MedicarePartD.guide

A non-government resource built from CMS public data

XCOPRI TITRATION PACK Kit

Also known as Cenobamate. Coverage in Alaska (CMS PDP Region 34).

9 of 9 stand-alone Part D plans in Alaska cover this drug on tier 4–5.

9 of 9 plans apply a prior authorization, step therapy or quantity limit.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible4Non-Preferred Drug28%—$44.7417$1,342.2530 units
  • Prior authorization
  • Quantity limit 28 per 28 days
Humana Value Rx Plan (PDP)$10.60/mo premium · $601.00 deductible4Non-Preferred Drug33%—$44.7417$1,342.2530 units
  • Prior authorization
  • Quantity limit 28 per 28 days
Humana Premier Rx Plan (PDP)$112.40/mo premium · $0.00 deductible4Non-Preferred Drug50%50%$44.7417$1,342.2530 units
  • Prior authorization
  • Quantity limit 28 per 28 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$42.6998$213.505 units
  • Quantity limit 28 per 180 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$42.6208$213.105 units
  • Prior authorization
  • Quantity limit 56 per 365 days
Wellcare Value Script (PDP)$19.70/mo premium · $615.00 deductible5Specialty Tier25%—$42.6998$213.505 units
  • Quantity limit 28 per 180 days
AARP Medicare Rx Saver from UHC (PDP)$53.20/mo premium · $615.00 deductible5Specialty Tier25%—$46.5160$232.585 units
  • Prior authorization
  • Quantity limit 56 per 365 days
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible5Specialty Tier25%—$46.5081$1,395.2430 units
  • Quantity limit 28 per 28 days
AARP Medicare Rx Preferred from UHC (PDP)$100.20/mo premium · $130.00 deductible5Specialty Tier31%—$46.5160$232.585 units
  • Prior authorization
  • Quantity limit 56 per 365 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 →