MedicarePartD.guide

A non-government resource built from CMS public data

PYZCHIVA 45 mg/.5mL Injection, Solution

Also known as Ustekinumab-Ttwe. Coverage in Mississippi (CMS PDP Region 20).

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

1 of 1 plans apply a prior authorization, step therapy or quantity limit.

28 Medicare Advantage plans in MS 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. MS: 28 plans.

Every plan that covers it

PlanTier30-day preferred90-day mailUnit costEst. 30-day fillRestrictions
SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible3Preferred Brand18%18%$4316.9407$2,331.150.54 units
  • Prior authorization
  • Quantity limit 0.5 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 →