DIMETHYL FUMARATE 120 mg Capsule, Delayed Release
Coverage in Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming (CMS PDP Region 25).
8 of 11 stand-alone Part D plans in Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming cover this drug on tier 4.
8 of 8 plans apply a prior authorization, step therapy or quantity limit.
Every plan that covers it
Showing 8 of 8 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Saver from UHC (PDP)$5.30/mo premium · $615.00 deductible · $0 with full Extra Help | 4Non-Preferred Drug | 35% | — | $1.8145 | $108.8760 units |
|
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $4.1331 | $247.9960 units |
|
| Wellcare Classic (PDP)$12.70/mo premium · $615.00 deductible · $0 with full Extra Help | 4Non-Preferred Drug | 27% | 27% | $4.1331 | $247.9960 units |
|
| HealthSpring Extra Rx (PDP)$66.50/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $59.5900 | $834.2614 units |
|
| MedicareBlue Rx Standard (PDP)$101.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 42% | 42% | $0.9918 | $5.956 units |
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| Humana Premier Rx Plan (PDP)$103.70/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $4.6550 | $65.1714 units |
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| HealthSpring Assurance Rx (PDP)$125.90/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $59.5887 | $834.2414 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$140.20/mo premium · $130.00 deductible | 4Non-Preferred Drug | 34% | — | $1.8695 | $112.1760 units |
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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.
193 Medicare Advantage plans in IA, MN, MT, ND, NE, SD, WY do cover it
A patient on an MA-PD plan may have coverage even where no PDP lists the drug. IA: 37 plans · MN: 59 plans · MT: 25 plans · ND: 20 plans · NE: 31 plans · SD: 13 plans · WY: 8 plans.