Those phases are 1) Deductible, 2) Initial coverage, 3) Coverage gap, Medicare Part D drugĬoverage is divided into four phases, each with a different cost-sharing amount. ‡Your out-of-pocket costs can vary throughout the year depending on which phase of the Part D benefit you are currently in. *Based on IQVIA claims data from 01/2021 through 10/2021. You can also call 1-844-REPATHA and speak with a Repatha Ready ® Which phase of the Part D benefit you are currently in. If you don’t qualify for Low Income Subsidy, your out-of-pocket costs will vary based on If you are unsure whether you qualify for Extra Help and would like more information, If you have Medicare Part D coverage and are eligible for Part D Low Income Subsidy, youĬan expect to pay less than $10 per month. Please call the number on the back of your member ID card for assistance.72% of Medicare prescriptions for Repatha ® patients cost less than $50 per month. To assist in the management of select specialty medications, some pharmacy benefit designs require the use of a preferred specialty pharmacy. Click the Quantity Limit icon next to the drug name for more details. Limits the amount of drug that a beneficiary may receive in a certain period. Medications may beĪvailable to some members at no cost with a prescription.Ĭoverage of this drug is subject to review by the plan and is based on Pharmacy policy. Medication: May be available with a copay exception. Please click icon next to medication for further details. Click the Market Watch icon next to the drug name for more details. Select High-Cost Low-Value medications (HCLV), Prescription Drugs with an Over-the-Counter (OTC) Equivalent (RxOTC), and New to Market (NTM) products may be included in the Market Watch Program. Authorized generic medications may take a brand cost-share.Ĭoverage of this drug is subject to review by the plan and is based on Pharmacy policy. Generic or Authorized Generic Medication. Products available as prepackaged products that supply a day supply greater Limited to a 30, 31, or 34 day supply at retail and/or mail pharmacies. Contact Member Services for more information.įor select plans, this medication may be covered at a lower cost share than the tier identified due to being part of the Care Advantage Program.ĭepending on member benefits, this medication may be This medication may not be covered under your Plan. Coverage is not provided for Prescription Drugs and Over-the-Counter Drugs not appearing on the Formulary drug list, unless an exception has been granted by the Plan pursuant to the Step Therapy Program. Non-Formulary drugs are not on the Formulary drug list. Unless an exception has been granted by the Plan pursuant to the Step Therapy Coverage is not provided for Prescriptionĭrugs and Over-the-Counter Drugs not appearing on the Formulary drug list, Includes brand and generic drugs and specialty medications.Īre not on the Formulary drug list. Tier 3 includes standard brands and some generic drugs.Ĥ Generic and Brand Drugs: typically have the highest member cost share. Tier 2 is still mostly generic drugs with only very select categories ofģ Generic and Brand Drugs: typically have a higher member cost share than lower (Arni)ġ Generic Drugs: typically have the lowest member cost share.Ģ Generic and Brand Drugs: typically have a higher member cost share than Tierġ. Results Brand NameĪngiotensin Ii Receptor Blocker-Neprilysin Inhibitor Comb. To view other medications in a therapeutic class, click any class hyperlink in your search results.
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