INVEGA HAFYERA 1560 mg/5mL Injection, Suspension, Extended Release
Also known as Paliperidone Palmitate. Coverage in Colorado (CMS PDP Region 27).
10 of 10 stand-alone Part D plans in Colorado cover this drug on tier 4–5.
8 of 10 plans apply a prior authorization, step therapy or quantity limit.
93 Medicare Advantage plans in CO 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. CO: 93 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)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | — | $4125.9405 | $3,424.530.83 units |
|
| Humana Value Rx Plan (PDP)$48.50/mo premium · $601.00 deductible | 4Non-Preferred Drug | 34% | — | $4125.9405 | $3,424.530.83 units |
|
| Humana Premier Rx Plan (PDP)$137.10/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $4125.9405 | $3,424.530.83 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $4318.8391 | $3,584.640.83 units |
|
| Wellcare Classic (PDP)$2.20/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $4318.8391 | $3,584.640.83 units |
|
| HealthSpring Assurance Rx (PDP)$61.70/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $4315.5917 | $3,581.940.83 units |
|
| HealthSpring Extra Rx (PDP)$70.70/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $4313.4866 | $3,580.190.83 units |
|
| SilverScript Choice (PDP)$105.10/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $4315.5994 | $3,581.950.83 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$125.00/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $4670.9240 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$151.90/mo premium · $130.00 deductible | 5Specialty Tier | 31% | — | $4670.9240 | — | 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.