MedicarePartD.guide

A non-government resource built from CMS public data

TREMFYA 200 mg/2mL Injection

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

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

11 of 11 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 11 of 11 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$4.70/mo premium · $615.00 deductible · $0 with full Extra Help5Specialty Tier25%—$7188.5372$28,754.154 units
  • Prior authorization
  • Quantity limit 4 per 28 days
AARP Medicare Rx Saver from UHC (PDP)$5.30/mo premium · $615.00 deductible · $0 with full Extra Help5Specialty Tier25%—$7662.6741$15,325.352 units
  • Prior authorization
  • Quantity limit 2 per 28 days
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible5Specialty Tier25%—$6968.4550$13,936.912 units
  • Prior authorization
  • Quantity limit 2 per 28 days
Wellcare Classic (PDP)$12.70/mo premium · $615.00 deductible · $0 with full Extra Help5Specialty Tier25%—$6968.4550$13,936.912 units
  • Prior authorization
  • Quantity limit 2 per 28 days
Humana Value Rx Plan (PDP)$20.80/mo premium · $601.00 deductible5Specialty Tier26%—$7188.5372$28,754.154 units
  • Prior authorization
  • Quantity limit 4 per 28 days
SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible · $0 with full Extra Help5Specialty Tier25%—$7525.0211$30,100.084 units
  • Prior authorization
  • Quantity limit 4 per 28 days
HealthSpring Extra Rx (PDP)$66.50/mo premium · $615.00 deductible5Specialty Tier25%—$7051.5050$14,103.012 units
  • Prior authorization
  • Quantity limit 2 per 28 days
MedicareBlue Rx Standard (PDP)$101.00/mo premium · $615.00 deductible5Specialty Tier25%—$7741.5550$15,483.112 units
  • Prior authorization
  • Quantity limit 2 per 28 days
Humana Premier Rx Plan (PDP)$103.70/mo premium · $0.00 deductible5Specialty Tier33%—$7188.5372$28,754.154 units
  • Prior authorization
  • Quantity limit 4 per 28 days
HealthSpring Assurance Rx (PDP)$125.90/mo premium · $615.00 deductible5Specialty Tier25%—$7052.8800$14,105.762 units
  • Prior authorization
  • Quantity limit 2 per 28 days
AARP Medicare Rx Preferred from UHC (PDP)$140.20/mo premium · $130.00 deductible5Specialty Tier31%—$7662.6741$15,325.352 units
  • Prior authorization
  • Quantity limit 2 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.

201 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: 46 plans · MN: 55 plans · MT: 24 plans · ND: 15 plans · NE: 40 plans · SD: 15 plans · WY: 6 plans.

See coverage in all 39 regions →