MedicarePartD.guide

A non-government resource built from CMS public data

KALYDECO 5.8 mg Granule

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

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

4 of 4 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 4 of 4 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Saver from UHC (PDP)$5.30/mo premium · $615.00 deductible · $0 with full Extra Help5Specialty Tier25%—$527.7100$31,662.6060 units
  • Prior authorization
  • Quantity limit 56 per 28 days
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible · $0 with full Extra Help5Specialty Tier25%—$535.7374$32,144.2460 units
  • Prior authorization
  • Quantity limit 56 per 28 days
MedicareBlue Rx Standard (PDP)$101.00/mo premium · $615.00 deductible5Specialty Tier25%—$504.6802$3,028.086 units
  • Prior authorization
  • Quantity limit 6 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$140.20/mo premium · $130.00 deductible5Specialty Tier31%—$527.7100$31,662.6060 units
  • Prior authorization
  • Quantity limit 56 per 28 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.

193 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: 40 plans · MN: 64 plans · MT: 10 plans · ND: 22 plans · NE: 32 plans · SD: 19 plans · WY: 6 plans.

See coverage in all 39 regions →