MedicarePartD.guide

A non-government resource built from CMS public data

QULIPTA 60 mg Tablet

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

7 of 11 stand-alone Part D plans in Connecticut, Massachusetts, Rhode Island and Vermont cover this drug on tier 3–4.

Lowest 30-day cost $30.00 at a preferred pharmacy. 7 of 7 plans apply a prior authorization, step therapy or quantity limit.

127 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: 34 plans · MA: 76 plans · RI: 15 plans · VT: 2 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Blue MedicareRx Value Plus (PDP)$20.70/mo premium · $615.00 deductible3Preferred Brand17%17%$38.3258$114.983 units
  • Prior authorization
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible3Preferred Brand19%19%$40.4711$121.413 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible3Preferred Brand$30.00$60.00$38.3258$114.983 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$8.40/mo premium · $615.00 deductible4Non-Preferred Drug32%—$38.6204$115.863 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$73.60/mo premium · $601.00 deductible4Non-Preferred Drug31%—$38.6204$115.863 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$138.60/mo premium · $0.00 deductible4Non-Preferred Drug50%50%$38.6204$115.863 units
  • Prior authorization
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible4Non-Preferred Drug30%—$40.7742$122.323 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 →