MedicarePartD.guide

A non-government resource built from CMS public data

INGREZZA Kit

Also known as Valbenazine. Coverage in North Carolina (CMS PDP Region 08).

7 of 12 stand-alone Part D plans in North Carolina cover this drug on tier 5.

7 of 7 plans apply a prior authorization, step therapy or quantity limit.

97 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: 97 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Value Script (PDP)$3.60/mo premium · $615.00 deductible5Specialty Tier25%—$281.5818$1,407.915 units
  • Prior authorization
  • Quantity limit 28 per 180 days
Wellcare Classic (PDP)$4.70/mo premium · $615.00 deductible5Specialty Tier25%—$281.5818$1,407.915 units
  • Prior authorization
  • Quantity limit 28 per 180 days
HealthSpring Extra Rx (PDP)$78.00/mo premium · $615.00 deductible5Specialty Tier25%—$283.0764$1,415.385 units
  • Prior authorization
  • Quantity limit 56 per 365 days
Blue Medicare Rx Standard (PDP)$83.90/mo premium · $615.00 deductible5Specialty Tier25%—$320.5295$9,615.8930 units
  • Prior authorization
  • Quantity limit 28 per 28 days
HealthSpring Assurance Rx (PDP)$110.40/mo premium · $615.00 deductible5Specialty Tier25%—$282.9918$1,414.965 units
  • Prior authorization
  • Quantity limit 56 per 365 days
AARP Medicare Rx Preferred from UHC (PDP)$119.80/mo premium · $130.00 deductible5Specialty Tier31%—$326.9903$9,809.7130 units
  • Prior authorization
  • Quantity limit 28 per 28 days
Blue Medicare Rx Enhanced (PDP)$163.20/mo premium · $0.00 deductible5Specialty Tier33%—$320.5295$9,615.8930 units
  • Prior authorization
  • Quantity limit 28 per 28 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 →