MedicarePartD.guide

A non-government resource built from CMS public data

PYRUKYND 5 mg Tablet, Film Coated

Also known as Mitapivat. Coverage in Connecticut, Massachusetts, Rhode Island and Vermont (CMS PDP Region 02).

2 of 11 stand-alone Part D plans in Connecticut, Massachusetts, Rhode Island and Vermont cover this drug on tier 5.

2 of 2 plans apply a prior authorization, step therapy or quantity limit.

62 Medicare Advantage plans in CT, MA, RI 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. CT: 7 plans · MA: 40 plans · RI: 15 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible5Specialty Tier25%—$478.5842$28,715.0560 units
  • Prior authorization
  • Quantity limit 56 per 28 days
AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible5Specialty Tier31%—$478.5842$28,715.0560 units
  • Prior authorization
  • Quantity limit 56 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 →