BETASERON Kit

Also known as Interferon Beta-1B. Coverage in Pennsylvania and West Virginia (CMS PDP Region 06).

7 of 12 stand-alone Part D plans in Pennsylvania and West Virginia cover this drug on tier 5.

7 of 7 plans apply a prior authorization, step therapy or quantity limit.

269 Medicare Advantage plans in PA, WV 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. PA: 227 plans · WV: 42 plans.

Every plan that covers it

Plan	Tier	30-day preferred	90-day mail	Unit cost	Est. 30-day fill	Restrictions
Wellcare Value Script (PDP)$8.20/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$677.7848	$10,166.7715 units	Prior authorization Quantity limit 14 per 28 days
Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$677.7848	$10,166.7715 units	Prior authorization Quantity limit 14 per 28 days
SilverScript Choice (PDP)$22.70/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$733.7296	$11,005.9415 units	Prior authorization Quantity limit 14 per 28 days
AARP Medicare Rx Saver from UHC (PDP)$43.50/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$746.9374	$11,204.0615 units	Quantity limit 15 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$121.90/mo premium · $130.00 deductible	5Specialty Tier	31%	—	$746.9374	$11,204.0615 units	Quantity limit 15 per 30 days
Blue Rx PDP Complete (PDP)$164.80/mo premium · $200.00 deductible	5Specialty Tier	25%	—	$678.8645	$10,182.9715 units	Prior authorization Quantity limit 14 per 28 days
Blue Rx PDP Plus (PDP)$193.20/mo premium · $615.00 deductible	5Specialty Tier	25%	25%	$678.0146	$10,170.2215 units	Prior authorization Quantity limit 14 per 28 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 →