INVEGA HAFYERA 1092 mg/3.5mL Injection, Suspension, Extended Release
Also known as Paliperidone Palmitate. Coverage in Kansas (CMS PDP Region 24).
12 of 12 stand-alone Part D plans in Kansas cover this drug on tier 4–5.
10 of 12 plans apply a prior authorization, step therapy or quantity limit.
77 Medicare Advantage plans in KS 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. KS: 77 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$15.50/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | — | $3951.4691 | $2,291.850.58 units |
|
| Humana Value Rx Plan (PDP)$55.60/mo premium · $601.00 deductible | 4Non-Preferred Drug | 32% | — | $3951.4691 | $2,291.850.58 units |
|
| Humana Premier Rx Plan (PDP)$116.30/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $3951.4691 | $2,291.850.58 units |
|
| Blue MedicareRx Essentials (PDP)$0.00/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $4266.7686 | $2,474.730.58 units |
|
| Blue MedicareRx Value (PDP)$0.70/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $4256.7443 | $2,468.910.58 units |
|
| HealthSpring Assurance Rx (PDP)$6.70/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $4101.3083 | $2,378.760.58 units |
|
| Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $4149.2592 | $2,406.570.58 units |
|
| Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $4149.2592 | $2,406.570.58 units |
|
| Blue MedicareRx Plus (PDP)$67.40/mo premium · $0.00 deductible | 5Specialty Tier | 33% | — | $4256.7443 | $2,468.910.58 units |
|
| SilverScript Choice (PDP)$88.30/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $4148.3862 | $2,406.060.58 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$105.40/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $4367.9125 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$147.00/mo premium · $130.00 deductible | 5Specialty Tier | 31% | — | $4367.9125 | — | 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.