MedicarePartD.guide

A non-government resource built from CMS public data

RINVOQ 30 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

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$215.3145$645.943 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible5Specialty Tier25%—$213.0405$639.123 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Wellcare Classic (PDP)$6.20/mo premium · $615.00 deductible5Specialty Tier25%—$213.0405$639.123 units
  • Prior authorization
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$70.60/mo premium · $615.00 deductible5Specialty Tier25%—$215.3536$646.063 units
  • Prior authorization
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$103.60/mo premium · $615.00 deductible5Specialty Tier25%—$232.5654$697.703 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$104.60/mo premium · $601.00 deductible5Specialty Tier26%—$226.0345$678.103 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$132.20/mo premium · $615.00 deductible5Specialty Tier25%—$226.0345$678.103 units
  • Prior authorization
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$165.40/mo premium · $130.00 deductible5Specialty Tier31%—$236.9230$710.773 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$172.90/mo premium · $0.00 deductible5Specialty Tier33%—$226.0345$678.103 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Blue Shield Rx Plus (PDP)$199.70/mo premium · $615.00 deductible5Specialty Tier25%—$230.8693$6,926.0830 units
  • Prior authorization
  • Quantity limit 1 per 1 days
Blue Shield Rx Enhanced (PDP)$227.80/mo premium · $0.00 deductible5Specialty Tier33%—$230.8693$6,926.0830 units
  • Prior authorization
  • Quantity limit 1 per 1 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 →