XDEMVY 2.5 mg/mL Solution/ Drops

Also known as Lotilaner Ophthalmic Solution. Coverage in Florida (CMS PDP Region 11).

10 of 10 stand-alone Part D plans in Florida cover this drug on tier 4–5.

10 of 10 plans apply a prior authorization, step therapy or quantity limit.

583 Medicare Advantage plans in FL 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. FL: 583 plans.

Every plan that covers it

Plan	Tier	30-day preferred	90-day mail	Unit cost	Est. 30-day fill	Restrictions
Humana Value Rx Plan (PDP)$25.90/mo premium · $601.00 deductible	4Non-Preferred Drug	33%	—	$203.2486	$144.310.71 units	Prior authorization Quantity limit 1 per 42 days
Humana Basic Rx Plan (PDP)$92.70/mo premium · $615.00 deductible	4Non-Preferred Drug	36%	—	$203.2486	$144.310.71 units	Prior authorization Quantity limit 1 per 42 days
AARP Medicare Rx Saver from UHC (PDP)$98.70/mo premium · $615.00 deductible	4Non-Preferred Drug	35%	—	$219.7939	$156.050.71 units	Quantity limit 1 per 42 days
Humana Premier Rx Plan (PDP)$115.90/mo premium · $0.00 deductible	4Non-Preferred Drug	50%	50%	$203.2486	$144.310.71 units	Prior authorization Quantity limit 1 per 42 days
AARP Medicare Rx Preferred from UHC (PDP)$119.10/mo premium · $130.00 deductible	4Non-Preferred Drug	34%	—	$219.7939	$156.050.71 units	Quantity limit 1 per 42 days
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$191.9532	$136.290.71 units	Prior authorization Quantity limit 1 per 42 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$191.9532	$136.290.71 units	Prior authorization Quantity limit 1 per 42 days
SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$201.5950	$143.130.71 units	Prior authorization Quantity limit 1 per 42 days
BlueMedicare Premier Rx (PDP)$98.60/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$214.2009	—	Prior authorization
BlueMedicare Complete Rx (PDP)$217.00/mo premium · $615.00 deductible	5Specialty Tier	25%	—	$214.2009	—	Prior authorization

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 →