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INVEGA HAFYERA 1560 mg/5mL Injection, Suspension, Extended Release

Also known as Paliperidone Palmitate. Coverage in Texas (CMS PDP Region 22).

12 of 12 stand-alone Part D plans in Texas cover this drug on tier 4–5.

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

379 Medicare Advantage plans in TX 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. TX: 379 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Value Rx Plan (PDP)$22.90/mo premium · $601.00 deductible4Non-Preferred Drug34%—$4173.8780$3,464.320.83 units
  • Quantity limit 5 per 180 days
Humana Basic Rx Plan (PDP)$41.70/mo premium · $615.00 deductible4Non-Preferred Drug34%—$4173.8780$3,464.320.83 units
  • Quantity limit 5 per 180 days
Humana Premier Rx Plan (PDP)$118.20/mo premium · $0.00 deductible4Non-Preferred Drug50%50%$4173.8780$3,464.320.83 units
  • Quantity limit 5 per 180 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$4204.5841$3,489.800.83 units
  • Quantity limit 5 per 180 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$4204.5841$3,489.800.83 units
  • Quantity limit 5 per 180 days
HealthSpring Extra Rx (PDP)$70.00/mo premium · $615.00 deductible5Specialty Tier25%—$4233.3099$3,513.650.83 units
  • Quantity limit 5 per 180 days
AARP Medicare Rx Saver from UHC (PDP)$89.20/mo premium · $615.00 deductible5Specialty Tier25%—$4610.7540—None
SilverScript Choice (PDP)$94.80/mo premium · $615.00 deductible5Specialty Tier25%—$4315.5994$3,581.950.83 units
  • Quantity limit 5 per 180 days
Blue Cross MedicareRx Basic (PDP)$104.70/mo premium · $615.00 deductible5Specialty Tier25%—$4519.5544$3,751.230.83 units
  • Quantity limit 5 per 180 days
HealthSpring Assurance Rx (PDP)$111.40/mo premium · $615.00 deductible5Specialty Tier25%—$4227.7133$3,509.000.83 units
  • Quantity limit 5 per 180 days
AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $130.00 deductible5Specialty Tier31%—$4610.7540—None
Blue Cross MedicareRx Value (PDP)$167.40/mo premium · $615.00 deductible5Specialty Tier25%—$4486.4727$3,723.770.83 units
  • Quantity limit 5 per 180 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.

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