MedicarePartD.guide

A non-government resource built from CMS public data

RINVOQ 1 mg/mL Solution

Also known as Upadacitinib. Coverage in Connecticut, Massachusetts, Rhode Island and Vermont (CMS PDP Region 02).

10 of 11 stand-alone Part D plans in Connecticut, Massachusetts, Rhode Island and Vermont cover this drug on tier 5.

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

152 Medicare Advantage plans in CT, MA, RI, VT 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. CT: 42 plans · MA: 88 plans · RI: 20 plans · VT: 2 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$8.40/mo premium · $615.00 deductible5Specialty Tier25%—$17.7734$639.8436 units
  • Prior authorization
  • Quantity limit 36 per 30 days
Wellcare Value Script (PDP)$16.40/mo premium · $615.00 deductible5Specialty Tier25%—$16.7300$602.2836 units
  • Prior authorization
  • Quantity limit 36 per 30 days
Blue MedicareRx Value Plus (PDP)$20.70/mo premium · $615.00 deductible5Specialty Tier25%—$18.0608$650.1936 units
  • Prior authorization
  • Quantity limit 36 per 30 days
Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible5Specialty Tier25%—$16.7300$602.2836 units
  • Prior authorization
  • Quantity limit 36 per 30 days
SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible5Specialty Tier25%—$18.6054$669.7936 units
  • Prior authorization
  • Quantity limit 36 per 30 days
Humana Value Rx Plan (PDP)$73.60/mo premium · $601.00 deductible5Specialty Tier26%—$17.7734$639.8436 units
  • Prior authorization
  • Quantity limit 36 per 30 days
Humana Premier Rx Plan (PDP)$138.60/mo premium · $0.00 deductible5Specialty Tier33%—$17.7734$639.8436 units
  • Prior authorization
  • Quantity limit 36 per 30 days
HealthSpring Assurance Rx (PDP)$139.30/mo premium · $615.00 deductible5Specialty Tier25%—$16.7300$602.2836 units
  • Prior authorization
  • Quantity limit 36 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible5Specialty Tier31%—$18.9459$682.0536 units
  • Prior authorization
  • Quantity limit 36 per 30 days
Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible5Specialty Tier33%—$18.0608$650.1936 units
  • Prior authorization
  • Quantity limit 36 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 →