MedicarePartD.guide

A non-government resource built from CMS public data

OJEMDA 100 mg Tablet, Film Coated

Also known as Tovorafenib. Coverage in Texas (CMS PDP Region 22).

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

12 of 12 plans apply a prior authorization, step therapy or quantity limit.

389 Medicare Advantage plans in TX 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. TX: 389 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$2902.7300$49,346.4117 units
  • Prior authorization
  • Quantity limit 16 per 28 days
Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible5Specialty Tier25%—$2902.7300$49,346.4117 units
  • Prior authorization
  • Quantity limit 16 per 28 days
Humana Value Rx Plan (PDP)$22.90/mo premium · $601.00 deductible5Specialty Tier26%—$2427.4480$41,266.6217 units
  • Prior authorization
  • Quantity limit 16 per 28 days
Humana Basic Rx Plan (PDP)$41.70/mo premium · $615.00 deductible5Specialty Tier25%—$2427.4480$41,266.6217 units
  • Prior authorization
  • Quantity limit 16 per 28 days
HealthSpring Extra Rx (PDP)$70.00/mo premium · $615.00 deductible5Specialty Tier25%—$2305.0914$39,186.5517 units
  • Prior authorization
  • Quantity limit 16 per 28 days
AARP Medicare Rx Saver from UHC (PDP)$89.20/mo premium · $615.00 deductible5Specialty Tier25%—$2516.6563$65,433.0626 units
  • Prior authorization
  • Quantity limit 24 per 28 days
SilverScript Choice (PDP)$94.80/mo premium · $615.00 deductible5Specialty Tier25%—$2554.9397$66,428.4326 units
  • Prior authorization
  • Quantity limit 24 per 28 days
Blue Cross MedicareRx Basic (PDP)$104.70/mo premium · $615.00 deductible5Specialty Tier25%—$2408.9097$62,631.6526 units
  • Prior authorization
  • Quantity limit 24 per 28 days
HealthSpring Assurance Rx (PDP)$111.40/mo premium · $615.00 deductible5Specialty Tier25%—$2305.4027$39,191.8517 units
  • Prior authorization
  • Quantity limit 16 per 28 days
AARP Medicare Rx Preferred from UHC (PDP)$114.80/mo premium · $130.00 deductible5Specialty Tier31%—$2516.6563$65,433.0626 units
  • Prior authorization
  • Quantity limit 24 per 28 days
Humana Premier Rx Plan (PDP)$118.20/mo premium · $0.00 deductible5Specialty Tier33%—$2427.4480$41,266.6217 units
  • Prior authorization
  • Quantity limit 16 per 28 days
Blue Cross MedicareRx Value (PDP)$167.40/mo premium · $615.00 deductible5Specialty Tier25%—$2385.1903$62,014.9526 units
  • Prior authorization
  • Quantity limit 24 per 28 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 →