MedicarePartD.guide

A non-government resource built from CMS public data

ORENITRAM 1 mg Tablet, Extended Release

Also known as Treprostinil. Coverage in Maine and New Hampshire (CMS PDP Region 01).

3 of 9 stand-alone Part D plans in Maine and New Hampshire cover this drug on tier 5.

3 of 3 plans apply a prior authorization, step therapy or quantity limit.

23 Medicare Advantage plans in ME, NH 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. ME: 16 plans · NH: 7 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$58.2518—
  • Prior authorization
AARP Medicare Rx Saver from UHC (PDP)$82.40/mo premium · $615.00 deductible5Specialty Tier25%—$63.5790—
  • Prior authorization
AARP Medicare Rx Preferred from UHC (PDP)$104.30/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 →