DIMETHYL FUMARATE 240 mg Capsule, Delayed Release
Coverage in Colorado (CMS PDP Region 27).
7 of 10 stand-alone Part D plans in Colorado cover this drug on tier 4–5.
7 of 7 plans apply a prior authorization, step therapy or quantity limit.
74 Medicare Advantage plans in CO 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. CO: 74 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Saver from UHC (PDP)$125.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | — | $1.1754 | $7.056 units |
|
| Humana Premier Rx Plan (PDP)$137.10/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $1.8850 | $11.316 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$151.90/mo premium · $130.00 deductible | 4Non-Preferred Drug | 37% | — | $1.1769 | $7.066 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $3.5231 | $21.146 units |
|
| Wellcare Classic (PDP)$2.20/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $3.5231 | $21.146 units |
|
| HealthSpring Assurance Rx (PDP)$61.70/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $58.7499 | $352.506 units |
|
| HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $59.0377 | $354.236 units |
|
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.