MedicarePartD.guide

A non-government resource built from CMS public data

RISPERIDONE 4 mg Tablet, Orally Disintegrating

Coverage in Connecticut, Massachusetts, Rhode Island and Vermont (CMS PDP Region 02).

11 of 11 stand-alone Part D plans in Connecticut, Massachusetts, Rhode Island and Vermont cover this drug on tier 4.

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

152 Medicare Advantage plans in CT, MA, RI, VT 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. CT: 42 plans · MA: 88 plans · RI: 20 plans · VT: 2 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$8.40/mo premium · $615.00 deductible4Non-Preferred Drug32%—$2.9773$17.866 units
  • Step therapy
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$16.40/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$7.0119$84.1412 units
  • Quantity limit 12 per 30 days
Blue MedicareRx Value Plus (PDP)$20.70/mo premium · $615.00 deductible4Non-Preferred Drug32%32%$6.7165$80.6012 units
  • Step therapy
  • Quantity limit 12 per 30 days
Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible4Non-Preferred Drug29%29%$7.0119$84.1412 units
  • Quantity limit 12 per 30 days
SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible4Non-Preferred Drug35%35%$1.0924$13.1112 units
  • Quantity limit 12 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible4Non-Preferred Drug35%—$3.6877—None
Humana Value Rx Plan (PDP)$73.60/mo premium · $601.00 deductible4Non-Preferred Drug31%—$2.9842$17.916 units
  • Step therapy
  • Quantity limit 6 per 30 days
Humana Premier Rx Plan (PDP)$138.60/mo premium · $0.00 deductible4Non-Preferred Drug50%50%$2.9734$17.846 units
  • Step therapy
  • Quantity limit 6 per 30 days
HealthSpring Assurance Rx (PDP)$139.30/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$5.0884$61.0612 units
  • Quantity limit 12 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible4Non-Preferred Drug30%—$3.6312—None
Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible4Non-Preferred Drug35%35%$6.7165$80.6012 units
  • Step therapy
  • Quantity limit 12 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.

See coverage in all 39 regions →