ABILIFY ASIMTUFII 720 mg/2.4mL Injection, Suspension, Extended Release

Also known as Aripiprazole. Coverage in New York (CMS PDP Region 03).

10 of 10 stand-alone Part D plans in New York cover this drug on tier 4–5.

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

153 Medicare Advantage plans in NY 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. NY: 153 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)$140.90/mo premium · $615.00 deductible	4Non-Preferred Drug	30%	—	$1763.5804	$1,763.581 unit	Quantity limit 2.4 per 56 days
Humana Value Rx Plan (PDP)$158.90/mo premium · $601.00 deductible	4Non-Preferred Drug	31%	—	$1763.5804	$1,763.581 unit	Quantity limit 2.4 per 56 days
Humana Premier Rx Plan (PDP)$173.60/mo premium · $0.00 deductible	4Non-Preferred Drug	50%	50%	$1763.5804	$1,763.581 unit	Quantity limit 2.4 per 56 days
HealthSpring Assurance Rx (PDP)$35.70/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$1774.2987	$1,774.301 unit	Quantity limit 2.4 per 56 days
Wellcare Value Script (PDP)$42.40/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$1765.8313	$1,765.831 unit	Quantity limit 2.4 per 56 days
Wellcare Classic (PDP)$45.70/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$1765.8313	$1,765.831 unit	Quantity limit 2.4 per 56 days
HealthSpring Extra Rx (PDP)$91.60/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$1774.3761	$1,774.381 unit	Quantity limit 2.4 per 56 days
AARP Medicare Rx Saver from UHC (PDP)$105.80/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$1936.9026	$1,936.901 unit	Quantity limit 2.4 per 56 days
SilverScript Choice (PDP)$116.00/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$1839.8135	$1,839.811 unit	Quantity limit 2.4 per 56 days
AARP Medicare Rx Preferred from UHC (PDP)$163.70/mo premium · $130.00 deductible	5Specialty Tier	31%	—	$1936.9026	$1,936.901 unit	Quantity limit 2.4 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 →