TOLVAPTAN Kit
Coverage in Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming (CMS PDP Region 25).
2 of 11 stand-alone Part D plans in Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming cover this drug on tier 5.
2 of 2 plans apply a prior authorization, step therapy or quantity limit.
Every plan that covers it
Showing 2 of 2 plans
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| SilverScript Choice (PDP)$29.70/mo premium · $615.00 deductible · $0 with full Extra Help | 5Specialty Tier | 25% | — | $325.1444 | $19,508.6660 units |
|
| MedicareBlue Rx Standard (PDP)$101.00/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $258.5092 | — |
|
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.
Medicare Advantage plans
Medicare Advantage plans carry their own formularies, separate from stand-alone Part D, and are sold county by county. Pick a county to see every Medicare Advantage drug plan there that covers this drug.
121 Medicare Advantage plans in IA, MN, MT, ND, NE, SD do cover it
A patient on an MA-PD plan may have coverage even where no PDP lists the drug. IA: 22 plans · MN: 49 plans · MT: 6 plans · ND: 10 plans · NE: 21 plans · SD: 13 plans.