MedicarePartD.guide

A non-government resource built from CMS public data

RISPERIDONE .5 mg Tablet, Orally Disintegrating

Coverage in New Mexico (CMS PDP Region 26).

11 of 11 stand-alone Part D plans in New Mexico cover this drug on tier 4.

9 of 11 plans apply a prior authorization, step therapy or quantity limit.

67 Medicare Advantage plans in NM 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. NM: 67 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$2.0327$12.206 units
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$2.2701$13.626 units
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug29%29%$2.1411$25.6912 units
  • Quantity limit 12 per 30 days
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug32%—$1.2556$15.0712 units
  • Step therapy
  • Quantity limit 12 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug43%—$1.1908—None
Humana Value Rx Plan (PDP)$69.60/mo premium · $601.00 deductible4Non-Preferred Drug30%—$1.2918$15.5012 units
  • Step therapy
  • Quantity limit 12 per 30 days
Humana Premier Rx Plan (PDP)$75.60/mo premium · $0.00 deductible4Non-Preferred Drug50%50%$1.2354$14.8212 units
  • Step therapy
  • Quantity limit 12 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible4Non-Preferred Drug35%—$1.1790—None
SilverScript Choice (PDP)$104.00/mo premium · $615.00 deductible4Non-Preferred Drug33%33%$0.3310$2.989 units
  • Quantity limit 9 per 30 days
Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible4Non-Preferred Drug33%33%$2.3547$14.136 units
  • Prior authorization
  • Quantity limit 6 per 30 days
Blue Cross MedicareRx Basic (PDP)$145.40/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$2.3446$14.076 units
  • Prior authorization
  • Quantity limit 6 per 30 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.

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