MedicarePartD.guide

A non-government resource built from CMS public data

TASIMELTEON 20 mg Capsule, Gelatin Coated

Coverage in California (CMS PDP Region 32).

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

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

326 Medicare Advantage plans in CA 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. CA: 326 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$433.4557$1,300.373 units
  • Prior authorization
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$70.60/mo premium · $615.00 deductible5Specialty Tier25%—$372.7834$1,118.353 units
  • Prior authorization
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$103.60/mo premium · $615.00 deductible5Specialty Tier25%—$538.5315$1,615.593 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$104.60/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)$109.40/mo premium · $615.00 deductible5Specialty Tier25%—$546.2805$1,638.843 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$132.20/mo premium · $615.00 deductible5Specialty Tier25%—$683.4400$2,050.323 units
  • Prior authorization
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$165.40/mo premium · $130.00 deductible5Specialty Tier31%—$546.2805$1,638.843 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$172.90/mo premium · $0.00 deductible5Specialty Tier33%—$683.4400$2,050.323 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Blue Shield Rx Plus (PDP)$199.70/mo premium · $615.00 deductible5Specialty Tier25%—$567.7900$17,033.7030 units
  • Prior authorization
  • Quantity limit 1 per 1 days
Blue Shield Rx Enhanced (PDP)$227.80/mo premium · $0.00 deductible5Specialty Tier33%—$567.7900$17,033.7030 units
  • Prior authorization
  • Quantity limit 1 per 1 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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