MedicarePartD.guide

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SPIRIVA RESPIMAT 1.562 ug Spray, Metered

Also known as Tiotropium Bromide Inhalation Spray. Coverage in Pennsylvania and West Virginia (CMS PDP Region 06).

12 of 12 stand-alone Part D plans in Pennsylvania and West Virginia cover this drug on tier 3–4.

Lowest 30-day cost $45.00 at a preferred pharmacy. 12 of 12 plans apply a prior authorization, step therapy or quantity limit.

365 Medicare Advantage plans in PA, WV 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. PA: 306 plans · WV: 59 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$6.60/mo premium · $615.00 deductible3Preferred Brand25%20%$126.0257$504.104 units
  • Quantity limit 4 per 28 days
Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible3Preferred Brand20%15%$126.0257$504.104 units
  • Quantity limit 4 per 28 days
AARP Medicare Rx Saver from UHC (PDP)$43.50/mo premium · $615.00 deductible3Preferred Brand16%16%$133.4773$533.914 units
  • Quantity limit 4 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$121.90/mo premium · $130.00 deductible3Preferred Brand16%16%$133.4773$533.914 units
  • Quantity limit 4 per 30 days
Humana Premier Rx Plan (PDP)$123.60/mo premium · $0.00 deductible3Preferred Brand$45.00$125.00$126.0257$504.104 units
  • Quantity limit 4 per 28 days
Blue Rx PDP Complete (PDP)$164.80/mo premium · $200.00 deductible3Preferred Brand25%25%$103.9993$416.004 units
  • Quantity limit 4 per 30 days
Blue Rx PDP Plus (PDP)$193.20/mo premium · $615.00 deductible3Preferred Brand25%25%$103.9997$416.004 units
  • Quantity limit 4 per 30 days
Wellcare Value Script (PDP)$8.20/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$120.5857$482.344 units
  • Quantity limit 4 per 30 days
Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible4Non-Preferred Drug28%28%$120.5857$482.344 units
  • Quantity limit 4 per 30 days
SilverScript Choice (PDP)$22.70/mo premium · $615.00 deductible4Non-Preferred Drug35%35%$129.7652$519.064 units
  • Quantity limit 4 per 30 days
HealthSpring Extra Rx (PDP)$62.60/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$123.3593$493.444 units
  • Step therapy
  • Quantity limit 4 per 30 days
HealthSpring Assurance Rx (PDP)$74.00/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$123.3700$493.484 units
  • Step therapy
  • Quantity limit 4 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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