IMOVAX RABIES Kit

Also known as Rabies Virus Strain Pm-1503-3M Antigen (Propiolactone Inactivated) And Water. Coverage in Wisconsin (CMS PDP Region 16).

10 of 10 stand-alone Part D plans in Wisconsin cover this drug on tier 1–4.

Lowest 30-day cost $0.00 at a preferred pharmacy. 10 of 10 plans apply a prior authorization, step therapy or quantity limit.

88 Medicare Advantage plans in WI 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. WI: 88 plans.

Every plan that covers it

Plan	Tier	30-day preferred	90-day mail	Unit cost	Est. 30-day fill	Restrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible	1Preferred Generic	$0.00	$0.00	$450.4416	—	Prior authorization
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible	1Preferred Generic	$0.00	$0.00	$450.4416	—	Prior authorization
SilverScript Choice (PDP)$26.70/mo premium · $615.00 deductible	1Preferred Generic	$2.00	$6.00	$439.1790	—	Prior authorization
Humana Premier Rx Plan (PDP)$110.60/mo premium · $0.00 deductible	1Preferred Generic	$0.00	$0.00	$450.4416	—	Prior authorization
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible	3Preferred Brand	25%	25%	$434.1200	—	Prior authorization
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible	3Preferred Brand	17%	17%	$498.2995	$14,948.9930 units	Prior authorization Quantity limit 1 per 1 days
AARP Medicare Rx Preferred from UHC (PDP)$113.90/mo premium · $130.00 deductible	3Preferred Brand	15%	15%	$498.2995	$14,948.9930 units	Prior authorization Quantity limit 1 per 1 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible	4Non-Preferred Drug	26%	26%	$434.1200	—	Prior authorization
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible	4Non-Preferred Drug	30%	30%	$441.8400	$181.150.41 units	Prior authorization Quantity limit 5 per 365 days
HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible	4Non-Preferred Drug	33%	33%	$442.2900	$181.340.41 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.

See coverage in all 39 regions →