MedicarePartD.guide

A non-government resource built from CMS public data

ORENITRAM 1 mg Tablet, Extended Release

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

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

4 of 4 plans apply a prior authorization, step therapy or quantity limit.

30 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: 10 plans · DC: 7 plans · MD: 13 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$32.60/mo premium · $615.00 deductible5Specialty Tier25%—$58.2518—
  • Prior authorization
AARP Medicare Rx Saver from UHC (PDP)$37.80/mo premium · $615.00 deductible5Specialty Tier25%—$63.5790—
  • Prior authorization
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible5Specialty Tier25%—$58.2439—
  • Prior authorization
AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible5Specialty Tier31%—$63.5790—
  • Prior authorization

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 →