MedicarePartD.guide

A non-government resource built from CMS public data

ODOMZO 200 mg Capsule

Also known as Sonidegib. Coverage in Oklahoma (CMS PDP Region 23).

11 of 11 stand-alone Part D plans in Oklahoma cover this drug on tier 5.

11 of 11 plans apply a prior authorization, step therapy or quantity limit.

71 Medicare Advantage plans in OK 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. OK: 71 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Blue Cross MedicareRx Basic (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$504.5750$1,513.723 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$490.1443$1,470.433 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible5Specialty Tier25%—$463.9900$1,391.973 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible5Specialty Tier25%—$463.9900$1,391.973 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Humana Value Rx Plan (PDP)$33.70/mo premium · $601.00 deductible5Specialty Tier26%—$490.1443$1,470.433 units
  • Prior authorization
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$65.40/mo premium · $615.00 deductible5Specialty Tier25%—$471.4530$1,414.363 units
  • Prior authorization
  • Quantity limit 3 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible5Specialty Tier25%—$529.2459—
  • Prior authorization
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible5Specialty Tier33%—$490.1443$1,470.433 units
  • Prior authorization
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$121.00/mo premium · $130.00 deductible5Specialty Tier31%—$529.2459—
  • Prior authorization
HealthSpring Assurance Rx (PDP)$126.50/mo premium · $615.00 deductible5Specialty Tier25%—$471.0450$1,413.133 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Blue Cross MedicareRx Value (PDP)$167.30/mo premium · $615.00 deductible5Specialty Tier25%—$504.5750$1,513.723 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.

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