MedicarePartD.guide

A non-government resource built from CMS public data

PEMAZYRE 13.5 mg Tablet

Also known as Pemigatinib. Coverage in Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming (CMS PDP Region 25).

11 of 11 stand-alone Part D plans in Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming cover this drug on tier 5.

11 of 11 plans apply a prior authorization, step therapy or quantity limit.

Every plan that covers it

Prior authorization
Step therapy
Quantity limit
Extra Help (LIS)

Showing 11 of 11 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$4.70/mo premium · $615.00 deductible · $0 with full Extra Help5Specialty Tier25%—$1423.6043$42,708.1330 units
  • Prior authorization
  • Quantity limit 28 per 28 days
AARP Medicare Rx Saver from UHC (PDP)$5.30/mo premium · $615.00 deductible · $0 with full Extra Help5Specialty Tier25%—$1509.9426$30,198.8520 units
  • Prior authorization
  • Quantity limit 14 per 21 days
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible5Specialty Tier25%—$1808.3200$54,249.6030 units
  • Prior authorization
  • Quantity limit 28 per 28 days
Wellcare Classic (PDP)$12.70/mo premium · $615.00 deductible · $0 with full Extra Help5Specialty Tier25%—$1808.3200$54,249.6030 units
  • Prior authorization
  • Quantity limit 28 per 28 days
Humana Value Rx Plan (PDP)$20.80/mo premium · $601.00 deductible5Specialty Tier26%—$1423.6043$42,708.1330 units
  • Prior authorization
  • Quantity limit 28 per 28 days
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible · $0 with full Extra Help5Specialty Tier25%—$1537.0672$46,112.0230 units
  • Prior authorization
  • Quantity limit 28 per 28 days
HealthSpring Extra Rx (PDP)$66.50/mo premium · $615.00 deductible5Specialty Tier25%—$1348.1075$26,962.1520 units
  • Prior authorization
  • Quantity limit 14 per 21 days
MedicareBlue Rx Standard (PDP)$101.00/mo premium · $615.00 deductible5Specialty Tier25%—$1428.6631$28,573.2620 units
  • Prior authorization
  • Quantity limit 14 per 21 days
Humana Premier Rx Plan (PDP)$103.70/mo premium · $0.00 deductible5Specialty Tier33%—$1423.6043$42,708.1330 units
  • Prior authorization
  • Quantity limit 28 per 28 days
HealthSpring Assurance Rx (PDP)$125.90/mo premium · $615.00 deductible5Specialty Tier25%—$1348.1075$26,962.1520 units
  • Prior authorization
  • Quantity limit 14 per 21 days
AARP Medicare Rx Preferred from UHC (PDP)$140.20/mo premium · $130.00 deductible5Specialty Tier31%—$1509.9426$30,198.8520 units
  • Prior authorization
  • Quantity limit 14 per 21 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.

Medicare Advantage plans

Medicare Advantage plans carry their own formularies, separate from stand-alone Part D, and are sold county by county. Pick a county to see every Medicare Advantage drug plan there that covers this drug.

241 Medicare Advantage plans in IA, MN, MT, ND, NE, SD, WY do cover it

A patient on an MA-PD plan may have coverage even where no PDP lists the drug. IA: 54 plans · MN: 69 plans · MT: 25 plans · ND: 22 plans · NE: 44 plans · SD: 19 plans · WY: 8 plans.

See coverage in all 39 regions →