ARISTADA 662 mg/2.4mL Injection, Suspension, Extended Release
Also known as Aripiprazole Lauroxil. Coverage in Arkansas (CMS PDP Region 19).
10 of 12 stand-alone Part D plans in Arkansas cover this drug on tier 4–5.
8 of 10 plans apply a prior authorization, step therapy or quantity limit.
77 Medicare Advantage plans in AR 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. AR: 77 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)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 34% | — | $1001.8398 | $3,005.523 units |
|
| Humana Value Rx Plan (PDP)$0.00/mo premium · $601.00 deductible | 4Non-Preferred Drug | 33% | — | $1001.8398 | $3,005.523 units |
|
| BlueMedicare Value Rx (PDP)$52.50/mo premium · $615.00 deductible | 4Non-Preferred Drug | 34% | 34% | $1024.0356 | $3,072.113 units |
|
| Humana Premier Rx Plan (PDP)$92.40/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $1001.8398 | $3,005.523 units |
|
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $989.3920 | $2,968.183 units |
|
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $989.3920 | $2,968.183 units |
|
| AARP Medicare Rx Saver from UHC (PDP)$65.10/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $1116.0655 | — | None |
| SilverScript Choice (PDP)$73.50/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $1037.9595 | $3,113.883 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$114.90/mo premium · $130.00 deductible | 5Specialty Tier | 31% | — | $1116.0655 | — | None |
| BlueMedicare Premier Rx (PDP)$181.20/mo premium · $0.00 deductible | 5Specialty Tier | 33% | — | $1024.0356 | $3,072.113 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.