MedicarePartD.guide

A non-government resource built from CMS public data

APREPITANT 125 mg Capsule

Coverage in California (CMS PDP Region 32).

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

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

385 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: 385 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$215.1889—
  • Prior authorization
Wellcare Classic (PDP)$6.20/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$210.6070—
  • Prior authorization
AARP Medicare Rx Saver from UHC (PDP)$109.40/mo premium · $615.00 deductible4Non-Preferred Drug38%—$168.4622$336.922 units
  • Prior authorization
  • Quantity limit 2 per 28 days
AARP Medicare Rx Preferred from UHC (PDP)$165.40/mo premium · $130.00 deductible4Non-Preferred Drug31%—$181.3887$362.782 units
  • Prior authorization
  • Quantity limit 2 per 28 days
Blue Shield Rx Plus (PDP)$199.70/mo premium · $615.00 deductible4Non-Preferred Drug49%49%$459.4488—
  • Prior authorization
Blue Shield Rx Enhanced (PDP)$227.80/mo premium · $0.00 deductible4Non-Preferred Drug37%37%$459.4488—
  • Prior authorization
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$163.6071—
  • Prior authorization
HealthSpring Extra Rx (PDP)$70.60/mo premium · $615.00 deductible5Specialty Tier25%—$179.3236—
  • Prior authorization
SilverScript Choice (PDP)$103.60/mo premium · $615.00 deductible5Specialty Tier25%—$137.6316—
  • Prior authorization
Humana Value Rx Plan (PDP)$104.60/mo premium · $601.00 deductible5Specialty Tier26%—$283.1502$566.302 units
  • Prior authorization
  • Quantity limit 2 per 28 days
Humana Basic Rx Plan (PDP)$132.20/mo premium · $615.00 deductible5Specialty Tier25%—$283.1502$566.302 units
  • Prior authorization
  • Quantity limit 2 per 28 days
Humana Premier Rx Plan (PDP)$172.90/mo premium · $0.00 deductible5Specialty Tier33%—$283.1502$566.302 units
  • Prior authorization
  • Quantity limit 2 per 28 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 →