NURTEC ODT 75 mg Tablet, Orally Disintegrating

Also known as Rimegepant Sulfate. Coverage in Arizona (CMS PDP Region 28).

7 of 10 stand-alone Part D plans in Arizona cover this drug on tier 3–5.

7 of 7 plans apply a prior authorization, step therapy or quantity limit.

107 Medicare Advantage plans in AZ 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. AZ: 107 plans.

Every plan that covers it

Plan	Tier	30-day preferred	90-day mail	Unit cost	Est. 30-day fill	Restrictions
SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible	3Preferred Brand	18%	18%	$135.4589	$2,167.3416 units	Prior authorization Quantity limit 16 per 30 days
AARP Medicare Rx Saver from UHC (PDP)$38.70/mo premium · $615.00 deductible	4Non-Preferred Drug	36%	—	$137.2686	$2,470.8318 units	Prior authorization Quantity limit 18 per 30 days
AARP Medicare Rx Preferred from UHC (PDP)$97.50/mo premium · $130.00 deductible	4Non-Preferred Drug	35%	—	$137.2686	$2,470.8318 units	Prior authorization Quantity limit 18 per 30 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$125.0542	$2,000.8716 units	Prior authorization Quantity limit 16 per 30 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$125.0542	$2,000.8716 units	Prior authorization Quantity limit 16 per 30 days
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$127.9544	$2,047.2716 units	Prior authorization Quantity limit 16 per 30 days
HealthSpring Extra Rx (PDP)$66.40/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$127.8619	$2,045.7916 units	Prior authorization Quantity limit 16 per 30 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.

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