MedicarePartD.guide

A non-government resource built from CMS public data

RISPERDAL CONSTA Kit

Also known as Risperidone. Coverage in New York (CMS PDP Region 03).

5 of 10 stand-alone Part D plans in New York cover this drug on tier 4.

5 of 5 plans apply a prior authorization, step therapy or quantity limit.

29 Medicare Advantage plans in NY 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. NY: 29 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$42.40/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$306.3871$612.772 units
  • Quantity limit 2 per 28 days
Wellcare Classic (PDP)$45.70/mo premium · $615.00 deductible4Non-Preferred Drug28%28%$306.3871$612.772 units
  • Quantity limit 2 per 28 days
Humana Basic Rx Plan (PDP)$140.90/mo premium · $615.00 deductible4Non-Preferred Drug30%—$313.8356$627.672 units
  • Quantity limit 2 per 28 days
Humana Value Rx Plan (PDP)$158.90/mo premium · $601.00 deductible4Non-Preferred Drug31%—$313.8356$627.672 units
  • Quantity limit 2 per 28 days
Humana Premier Rx Plan (PDP)$173.60/mo premium · $0.00 deductible4Non-Preferred Drug50%50%$313.8356$627.672 units
  • Quantity limit 2 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 →