MedicarePartD.guide

A non-government resource built from CMS public data

APREPITANT 125 mg Capsule

Coverage in Texas (CMS PDP Region 22).

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

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

389 Medicare Advantage plans in TX 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. TX: 389 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug29%29%$244.8216—
  • Prior authorization
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$256.9025—
  • Prior authorization
AARP Medicare Rx Saver from UHC (PDP)$89.20/mo premium · $615.00 deductible4Non-Preferred Drug38%—$168.4622$336.922 units
  • Prior authorization
  • Quantity limit 2 per 28 days
Blue Cross MedicareRx Basic (PDP)$104.70/mo premium · $615.00 deductible4Non-Preferred Drug42%42%$104.8920—
  • Prior authorization
AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $130.00 deductible4Non-Preferred Drug35%—$206.2905$412.582 units
  • Prior authorization
  • Quantity limit 2 per 28 days
Blue Cross MedicareRx Value (PDP)$167.40/mo premium · $615.00 deductible4Non-Preferred Drug32%32%$102.0793—
  • Prior authorization
Humana Value Rx Plan (PDP)$22.90/mo premium · $601.00 deductible5Specialty Tier26%—$268.1366$536.272 units
  • Prior authorization
  • Quantity limit 2 per 28 days
Humana Basic Rx Plan (PDP)$41.70/mo premium · $615.00 deductible5Specialty Tier25%—$268.1366$536.272 units
  • Prior authorization
  • Quantity limit 2 per 28 days
HealthSpring Extra Rx (PDP)$70.00/mo premium · $615.00 deductible5Specialty Tier25%—$167.5042—
  • Prior authorization
SilverScript Choice (PDP)$94.80/mo premium · $615.00 deductible5Specialty Tier25%—$133.0204—
  • Prior authorization
HealthSpring Assurance Rx (PDP)$111.40/mo premium · $615.00 deductible5Specialty Tier25%—$136.1646—
  • Prior authorization
Humana Premier Rx Plan (PDP)$118.20/mo premium · $0.00 deductible5Specialty Tier33%—$268.1366$536.272 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 →