PITAVASTATIN 4 mg Tablet, Film Coated
Coverage in North Carolina (CMS PDP Region 08).
4 of 12 stand-alone Part D plans in North Carolina cover this drug on tier 1–4.
Lowest 30-day cost $0.00 at a preferred pharmacy. 4 of 4 plans apply a prior authorization, step therapy or quantity limit.
54 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: 54 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| HealthSpring Extra Rx (PDP)$78.00/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $1.1348 | $3.403 units |
|
| HealthSpring Assurance Rx (PDP)$110.40/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $2.2308 | $6.693 units |
|
| Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible | 4Non-Preferred Drug | 40% | 40% | $4.5059 | $13.523 units |
|
| Wellcare Classic (PDP)$4.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 27% | 27% | $4.5059 | $13.523 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.