ARISTADA 1064 mg/3.9mL Injection, Suspension, Extended Release

Also known as Aripiprazole Lauroxil. Coverage in Delaware, DC and Maryland (CMS PDP Region 05).

8 of 10 stand-alone Part D plans in Delaware, DC and Maryland cover this drug on tier 4–5.

6 of 8 plans apply a prior authorization, step therapy or quantity limit.

94 Medicare Advantage plans in DE, DC, MD 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. DE: 29 plans · DC: 15 plans · MD: 50 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	33%	—	$984.4272	$1,968.852 units	Quantity limit 3.9 per 56 days
Humana Value Rx Plan (PDP)$4.30/mo premium · $601.00 deductible	4Non-Preferred Drug	33%	—	$984.4272	$1,968.852 units	Quantity limit 3.9 per 56 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible	4Non-Preferred Drug	50%	50%	$984.4272	$1,968.852 units	Quantity limit 3.9 per 56 days
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$977.2344	$1,954.472 units	Quantity limit 3.9 per 56 days
Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$977.2344	$1,954.472 units	Quantity limit 3.9 per 56 days
AARP Medicare Rx Saver from UHC (PDP)$37.80/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$1076.1814	—	None
AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible	5Specialty Tier	31%	—	$1076.1814	—	None
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$1026.6232	$2,053.252 units	Quantity limit 3.9 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 →