MedicarePartD.guide

A non-government resource built from CMS public data

INGREZZA 80 mg Capsule

Also known as Valbenazine. Coverage in Idaho and Utah (CMS PDP Region 31).

5 of 10 stand-alone Part D plans in Idaho and Utah cover this drug on tier 5.

5 of 5 plans apply a prior authorization, step therapy or quantity limit.

33 Medicare Advantage plans in ID, UT 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. ID: 15 plans · UT: 18 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$9.60/mo premium · $615.00 deductible5Specialty Tier25%—$285.0301$855.093 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Wellcare Classic (PDP)$23.70/mo premium · $615.00 deductible5Specialty Tier25%—$285.0301$855.093 units
  • Prior authorization
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$56.30/mo premium · $615.00 deductible5Specialty Tier25%—$285.0160$855.053 units
  • Prior authorization
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$128.60/mo premium · $615.00 deductible5Specialty Tier25%—$285.0139$855.043 units
  • Prior authorization
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$132.60/mo premium · $130.00 deductible5Specialty Tier31%—$311.7527$935.263 units
  • Prior authorization
  • Quantity limit 3 per 30 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 →