MedicarePartD.guide

A non-government resource built from CMS public data

TASIMELTEON 20 mg Capsule, Gelatin Coated

Coverage in Wisconsin (CMS PDP Region 16).

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

8 of 8 plans apply a prior authorization, step therapy or quantity limit.

61 Medicare Advantage plans in WI 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. WI: 61 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%—$379.5714$1,138.713 units
  • Prior authorization
  • Quantity limit 3 per 30 days
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)$0.00/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)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$529.3902$1,588.173 units
  • Prior authorization
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$26.70/mo premium · $615.00 deductible5Specialty Tier25%—$587.0453$1,761.143 units
  • Prior authorization
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible5Specialty Tier25%—$375.6800$1,127.043 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$110.60/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)$113.90/mo premium · $130.00 deductible5Specialty Tier31%—$529.3902$1,588.173 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 →