RINVOQ 45 mg Tablet, Extended Release

Also known as Upadacitinib. Coverage in New Mexico (CMS PDP Region 26).

10 of 11 stand-alone Part D plans in New Mexico cover this drug on tier 5.

10 of 10 plans apply a prior authorization, step therapy or quantity limit.

61 Medicare Advantage plans in NM 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. NM: 61 plans.

Every plan that covers it

Plan	Tier	30-day preferred	90-day mail	Unit cost	Est. 30-day fill	Restrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$432.5511	$6,055.7214 units	Prior authorization Quantity limit 84 per 180 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$432.5511	$6,055.7214 units	Prior authorization Quantity limit 84 per 180 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$436.4767	$6,110.6714 units	Prior authorization Quantity limit 168 per 365 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$454.4379	$6,362.1314 units	Prior authorization Quantity limit 168 per 365 days
Humana Value Rx Plan (PDP)$69.60/mo premium · $601.00 deductible	5Specialty Tier	26%	—	$454.4379	$6,362.1314 units	Prior authorization Quantity limit 168 per 365 days
Humana Premier Rx Plan (PDP)$75.60/mo premium · $0.00 deductible	5Specialty Tier	33%	—	$454.4379	$6,362.1314 units	Prior authorization Quantity limit 168 per 365 days
AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible	5Specialty Tier	31%	—	$486.5547	$1,459.663 units	Prior authorization Quantity limit 3 per 30 days
SilverScript Choice (PDP)$104.00/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$465.1260	$6,511.7614 units	Prior authorization Quantity limit 168 per 365 days
Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$470.5211	$6,587.3014 units	Prior authorization Quantity limit 84 per 180 days
Blue Cross MedicareRx Basic (PDP)$145.40/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$474.3911	$6,641.4814 units	Prior authorization Quantity limit 84 per 180 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 →