MedicarePartD.guide

A non-government resource built from CMS public data

RINVOQ 15 mg Tablet, Extended Release

Also known as Upadacitinib. Coverage in Illinois (CMS PDP Region 17).

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

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

137 Medicare Advantage plans in IL 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. IL: 137 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$216.5602$649.683 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$216.5602$649.683 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$227.2821$681.853 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible5Specialty Tier26%—$227.2821$681.853 units
  • Prior authorization
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible5Specialty Tier25%—$218.9270$656.783 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Blue Cross MedicareRx Basic (PDP)$89.70/mo premium · $615.00 deductible5Specialty Tier25%—$234.6630$703.993 units
  • Prior authorization
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible5Specialty Tier25%—$232.6003$697.803 units
  • Prior authorization
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$103.90/mo premium · $130.00 deductible5Specialty Tier31%—$242.2715$726.813 units
  • Prior authorization
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$104.20/mo premium · $615.00 deductible5Specialty Tier25%—$219.0395$657.123 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$119.40/mo premium · $0.00 deductible5Specialty Tier33%—$227.2821$681.853 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Blue Cross MedicareRx Value (PDP)$119.70/mo premium · $615.00 deductible5Specialty Tier25%—$232.5100$697.533 units
  • Prior authorization
  • Quantity limit 3 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 →