deductible5Specialty Tier31%—$22.2203$66.663 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Prescription Blue Select (PDP)$78.40/mo premium · $615.00 deductible5Specialty Tier25%—$21.7799$1,568.1572 units
  • Prior authorization
  • Quantity limit 72 per 30 days
Prescription Blue Premium (PDP)$106.70/mo premium · $0.00 deductible5Specialty Tier33%—$21.7799$1,568.1572 units
  • Prior authorization
  • Quantity limit 72 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 →