MAVYRET 40/100 mg Tablet, Film Coated
Also known as Glecaprevir And Pibrentasvir. Coverage in Delaware, DC and Maryland (CMS PDP Region 05).
3 of 10 stand-alone Part D plans in Delaware, DC and Maryland cover this drug on tier 5.
3 of 3 plans apply a prior authorization, step therapy or quantity limit.
Every plan that covers it
Showing 3 of 3 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Saver from UHC (PDP)$37.80/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $156.3746 | $14,073.7190 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible | 5Specialty Tier | 31% | — | $156.3746 | $14,073.7190 units |
|
| SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $154.6286 | — |
|
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.
Medicare Advantage plans
Medicare Advantage plans carry their own formularies, separate from stand-alone Part D, and are sold county by county. Pick a county to see every Medicare Advantage drug plan there that covers this drug.
64 Medicare Advantage plans in DC, DE, MD do cover it
A patient on an MA-PD plan may have coverage even where no PDP lists the drug. DC: 11 plans · DE: 22 plans · MD: 31 plans.