MedicarePartD.guide

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HERNEXEOS 60 mg Tablet, Film Coated

Also known as Zongertinib. Coverage in Kansas (CMS PDP Region 24).

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

12 of 12 plans apply a prior authorization, step therapy or quantity limit.

77 Medicare Advantage plans in KS 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. KS: 77 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Blue MedicareRx Essentials (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$365.3724$3,288.359 units
  • Prior authorization
  • Quantity limit 18 per 60 days
Blue MedicareRx Value (PDP)$0.70/mo premium · $615.00 deductible5Specialty Tier25%—$365.8072$3,292.269 units
  • Prior authorization
  • Quantity limit 18 per 60 days
HealthSpring Assurance Rx (PDP)$6.70/mo premium · $615.00 deductible5Specialty Tier25%—$344.1778$3,097.609 units
  • Prior authorization
  • Quantity limit 9 per 30 days
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible5Specialty Tier25%—$433.3500$3,900.159 units
  • Prior authorization
  • Quantity limit 9 per 30 days
Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible5Specialty Tier25%—$433.3500$3,900.159 units
  • Prior authorization
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$15.50/mo premium · $615.00 deductible5Specialty Tier25%—$362.3882$6,522.9918 units
  • Prior authorization
  • Quantity limit 18 per 30 days
Humana Value Rx Plan (PDP)$55.60/mo premium · $601.00 deductible5Specialty Tier26%—$362.3882$6,522.9918 units
  • Prior authorization
  • Quantity limit 18 per 30 days
Blue MedicareRx Plus (PDP)$67.40/mo premium · $0.00 deductible5Specialty Tier33%—$365.8072$3,292.269 units
  • Prior authorization
  • Quantity limit 18 per 60 days
SilverScript Choice (PDP)$88.30/mo premium · $615.00 deductible5Specialty Tier25%—$375.6435$4,507.7212 units
  • Prior authorization
  • Quantity limit 12 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$105.40/mo premium · $615.00 deductible5Specialty Tier25%—$375.7063$6,762.7118 units
  • Prior authorization
  • Quantity limit 18 per 30 days
Humana Premier Rx Plan (PDP)$116.30/mo premium · $0.00 deductible5Specialty Tier33%—$362.3882$6,522.9918 units
  • Prior authorization
  • Quantity limit 18 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$147.00/mo premium · $130.00 deductible5Specialty Tier31%—$375.7063$6,762.7118 units
  • Prior authorization
  • Quantity limit 18 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 →