MedicarePartD.guide

A non-government resource built from CMS public data

RINVOQ 1 mg/mL Solution

Also known as Upadacitinib. Coverage in Texas (CMS PDP Region 22).

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

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

389 Medicare Advantage plans in TX 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. TX: 389 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%—$16.7300$602.2836 units
  • Prior authorization
  • Quantity limit 36 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$16.7300$602.2836 units
  • Prior authorization
  • Quantity limit 36 per 30 days
Humana Value Rx Plan (PDP)$22.90/mo premium · $601.00 deductible5Specialty Tier26%—$18.9745$683.0836 units
  • Prior authorization
  • Quantity limit 36 per 30 days
Humana Basic Rx Plan (PDP)$41.70/mo premium · $615.00 deductible5Specialty Tier25%—$18.9745$683.0836 units
  • Prior authorization
  • Quantity limit 36 per 30 days
HealthSpring Extra Rx (PDP)$70.00/mo premium · $615.00 deductible5Specialty Tier25%—$16.7300$602.2836 units
  • Prior authorization
  • Quantity limit 36 per 30 days
SilverScript Choice (PDP)$94.80/mo premium · $615.00 deductible5Specialty Tier25%—$18.6054$669.7936 units
  • Prior authorization
  • Quantity limit 36 per 30 days
Blue Cross MedicareRx Basic (PDP)$104.70/mo premium · $615.00 deductible5Specialty Tier25%—$17.6820$636.5536 units
  • Prior authorization
  • Quantity limit 36 per 30 days
HealthSpring Assurance Rx (PDP)$111.40/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)$114.80/mo premium · $130.00 deductible5Specialty Tier31%—$18.9459$682.0536 units
  • Prior authorization
  • Quantity limit 36 per 30 days
Humana Premier Rx Plan (PDP)$118.20/mo premium · $0.00 deductible5Specialty Tier33%—$18.9745$683.0836 units
  • Prior authorization
  • Quantity limit 36 per 30 days
Blue Cross MedicareRx Value (PDP)$167.40/mo premium · $615.00 deductible5Specialty Tier25%—$17.6820$636.5536 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 →