AREXVY Kit

Also known as Respiratory Syncytial Virus Vaccine Recombinant, Adjuvanted. Coverage in Oregon and Washington (CMS PDP Region 30).

10 of 10 stand-alone Part D plans in Oregon and Washington cover this drug on tier 1–4.

Lowest 30-day cost $0.00 at a preferred pharmacy. 5 of 10 plans apply a prior authorization, step therapy or quantity limit.

202 Medicare Advantage plans in OR, WA 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. OR: 87 plans · WA: 115 plans.

Every plan that covers it

Plan	Tier	30-day preferred	90-day mail	Unit cost	Est. 30-day fill	Restrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible	1Preferred Generic	$0.00	$0.00	$309.2514	—	None
Humana Value Rx Plan (PDP)$22.10/mo premium · $601.00 deductible	1Preferred Generic	$0.00	$0.00	$309.2514	—	None
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible	1Preferred Generic	$0.00	$0.00	$309.2514	—	None
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible	3Preferred Brand	25%	25%	$296.2095	—	None
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible	3Preferred Brand	24%	24%	$300.6247	$24.050.08 units	Prior authorization Quantity limit 1 per 365 days
AARP Medicare Rx Saver from UHC (PDP)$38.40/mo premium · $615.00 deductible	3Preferred Brand	17%	17%	$326.9349	$9,808.0530 units	Prior authorization Quantity limit 1 per 1 days
HealthSpring Extra Rx (PDP)$50.00/mo premium · $615.00 deductible	3Preferred Brand	16%	16%	$301.1331	$24.090.08 units	Prior authorization Quantity limit 1 per 365 days
SilverScript Choice (PDP)$85.90/mo premium · $615.00 deductible	3Preferred Brand	18%	18%	$301.2156	$9.040.03 units	Prior authorization Quantity limit 1 per 999 days
AARP Medicare Rx Preferred from UHC (PDP)$110.00/mo premium · $130.00 deductible	3Preferred Brand	16%	16%	$326.9349	$9,808.0530 units	Prior authorization Quantity limit 1 per 1 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible	4Non-Preferred Drug	28%	28%	$296.2095	—	None

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 →