MedicarePartD.guide

A non-government resource built from CMS public data

CASPOFUNGIN ACETATE 5 mg/mL Injection, Powder, Lyophilized, For Solution

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

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

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

88 Medicare Advantage plans in CT, MA, RI, VT 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: 26 plans · MA: 50 plans · RI: 10 plans · VT: 2 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$8.40/mo premium · $615.00 deductible4Non-Preferred Drug32%—$137.9100—None
Wellcare Value Script (PDP)$16.40/mo premium · $615.00 deductible4Non-Preferred Drug40%40%$59.5215—None
Blue MedicareRx Value Plus (PDP)$20.70/mo premium · $615.00 deductible4Non-Preferred Drug32%32%$38.4480—None
Wellcare Classic (PDP)$21.70/mo premium · $615.00 deductible4Non-Preferred Drug29%29%$59.5584—None
SilverScript Choice (PDP)$32.70/mo premium · $615.00 deductible4Non-Preferred Drug35%35%$59.3089—None
Humana Value Rx Plan (PDP)$73.60/mo premium · $601.00 deductible4Non-Preferred Drug31%—$137.9100—None
Humana Premier Rx Plan (PDP)$138.60/mo premium · $0.00 deductible4Non-Preferred Drug50%50%$137.9100—None
HealthSpring Assurance Rx (PDP)$139.30/mo premium · $615.00 deductible4Non-Preferred Drug31%31%$55.5011—
  • Prior authorization
Blue MedicareRx Premier (PDP)$238.60/mo premium · $0.00 deductible4Non-Preferred Drug35%35%$38.4480—None

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 →