MedicarePartD.guide

A non-government resource built from CMS public data

INGREZZA SPRINKLE 60 mg Capsule

Also known as Valbenazine. Coverage in New Mexico (CMS PDP Region 26).

4 of 11 stand-alone Part D plans in New Mexico cover this drug on tier 5.

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

33 Medicare Advantage plans in NM 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. NM: 33 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%—$279.8292$839.493 units
  • Prior authorization
  • Quantity limit 3 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$82.30/mo premium · $130.00 deductible5Specialty Tier31%—$305.4616$916.383 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Blue Cross MedicareRx Value (PDP)$111.30/mo premium · $615.00 deductible5Specialty Tier25%—$293.6595$880.983 units
  • Prior authorization
  • Quantity limit 3 per 30 days
Blue Cross MedicareRx Basic (PDP)$145.40/mo premium · $615.00 deductible5Specialty Tier25%—$296.5673$889.703 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 →