MedicarePartD.guide

A non-government resource built from CMS public data

PERAMPANEL 6 mg Tablet, Film Coated

Coverage in California (CMS PDP Region 32).

10 of 12 stand-alone Part D plans in California cover this drug on tier 4–5.

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

344 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: 344 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$104.60/mo premium · $601.00 deductible4Non-Preferred Drug32%—$37.9845$113.953 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$132.20/mo premium · $615.00 deductible4Non-Preferred Drug32%—$37.9845$113.953 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$172.90/mo premium · $0.00 deductible4Non-Preferred Drug50%50%$37.9845$113.953 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Blue Shield Rx Plus (PDP)$199.70/mo premium · $615.00 deductible4Non-Preferred Drug49%49%$37.4560$1,123.6830 units
  • Quantity limit 1 per 1 days
Blue Shield Rx Enhanced (PDP)$227.80/mo premium · $0.00 deductible4Non-Preferred Drug37%37%$37.4560$1,123.6830 units
  • Quantity limit 1 per 1 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$19.5619$117.376 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible5Specialty Tier25%—$24.7665$74.303 units
  • Quantity limit 3 per 30 days
Wellcare Classic (PDP)$6.20/mo premium · $615.00 deductible5Specialty Tier25%—$24.7783$74.333 units
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$70.60/mo premium · $615.00 deductible5Specialty Tier25%—$18.9617$113.776 units
  • Quantity limit 6 per 30 days
SilverScript Choice (PDP)$103.60/mo premium · $615.00 deductible5Specialty Tier25%—$33.7150$101.153 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 →