MedicarePartD.guide

A non-government resource built from CMS public data

REZUROCK 200 mg Tablet

Also known as Belumosudil. Coverage in Ohio (CMS PDP Region 14).

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

3 of 3 plans apply a prior authorization, step therapy or quantity limit.

124 Medicare Advantage plans in OH 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. OH: 124 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
HealthSpring Extra Rx (PDP)$65.70/mo premium · $615.00 deductible5Specialty Tier25%—$593.4000$1,780.203 units
  • Prior authorization
  • Quantity limit 3 per 30 days
SilverScript Choice (PDP)$90.30/mo premium · $615.00 deductible5Specialty Tier25%—$647.4751$1,942.433 units
  • Prior authorization
  • Quantity limit 3 per 30 days
HealthSpring Assurance Rx (PDP)$109.50/mo premium · $615.00 deductible5Specialty Tier25%—$593.4000$1,780.203 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 →