MedicarePartD.guide

A non-government resource built from CMS public data

APREPITANT 40 mg Capsule

Coverage in Pennsylvania and West Virginia (CMS PDP Region 06).

12 of 12 stand-alone Part D plans in Pennsylvania and West Virginia cover this drug on tier 4.

12 of 12 plans apply a prior authorization, step therapy or quantity limit.

365 Medicare Advantage plans in PA, WV 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. PA: 306 plans · WV: 59 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$6.60/mo premium · $615.00 deductible4Non-Preferred Drug33%—$73.8751$147.752 units
  • Prior authorization
  • Quantity limit 2 per 28 days
Wellcare Value Script (PDP)$8.20/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$65.2968—
  • Prior authorization
Wellcare Classic (PDP)$14.70/mo premium · $615.00 deductible4Non-Preferred Drug28%28%$65.2968—
  • Prior authorization
Humana Value Rx Plan (PDP)$19.40/mo premium · $601.00 deductible4Non-Preferred Drug33%—$73.9835$147.972 units
  • Prior authorization
  • Quantity limit 2 per 28 days
SilverScript Choice (PDP)$22.70/mo premium · $615.00 deductible4Non-Preferred Drug35%35%$45.9100—
  • Prior authorization
AARP Medicare Rx Saver from UHC (PDP)$43.50/mo premium · $615.00 deductible4Non-Preferred Drug41%—$55.6505$222.604 units
  • Prior authorization
  • Quantity limit 4 per 28 days
HealthSpring Extra Rx (PDP)$62.60/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$61.2881—
  • Prior authorization
HealthSpring Assurance Rx (PDP)$74.00/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$55.5432—
  • Prior authorization
AARP Medicare Rx Preferred from UHC (PDP)$121.90/mo premium · $130.00 deductible4Non-Preferred Drug33%—$60.8678$243.474 units
  • Prior authorization
  • Quantity limit 4 per 28 days
Humana Premier Rx Plan (PDP)$123.60/mo premium · $0.00 deductible4Non-Preferred Drug50%50%$73.8141$147.632 units
  • Prior authorization
  • Quantity limit 2 per 28 days
Blue Rx PDP Complete (PDP)$164.80/mo premium · $200.00 deductible4Non-Preferred Drug25%25%$53.7876—
  • Prior authorization
Blue Rx PDP Plus (PDP)$193.20/mo premium · $615.00 deductible4Non-Preferred Drug25%25%$53.7918—
  • 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 →