MedicarePartD.guide

A non-government resource built from CMS public data

OTEZLA Kit

Also known as Apremilast. Coverage in Florida (CMS PDP Region 11).

6 of 10 stand-alone Part D plans in Florida cover this drug on tier 5.

6 of 6 plans apply a prior authorization, step therapy or quantity limit.

320 Medicare Advantage plans in FL 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. FL: 320 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$98.6302$887.679 units
  • Prior authorization
  • Quantity limit 55 per 180 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$98.6302$887.679 units
  • Prior authorization
  • Quantity limit 55 per 180 days
BlueMedicare Premier Rx (PDP)$98.60/mo premium · $615.00 deductible5Specialty Tier25%—$104.9876$944.899 units
  • Prior authorization
  • Quantity limit 55 per 180 days
AARP Medicare Rx Saver from UHC (PDP)$98.70/mo premium · $615.00 deductible5Specialty Tier25%—$103.4058$93.070.9 units
  • Prior authorization
  • Quantity limit 11 per 365 days
AARP Medicare Rx Preferred from UHC (PDP)$119.10/mo premium · $130.00 deductible5Specialty Tier31%—$103.4058$93.070.9 units
  • Prior authorization
  • Quantity limit 11 per 365 days
BlueMedicare Complete Rx (PDP)$217.00/mo premium · $615.00 deductible5Specialty Tier25%—$104.9876$944.899 units
  • Prior authorization
  • Quantity limit 55 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.

See coverage in all 39 regions →