MedicarePartD.guide

A non-government resource built from CMS public data

ZAVZPRET 10 mg/.1mL Spray

Also known as Zavegepant. Coverage in Pennsylvania and West Virginia (CMS PDP Region 06).

2 of 12 stand-alone Part D plans in Pennsylvania and West Virginia cover this drug on tier 5.

2 of 2 plans apply a prior authorization, step therapy or quantity limit.

95 Medicare Advantage plans in PA, WV 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. PA: 78 plans · WV: 17 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Blue Rx PDP Complete (PDP)$164.80/mo premium · $200.00 deductible5Specialty Tier25%—$185.7531$1,486.028 units
  • Prior authorization
  • Quantity limit 8 per 30 days
Blue Rx PDP Plus (PDP)$193.20/mo premium · $615.00 deductible5Specialty Tier25%25%$185.5378$1,484.308 units
  • Prior authorization
  • Quantity limit 8 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 →