MedicarePartD.guide

A non-government resource built from CMS public data

XCOPRI TITRATION PACK Kit

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

11 of 11 stand-alone Part D plans in Connecticut, Massachusetts, Rhode Island and Vermont cover this drug on tier 4–5.

11 of 11 plans apply a prior authorization, step therapy or quantity limit.

Every plan that covers it

Prior authorization
Step therapy
Quantity limit
Tier
Extra Help (LIS)

Showing 11 of 11 plans

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$8.40/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug32%—$43.2299$1,296.9030 units
  • Prior authorization
  • Quantity limit 28 per 28 days
Wellcare Value Script (PDP)$16.40/mo premium · $615.00 deductible5Specialty Tier25%—$40.7595$203.805 units
  • Quantity limit 28 per 180 days
Blue MedicareRx Value Plus (PDP)$20.70/mo premium · $615.00 deductible · $0 with full Extra Help4Non-Preferred Drug32%32%$42.6684$1,280.0530 units
  • Quantity limit 28 per 28 days
Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible · $0 with full Extra Help5Specialty Tier25%—$40.7595$203.805 units
  • Quantity limit 28 per 180 days
SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible · $0 with full Extra Help5Specialty Tier25%—$43.9942$1,319.8330 units
  • Quantity limit 28 per 28 days
AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible5Specialty Tier25%—$45.2218$226.115 units
  • Prior authorization
  • Quantity limit 56 per 365 days
Humana Value Rx Plan (PDP)$73.60/mo premium · $601.00 deductible4Non-Preferred Drug31%—$43.2299$1,296.9030 units
  • Prior authorization
  • Quantity limit 28 per 28 days
Humana Premier Rx Plan (PDP)$138.60/mo premium · $0.00 deductible4Non-Preferred Drug50%50%$43.2299$1,296.9030 units
  • Prior authorization
  • Quantity limit 28 per 28 days
HealthSpring Assurance Rx (PDP)$139.30/mo premium · $615.00 deductible5Specialty Tier25%—$42.5486$212.745 units
  • Prior authorization
  • Quantity limit 56 per 365 days
AARP Medicare Rx Preferred from UHC (PDP)$155.10/mo premium · $130.00 deductible5Specialty Tier31%—$45.2218$226.115 units
  • Prior authorization
  • Quantity limit 56 per 365 days
Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible5Specialty Tier33%—$42.6684$1,280.0530 units
  • Quantity limit 28 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.

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.

152 Medicare Advantage plans in CT, MA, RI, VT do cover it

A patient on an MA-PD plan may have coverage even where no PDP lists the drug. CT: 42 plans · MA: 88 plans · RI: 20 plans · VT: 2 plans.

See coverage in all 39 regions →