MedicarePartD.guide

A non-government resource built from CMS public data

RINVOQ 45 mg Tablet, Extended Release

Also known as Upadacitinib. Coverage in South Carolina (CMS PDP Region 09).

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

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

79 Medicare Advantage plans in SC 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. SC: 79 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$4.80/mo premium · $615.00 deductible5Specialty Tier25%—$429.3626$6,011.0814 units
  • Prior authorization
  • Quantity limit 84 per 180 days
Wellcare Classic (PDP)$9.70/mo premium · $615.00 deductible5Specialty Tier25%—$429.3626$6,011.0814 units
  • Prior authorization
  • Quantity limit 84 per 180 days
Humana Basic Rx Plan (PDP)$10.10/mo premium · $615.00 deductible5Specialty Tier25%—$458.0989$6,413.3814 units
  • Prior authorization
  • Quantity limit 168 per 365 days
Humana Value Rx Plan (PDP)$65.60/mo premium · $601.00 deductible5Specialty Tier26%—$458.0989$6,413.3814 units
  • Prior authorization
  • Quantity limit 168 per 365 days
HealthSpring Extra Rx (PDP)$71.20/mo premium · $615.00 deductible5Specialty Tier25%—$432.5762$6,056.0714 units
  • Prior authorization
  • Quantity limit 168 per 365 days
SilverScript Choice (PDP)$98.40/mo premium · $615.00 deductible5Specialty Tier25%—$465.1260$6,511.7614 units
  • Prior authorization
  • Quantity limit 168 per 365 days
AARP Medicare Rx Preferred from UHC (PDP)$139.20/mo premium · $130.00 deductible5Specialty Tier31%—$474.9232$1,424.773 units
  • Prior authorization
  • Quantity limit 3 per 30 days
BlueCross Rx Value (PDP)$139.70/mo premium · $615.00 deductible5Specialty Tier25%—$468.7321$1,406.203 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$145.60/mo premium · $0.00 deductible5Specialty Tier33%—$458.0989$6,413.3814 units
  • Prior authorization
  • Quantity limit 168 per 365 days
HealthSpring Assurance Rx (PDP)$152.50/mo premium · $615.00 deductible5Specialty Tier25%—$432.8522$6,059.9314 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 →