TOLVAPTAN 15 mg Tablet
Coverage in Oregon and Washington (CMS PDP Region 30).
6 of 10 stand-alone Part D plans in Oregon and Washington cover this drug on tier 4–5.
6 of 6 plans apply a prior authorization, step therapy or quantity limit.
Every plan that covers it
Showing 6 of 6 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help | 5Specialty Tier | 25% | — | $124.4336 | — |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help | 5Specialty Tier | 25% | — | $124.4336 | — |
|
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible · $0 with full Extra Help | 5Specialty Tier | 25% | — | $224.3326 | $2,691.9912 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$38.40/mo premium · $615.00 deductible | 4Non-Preferred Drug | 36% | — | $101.9768 | $1,223.7212 units |
|
| HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $225.4852 | $2,705.8212 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$110.00/mo premium · $130.00 deductible | 4Non-Preferred Drug | 37% | — | $104.6341 | $1,255.6112 units |
|
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.
116 Medicare Advantage plans in OR, WA do cover it
A patient on an MA-PD plan may have coverage even where no PDP lists the drug. OR: 44 plans · WA: 72 plans.