INCRUSE ELLIPTA 62.5 ug Aerosol, Powder
Also known as Umeclidinium. Coverage in Oregon and Washington (CMS PDP Region 30).
6 of 10 stand-alone Part D plans in Oregon and Washington cover this drug on tier 3.
6 of 6 plans apply a prior authorization, step therapy or quantity limit.
127 Medicare Advantage plans in OR, WA 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. OR: 60 plans · WA: 67 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $11.0223 | $33.073 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $11.0223 | $33.073 units |
|
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 24% | 24% | $11.1574 | $33.473 units |
|
| HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible | 3Preferred Brand | 16% | 16% | $11.1495 | $33.453 units |
|
| SilverScript Choice (PDP)$85.90/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $11.8952 | $35.693 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$110.00/mo premium · $130.00 deductible | 3Preferred Brand | 16% | 16% | $12.0306 | $36.093 units |
|
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.