MedicarePartD.guide

A non-government resource built from CMS public data

LENALIDOMIDE 2.5 mg Capsule

Coverage in Texas (CMS PDP Region 22).

12 of 12 stand-alone Part D plans in Texas cover this drug on tier 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 deductible5Specialty Tier25%—$142.4900$4,274.7030 units
  • Prior authorization
  • Quantity limit 28 per 28 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$142.4900$4,274.7030 units
  • Prior authorization
  • Quantity limit 28 per 28 days
Humana Value Rx Plan (PDP)$22.90/mo premium · $601.00 deductible5Specialty Tier26%—$237.5700$7,127.1030 units
  • Prior authorization
  • Quantity limit 28 per 28 days
Humana Basic Rx Plan (PDP)$41.70/mo premium · $615.00 deductible5Specialty Tier25%—$237.5700$7,127.1030 units
  • Prior authorization
  • Quantity limit 28 per 28 days
HealthSpring Extra Rx (PDP)$70.00/mo premium · $615.00 deductible5Specialty Tier25%—$409.9219$12,297.6630 units
  • Prior authorization
  • Quantity limit 28 per 28 days
AARP Medicare Rx Saver from UHC (PDP)$89.20/mo premium · $615.00 deductible5Specialty Tier25%—$332.4582$997.373 units
  • Prior authorization
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$94.80/mo premium · $615.00 deductible5Specialty Tier25%—$469.2667$14,078.0030 units
  • Prior authorization
  • Quantity limit 28 per 28 days
Blue Cross MedicareRx Basic (PDP)$104.70/mo premium · $615.00 deductible5Specialty Tier25%—$527.7500$1,583.253 units
  • Prior authorization
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$111.40/mo premium · $615.00 deductible5Specialty Tier25%—$409.9219$12,297.6630 units
  • Prior authorization
  • Quantity limit 28 per 28 days
AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $130.00 deductible5Specialty Tier31%—$332.4582$997.373 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Humana Premier Rx Plan (PDP)$118.20/mo premium · $0.00 deductible5Specialty Tier33%—$237.5700$7,127.1030 units
  • Prior authorization
  • Quantity limit 28 per 28 days
Blue Cross MedicareRx Value (PDP)$167.40/mo premium · $615.00 deductible5Specialty Tier25%—$527.7500$1,583.253 units
  • Prior authorization
  • Quantity limit 3 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.

See coverage in all 39 regions →