RINVOQ 45 mg Tablet, Extended Release

Also known as Upadacitinib. Coverage in California (CMS PDP Region 32).

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

11 of 11 plans apply a prior authorization, step therapy or quantity limit.

383 Medicare Advantage plans in CA 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. CA: 383 plans.

Every plan that covers it

Plan	Tier	30-day preferred	90-day mail	Unit cost	Est. 30-day fill	Restrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$426.7607	$5,974.6514 units	Prior authorization Quantity limit 168 per 365 days
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$423.4355	$5,928.1014 units	Prior authorization Quantity limit 84 per 180 days
Wellcare Classic (PDP)$6.20/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$423.4355	$5,928.1014 units	Prior authorization Quantity limit 84 per 180 days
HealthSpring Extra Rx (PDP)$70.60/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$426.9817	$5,977.7414 units	Prior authorization Quantity limit 168 per 365 days
SilverScript Choice (PDP)$103.60/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$465.1260	$6,511.7614 units	Prior authorization Quantity limit 168 per 365 days
Humana Value Rx Plan (PDP)$104.60/mo premium · $601.00 deductible	5Specialty Tier	26%	—	$451.9205	$6,326.8914 units	Prior authorization Quantity limit 168 per 365 days
Humana Basic Rx Plan (PDP)$132.20/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$451.9205	$6,326.8914 units	Prior authorization Quantity limit 168 per 365 days
AARP Medicare Rx Preferred from UHC (PDP)$165.40/mo premium · $130.00 deductible	5Specialty Tier	31%	—	$477.2210	$1,431.663 units	Prior authorization Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$172.90/mo premium · $0.00 deductible	5Specialty Tier	33%	—	$451.9205	$6,326.8914 units	Prior authorization Quantity limit 168 per 365 days
Blue Shield Rx Plus (PDP)$199.70/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$461.7807	$6,464.9314 units	Prior authorization Quantity limit 168 per 365 days
Blue Shield Rx Enhanced (PDP)$227.80/mo premium · $0.00 deductible	5Specialty Tier	33%	—	$461.7807	$6,464.9314 units	Prior authorization Quantity limit 168 per 365 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 →