MedicarePartD.guide

A non-government resource built from CMS public data

TASIMELTEON 20 mg Capsule, Gelatin Coated

Coverage in Alabama and Tennessee (CMS PDP Region 12).

10 of 12 stand-alone Part D plans in Alabama and Tennessee cover this drug on tier 5.

10 of 10 plans apply a prior authorization, step therapy or quantity limit.

194 Medicare Advantage plans in AL, TN 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. AL: 86 plans · TN: 108 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$683.4400$2,050.323 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$37.70/mo premium · $601.00 deductible5Specialty Tier26%—$683.4400$2,050.323 units
  • Prior authorization
  • Quantity limit 3 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$63.20/mo premium · $615.00 deductible5Specialty Tier25%—$529.3902$1,588.173 units
  • Prior authorization
  • Quantity limit 3 per 30 days
BlueRx Essential (PDP)$76.20/mo premium · $615.00 deductible5Specialty Tier25%25%$375.3704$1,126.113 units
  • Prior authorization
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$77.50/mo premium · $615.00 deductible5Specialty Tier25%—$370.3655$1,111.103 units
  • Prior authorization
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$87.20/mo premium · $615.00 deductible5Specialty Tier25%—$398.6902$1,196.073 units
  • Prior authorization
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$97.30/mo premium · $615.00 deductible5Specialty Tier25%—$532.9608$1,598.883 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible5Specialty Tier33%—$683.4400$2,050.323 units
  • Prior authorization
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$119.30/mo premium · $130.00 deductible5Specialty Tier31%—$529.3902$1,588.173 units
  • Prior authorization
  • Quantity limit 3 per 30 days
BlueRx Enhanced Plus (PDP)$129.50/mo premium · $150.00 deductible5Specialty Tier31%31%$375.3704$1,126.113 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.

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