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IMOVAX RABIES Kit

Also known as Rabies Virus Strain Pm-1503-3M Antigen (Propiolactone Inactivated) And Water. Coverage in New Jersey (CMS PDP Region 04).

12 of 12 stand-alone Part D plans in New Jersey cover this drug on tier 1–4.

Lowest 30-day cost $0.00 at a preferred pharmacy. 12 of 12 plans apply a prior authorization, step therapy or quantity limit.

72 Medicare Advantage plans in NJ 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. NJ: 72 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$4.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$449.3207—
  • Prior authorization
Humana Value Rx Plan (PDP)$35.60/mo premium · $601.00 deductible1Preferred Generic$0.00$0.00$449.3207—
  • Prior authorization
Horizon Medicare Blue Rx Standard (PDP)$72.30/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$469.8989—
  • Prior authorization
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible1Preferred Generic$0.00$0.00$439.1790—
  • Prior authorization
Humana Premier Rx Plan (PDP)$111.90/mo premium · $0.00 deductible1Preferred Generic$0.00$0.00$449.3207—
  • Prior authorization
Horizon Medicare Blue Rx Enhanced (PDP)$139.10/mo premium · $200.00 deductible1Preferred Generic$0.00$0.00$469.8989—
  • Prior authorization
Wellcare Value Script (PDP)$22.80/mo premium · $615.00 deductible3Preferred Brand25%25%$432.3056—
  • Prior authorization
AARP Medicare Rx Saver from UHC (PDP)$77.40/mo premium · $615.00 deductible3Preferred Brand17%17%$482.6592$14,479.7830 units
  • Prior authorization
  • Quantity limit 1 per 1 days
AARP Medicare Rx Preferred from UHC (PDP)$118.90/mo premium · $130.00 deductible3Preferred Brand15%15%$482.6592$14,479.7830 units
  • Prior authorization
  • Quantity limit 1 per 1 days
Wellcare Classic (PDP)$28.20/mo premium · $615.00 deductible4Non-Preferred Drug29%29%$432.3056—
  • Prior authorization
HealthSpring Extra Rx (PDP)$59.90/mo premium · $615.00 deductible4Non-Preferred Drug30%30%$441.2256$180.900.41 units
  • Prior authorization
  • Quantity limit 5 per 365 days
HealthSpring Assurance Rx (PDP)$109.30/mo premium · $615.00 deductible4Non-Preferred Drug27%27%$441.2300$180.900.41 units
  • Prior authorization
  • Quantity limit 5 per 365 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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