MIRABEGRON 50 mg Tablet, Extended Release
Coverage in Indiana and Kentucky (CMS PDP Region 15).
2 of 10 stand-alone Part D plans in Indiana and Kentucky cover this drug on tier 3.
2 of 2 plans apply a prior authorization, step therapy or quantity limit.
43 Medicare Advantage plans in IN, KY 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. IN: 23 plans · KY: 20 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Wellcare Value Script (PDP)$8.60/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $6.6091 | $19.833 units |
|
| Wellcare Classic (PDP)$8.70/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $6.6091 | $19.833 units |
|
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.