ADVAIR HFA 230/21 ug Aerosol, Metered
Also known as Fluticasone Propionate And Salmeterol Xinafoate. Coverage in Pennsylvania and West Virginia (CMS PDP Region 06).
6 of 12 stand-alone Part D plans in Pennsylvania and West Virginia cover this drug on tier 3.
6 of 6 plans apply a prior authorization, step therapy or quantity limit.
264 Medicare Advantage plans in PA, WV 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. PA: 219 plans · WV: 45 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$8.20/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $33.4204 | $401.0412 units |
|
| Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $33.4204 | $401.0412 units |
|
| HealthSpring Extra Rx (PDP)$62.60/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $34.2629 | $411.1512 units |
|
| HealthSpring Assurance Rx (PDP)$74.00/mo premium · $615.00 deductible | 3Preferred Brand | 21% | 21% | $34.2615 | $411.1412 units |
|
| Blue Rx PDP Complete (PDP)$164.80/mo premium · $200.00 deductible | 3Preferred Brand | 25% | 25% | $34.4384 | $413.2612 units |
|
| Blue Rx PDP Plus (PDP)$193.20/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $34.3290 | $411.9512 units |
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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.