MedicarePartD.guide

A non-government resource built from CMS public data

RINVOQ 45 mg Tablet, Extended Release

Also known as Upadacitinib. Coverage in Delaware, DC and Maryland (CMS PDP Region 05).

9 of 10 stand-alone Part D plans in Delaware, DC and Maryland cover this drug on tier 5.

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

95 Medicare Advantage plans in DE, DC, MD 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. DE: 30 plans · DC: 15 plans · MD: 50 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$447.5618$6,265.8714 units
  • Prior authorization
  • Quantity limit 168 per 365 days
Humana Value Rx Plan (PDP)$4.30/mo premium · $601.00 deductible5Specialty Tier26%—$447.5618$6,265.8714 units
  • Prior authorization
  • Quantity limit 168 per 365 days
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible5Specialty Tier25%—$424.8865$5,948.4114 units
  • Prior authorization
  • Quantity limit 84 per 180 days
Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible5Specialty Tier25%—$424.8865$5,948.4114 units
  • Prior authorization
  • Quantity limit 84 per 180 days
HealthSpring Assurance Rx (PDP)$32.60/mo premium · $615.00 deductible5Specialty Tier25%—$425.8727$5,962.2214 units
  • Prior authorization
  • Quantity limit 168 per 365 days
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible5Specialty Tier25%—$425.7312$5,960.2414 units
  • Prior authorization
  • Quantity limit 168 per 365 days
AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible5Specialty Tier31%—$469.2588$1,407.783 units
  • Prior authorization
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible5Specialty Tier25%—$465.1260$6,511.7614 units
  • Prior authorization
  • Quantity limit 168 per 365 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible5Specialty Tier33%—$447.5618$6,265.8714 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 →