PROLIA 60 mg/mL Injection
Also known as Denosumab. Coverage in Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming (CMS PDP Region 25).
5 of 11 stand-alone Part D plans in Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming cover this drug on tier 4.
5 of 5 plans apply a prior authorization, step therapy or quantity limit.
Every plan that covers it
Showing 5 of 5 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$4.70/mo premium · $615.00 deductible · $0 with full Extra Help | 4Non-Preferred Drug | 34% | — | $1855.8256 | $315.490.17 units |
|
| Humana Value Rx Plan (PDP)$20.80/mo premium · $601.00 deductible | 4Non-Preferred Drug | 34% | — | $1855.8256 | $315.490.17 units |
|
| HealthSpring Extra Rx (PDP)$66.50/mo premium · $615.00 deductible | 4Non-Preferred Drug | 31% | 31% | $1863.4269 | $316.780.17 units |
|
| Humana Premier Rx Plan (PDP)$103.70/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $1855.8256 | $315.490.17 units |
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| HealthSpring Assurance Rx (PDP)$125.90/mo premium · $615.00 deductible | 4Non-Preferred Drug | 30% | 30% | $1864.4511 | $316.960.17 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.
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.
58 Medicare Advantage plans in IA, MN, MT, NE, SD, WY do cover it
A patient on an MA-PD plan may have coverage even where no PDP lists the drug. IA: 20 plans · MN: 6 plans · MT: 14 plans · NE: 14 plans · SD: 2 plans · WY: 2 plans.