MedicarePartD.guide

A non-government resource built from CMS public data

TREMFYA 100 mg/mL Injection

Also known as Guselkumab. Coverage in Mississippi (CMS PDP Region 20).

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

10 of 10 plans apply a prior authorization, step therapy or quantity limit.

84 Medicare Advantage plans in MS 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. MS: 84 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%—$13583.0806$27,166.162 units
  • Prior authorization
  • Quantity limit 2 per 28 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$13583.0806$27,166.162 units
  • Prior authorization
  • Quantity limit 2 per 28 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$14613.0115$14,613.011 unit
  • Prior authorization
  • Quantity limit 3 per 84 days
Humana Value Rx Plan (PDP)$37.60/mo premium · $601.00 deductible5Specialty Tier26%—$14613.0115$14,613.011 unit
  • Prior authorization
  • Quantity limit 3 per 84 days
HealthSpring Assurance Rx (PDP)$59.70/mo premium · $615.00 deductible5Specialty Tier25%—$13604.6335$27,209.272 units
  • Prior authorization
  • Quantity limit 2 per 28 days
HealthSpring Extra Rx (PDP)$77.10/mo premium · $615.00 deductible5Specialty Tier25%—$13604.7623$27,209.522 units
  • Prior authorization
  • Quantity limit 2 per 28 days
AARP Medicare Rx Saver from UHC (PDP)$84.70/mo premium · $615.00 deductible5Specialty Tier25%—$15387.2051$15,387.211 unit
  • Prior authorization
  • Quantity limit 2 per 56 days
Humana Premier Rx Plan (PDP)$89.90/mo premium · $0.00 deductible5Specialty Tier33%—$14613.0115$14,613.011 unit
  • Prior authorization
  • Quantity limit 3 per 84 days
SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible5Specialty Tier25%—$15050.0422$15,050.041 unit
  • Prior authorization
  • Quantity limit 1 per 28 days
AARP Medicare Rx Preferred from UHC (PDP)$140.60/mo premium · $130.00 deductible5Specialty Tier31%—$15387.2051$15,387.211 unit
  • Prior authorization
  • Quantity limit 2 per 56 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 →