MedicarePartD.guide

A non-government resource built from CMS public data

PIRFENIDONE 267 mg Capsule

Coverage in Delaware, DC and Maryland (CMS PDP Region 05).

8 of 10 stand-alone Part D plans in Delaware, DC and Maryland cover this drug on tier 5.

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

Every plan that covers it

Prior authorization
Step therapy
Quantity limit
Extra Help (LIS)

Showing 8 of 8 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help5Specialty Tier25%—$14.8310$400.4427 units
  • Prior authorization
  • Quantity limit 27 per 30 days
Humana Value Rx Plan (PDP)$4.30/mo premium · $601.00 deductible5Specialty Tier26%—$14.8310$400.4427 units
  • Prior authorization
  • Quantity limit 27 per 30 days
HealthSpring Assurance Rx (PDP)$32.60/mo premium · $615.00 deductible5Specialty Tier25%—$3.0584$82.5827 units
  • Prior authorization
  • Quantity limit 27 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$37.80/mo premium · $615.00 deductible5Specialty Tier25%—$2.6993$72.8827 units
  • Prior authorization
  • Quantity limit 27 per 30 days
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible5Specialty Tier25%—$5.6153$151.6127 units
  • Prior authorization
  • Quantity limit 27 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible5Specialty Tier31%—$2.6993$72.8827 units
  • Prior authorization
  • Quantity limit 27 per 30 days
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible5Specialty Tier25%—$19.7177$532.3827 units
  • Prior authorization
  • Quantity limit 27 per 30 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible5Specialty Tier33%—$14.8310$400.4427 units
  • Prior authorization
  • Quantity limit 27 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.

Medicare Advantage plans

Medicare Advantage plans carry their own formularies, separate from stand-alone Part D, and are sold county by county. Pick a county to see every Medicare Advantage drug plan there that covers this drug.

81 Medicare Advantage plans in DC, DE, MD do cover it

A patient on an MA-PD plan may have coverage even where no PDP lists the drug. DC: 12 plans · DE: 29 plans · MD: 40 plans.

See coverage in all 39 regions →