VIVOTIF 6000000000 [CFU] Capsule, Coated
Also known as Salmonella Typhi Ty21A. Coverage in Oregon and Washington (CMS PDP Region 30).
10 of 10 stand-alone Part D plans in Oregon and Washington cover this drug on tier 1–3.
Lowest 30-day cost $0.00 at a preferred pharmacy. 4 of 10 plans apply a prior authorization, step therapy or quantity limit.
202 Medicare Advantage plans in OR, WA 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. OR: 87 plans · WA: 115 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 | 1Preferred Generic | $0.00 | $0.00 | $29.3411 | — | None |
| Humana Value Rx Plan (PDP)$22.10/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $29.3411 | — | None |
| SilverScript Choice (PDP)$85.90/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $29.8748 | — | None |
| Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $29.3411 | — | None |
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $28.0063 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $28.0063 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 24% | 24% | $27.9547 | $4.750.17 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$38.40/mo premium · $615.00 deductible | 3Preferred Brand | 17% | 17% | $30.5056 | $3.660.12 units |
|
| HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible | 3Preferred Brand | 16% | 16% | $27.9509 | $4.750.17 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$110.00/mo premium · $130.00 deductible | 3Preferred Brand | 16% | 16% | $30.5056 | $3.660.12 units |
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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.