ABILIFY ASIMTUFII 960 mg/3.2mL Injection, Suspension, Extended Release

Also known as Aripiprazole. Coverage in California (CMS PDP Region 32).

10 of 12 stand-alone Part D plans in California cover this drug on tier 4–5.

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

361 Medicare Advantage plans in CA 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. CA: 361 plans.

Every plan that covers it

Plan	Tier	30-day preferred	90-day mail	Unit cost	Est. 30-day fill	Restrictions
Humana Value Rx Plan (PDP)$104.60/mo premium · $601.00 deductible	4Non-Preferred Drug	32%	—	$1763.2860	$3,526.572 units	Quantity limit 3.2 per 56 days
Humana Basic Rx Plan (PDP)$132.20/mo premium · $615.00 deductible	4Non-Preferred Drug	32%	—	$1763.2860	$3,526.572 units	Quantity limit 3.2 per 56 days
Humana Premier Rx Plan (PDP)$172.90/mo premium · $0.00 deductible	4Non-Preferred Drug	50%	50%	$1763.2860	$3,526.572 units	Quantity limit 3.2 per 56 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$1729.5668	$3,459.132 units	Quantity limit 3.2 per 56 days
Wellcare Value Script (PDP)$5.70/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$1725.7969	$3,451.592 units	Quantity limit 3.2 per 56 days
Wellcare Classic (PDP)$6.20/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$1725.7969	$3,451.592 units	Quantity limit 3.2 per 56 days
HealthSpring Extra Rx (PDP)$70.60/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$1729.9523	$3,459.902 units	Quantity limit 3.2 per 56 days
SilverScript Choice (PDP)$103.60/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$1839.8161	$3,679.632 units	Quantity limit 3.2 per 56 days
AARP Medicare Rx Saver from UHC (PDP)$109.40/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$1899.4764	$3,798.952 units	Quantity limit 3.2 per 56 days
AARP Medicare Rx Preferred from UHC (PDP)$165.40/mo premium · $130.00 deductible	5Specialty Tier	31%	—	$1899.4764	$3,798.952 units	Quantity limit 3.2 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 →