MedicarePartD.guide

A non-government resource built from CMS public data

CAMZYOS 5 mg Capsule, Gelatin Coated

Also known as Mavacamten. Coverage in Arkansas (CMS PDP Region 19).

2 of 12 stand-alone Part D plans in Arkansas cover this drug on tier 5.

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

12 Medicare Advantage plans in AR 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. AR: 12 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$277.4192$832.263 units
  • Prior authorization
  • Quantity limit 3 per 30 days
HealthSpring Extra Rx (PDP)$54.50/mo premium · $615.00 deductible5Specialty Tier25%—$277.3816$832.143 units
  • Prior authorization
  • Quantity limit 3 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.

See coverage in all 39 regions →