MedicarePartD.guide

A non-government resource built from CMS public data

OGSIVEO 150 mg Tablet, Film Coated

Also known as Nirogacestat. Coverage in Delaware, DC and Maryland (CMS PDP Region 05).

10 of 10 stand-alone Part D plans in Delaware, DC and Maryland cover this drug on tier 5.

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

97 Medicare Advantage plans in DE, DC, MD 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. DE: 32 plans · DC: 15 plans · MD: 50 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$555.2753$3,331.656 units
  • Prior authorization
  • Quantity limit 6 per 30 days
Humana Value Rx Plan (PDP)$4.30/mo premium · $601.00 deductible5Specialty Tier26%—$555.2753$3,331.656 units
  • Prior authorization
  • Quantity limit 6 per 30 days
Wellcare Value Script (PDP)$5.60/mo premium · $615.00 deductible5Specialty Tier25%—$664.0000$39,840.0060 units
  • Prior authorization
  • Quantity limit 56 per 28 days
Wellcare Classic (PDP)$5.70/mo premium · $615.00 deductible5Specialty Tier25%—$664.0000$39,840.0060 units
  • Prior authorization
  • Quantity limit 56 per 28 days
HealthSpring Assurance Rx (PDP)$32.60/mo premium · $615.00 deductible5Specialty Tier25%—$527.3649$31,641.8960 units
  • Prior authorization
  • Quantity limit 56 per 28 days
AARP Medicare Rx Saver from UHC (PDP)$37.80/mo premium · $615.00 deductible5Specialty Tier25%—$575.6820$3,454.096 units
  • Prior authorization
  • Quantity limit 6 per 30 days
HealthSpring Extra Rx (PDP)$66.60/mo premium · $615.00 deductible5Specialty Tier25%—$527.2935$31,637.6160 units
  • Prior authorization
  • Quantity limit 56 per 28 days
AARP Medicare Rx Preferred from UHC (PDP)$94.50/mo premium · $130.00 deductible5Specialty Tier31%—$575.6820$3,454.096 units
  • Prior authorization
  • Quantity limit 6 per 30 days
SilverScript Choice (PDP)$97.40/mo premium · $615.00 deductible5Specialty Tier25%—$584.4392$35,066.3560 units
  • Prior authorization
  • Quantity limit 56 per 28 days
Humana Premier Rx Plan (PDP)$108.60/mo premium · $0.00 deductible5Specialty Tier33%—$555.2753$3,331.656 units
  • Prior authorization
  • Quantity limit 6 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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