OTEZLA Kit

Also known as Apremilast. Coverage in Oklahoma (CMS PDP Region 23).

8 of 11 stand-alone Part D plans in Oklahoma cover this drug on tier 5.

8 of 8 plans apply a prior authorization, step therapy or quantity limit.

36 Medicare Advantage plans in OK 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. OK: 36 plans.

Every plan that covers it

Plan	Tier	30-day preferred	90-day mail	Unit cost	Est. 30-day fill	Restrictions
Blue Cross MedicareRx Basic (PDP)$0.00/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$104.5607	$941.059 units	Prior authorization Quantity limit 55 per 180 days
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$101.1260	$910.139 units	Prior authorization Quantity limit 55 per 180 days
Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$101.1260	$910.139 units	Prior authorization Quantity limit 55 per 180 days
HealthSpring Extra Rx (PDP)$65.40/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$102.9676	$92.670.9 units	Prior authorization Quantity limit 11 per 365 days
AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$105.0466	$94.540.9 units	Prior authorization Quantity limit 11 per 365 days
AARP Medicare Rx Preferred from UHC (PDP)$121.00/mo premium · $130.00 deductible	5Specialty Tier	31%	—	$105.0466	$94.540.9 units	Prior authorization Quantity limit 11 per 365 days
HealthSpring Assurance Rx (PDP)$126.50/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$102.9283	$92.640.9 units	Prior authorization Quantity limit 11 per 365 days
Blue Cross MedicareRx Value (PDP)$167.30/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$105.0118	$945.119 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 →