MedicarePartD.guide

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ADEMPAS .5 mg Tablet, Film Coated

Also known as Riociguat. Coverage in Michigan (CMS PDP Region 13).

12 of 12 stand-alone Part D plans in Michigan cover this drug on tier 5.

12 of 12 plans apply a prior authorization, step therapy or quantity limit.

177 Medicare Advantage plans in MI 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. MI: 177 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$157.2265$1,415.049 units
  • Prior authorization
  • Quantity limit 9 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$157.2265$1,415.049 units
  • Prior authorization
  • Quantity limit 9 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$156.8079$1,411.279 units
  • Prior authorization
  • Quantity limit 9 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$165.0992$1,485.899 units
  • Prior authorization
  • Quantity limit 9 per 30 days
Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible5Specialty Tier26%—$165.0992$1,485.899 units
  • Prior authorization
  • Quantity limit 9 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$14.10/mo premium · $615.00 deductible5Specialty Tier25%—$171.1668—
  • Prior authorization
HealthSpring Extra Rx (PDP)$50.40/mo premium · $615.00 deductible5Specialty Tier25%—$156.7868$1,411.089 units
  • Prior authorization
  • Quantity limit 9 per 30 days
SilverScript Choice (PDP)$78.30/mo premium · $615.00 deductible5Specialty Tier25%—$171.1385$1,540.259 units
  • Prior authorization
  • Quantity limit 9 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$78.30/mo premium · $130.00 deductible5Specialty Tier31%—$171.1668—
  • Prior authorization
Prescription Blue Select (PDP)$78.40/mo premium · $615.00 deductible5Specialty Tier25%—$167.5187$15,076.6890 units
  • Prior authorization
  • Quantity limit 93 per 31 days
Humana Premier Rx Plan (PDP)$98.10/mo premium · $0.00 deductible5Specialty Tier33%—$165.0992$1,485.899 units
  • Prior authorization
  • Quantity limit 9 per 30 days
Prescription Blue Premium (PDP)$106.70/mo premium · $0.00 deductible5Specialty Tier33%—$167.5187$15,076.6890 units
  • Prior authorization
  • Quantity limit 93 per 31 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 →