ABILIFY ASIMTUFII 960 mg/3.2mL Injection, Suspension, Extended Release
Also known as Aripiprazole. Coverage in North Carolina (CMS PDP Region 08).
12 of 12 stand-alone Part D plans in North Carolina cover this drug on tier 4–5.
12 of 12 plans apply a prior authorization, step therapy or quantity limit.
147 Medicare Advantage plans in NC 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. NC: 147 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)$6.80/mo premium · $615.00 deductible | 4Non-Preferred Drug | 32% | — | $1781.1434 | $3,562.292 units |
|
| Humana Value Rx Plan (PDP)$32.00/mo premium · $601.00 deductible | 4Non-Preferred Drug | 34% | — | $1781.1434 | $3,562.292 units |
|
| Humana Premier Rx Plan (PDP)$110.90/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $1781.1434 | $3,562.292 units |
|
| Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $1757.0903 | $3,514.182 units |
|
| Wellcare Classic (PDP)$4.70/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $1757.0903 | $3,514.182 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$56.90/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $1949.1235 | $3,898.252 units |
|
| HealthSpring Extra Rx (PDP)$78.00/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $1781.1739 | $3,562.352 units |
|
| Blue Medicare Rx Standard (PDP)$83.90/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $1896.4608 | $3,792.922 units |
|
| SilverScript Choice (PDP)$90.20/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $1839.8161 | $3,679.632 units |
|
| HealthSpring Assurance Rx (PDP)$110.40/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $1781.0968 | $3,562.192 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$119.80/mo premium · $130.00 deductible | 5Specialty Tier | 31% | — | $1949.1235 | $3,898.252 units |
|
| Blue Medicare Rx Enhanced (PDP)$163.20/mo premium · $0.00 deductible | 5Specialty Tier | 33% | — | $1896.4608 | $3,792.922 units |
|
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.