ADACEL TDAP 5/2/2.5/5/3/5 [Lf]/.5mL/ug/.5mL Injection, Suspension
Also known as Clostridium Tetani Toxoid Antigen (Formaldehyde Inactivated), Corynebacterium Diphtheriae Toxoid Antigen (Formaldehyde Inactivated), Bordetella Pertussis Toxoid Antigen (Glutaraldehyde Inactivated), Bordetella Pertussis Filamentous Hemagglutinin Antigen (Formaldehyde Inactivated), Bordetella Pertussis Pertactin Antigen, And Bordetella Pertussis Fimbriae 2/3 Antigen. Coverage in Pennsylvania and West Virginia (CMS PDP Region 06).
12 of 12 stand-alone Part D plans in Pennsylvania and West Virginia cover this drug on tier 1–3.
Lowest 30-day cost $0.00 at a preferred pharmacy. 2 of 12 plans apply a prior authorization, step therapy or quantity limit.
Every plan that covers it
Showing 12 of 12 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$6.60/mo premium · $615.00 deductible · $0 with full Extra Help | 1Preferred Generic | $0.00 | $0.00 | $92.1768 | — | None |
| Wellcare Value Script (PDP)$8.20/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $45.2812 | — | None |
| Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible · $0 with full Extra Help | 3Preferred Brand | 25% | 25% | $45.2812 | — | None |
| Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $92.1768 | — | None |
| SilverScript Choice (PDP)$22.70/mo premium · $615.00 deductible · $0 with full Extra Help | 1Preferred Generic | $2.00 | $6.00 | $95.0147 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$43.50/mo premium · $615.00 deductible | 3Preferred Brand | 16% | 16% | $102.2534 | $1,533.8015 units |
|
| HealthSpring Extra Rx (PDP)$62.60/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $45.6094 | — | None |
| HealthSpring Assurance Rx (PDP)$74.00/mo premium · $615.00 deductible | 3Preferred Brand | 21% | 21% | $45.6073 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$121.90/mo premium · $130.00 deductible | 3Preferred Brand | 16% | 16% | $102.2534 | $1,533.8015 units |
|
| Humana Premier Rx Plan (PDP)$123.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $92.1768 | — | None |
| Blue Rx PDP Complete (PDP)$164.80/mo premium · $200.00 deductible | 3Preferred Brand | 25% | 25% | $45.6458 | — | None |
| Blue Rx PDP Plus (PDP)$193.20/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $45.6438 | — | None |
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.
Medicare Advantage plans
Medicare Advantage plans carry their own formularies, separate from stand-alone Part D, and are sold county by county. Pick a county to see every Medicare Advantage drug plan there that covers this drug.
365 Medicare Advantage plans in PA, WV do cover it
A patient on an MA-PD plan may have coverage even where no PDP lists the drug. PA: 306 plans · WV: 59 plans.