Medicare Advantage Drug Cost for Nucala



There are 43 Medicare Advantage Plans with additional prescription drug coverage for Nucala available to residents in New York. The average retail unit cost (e.g. per pill) for a 30-day supply at in-area retail pharmacies is $3,477.20 ($104,315.99). Nucala is typically listed as a Tier 5 drug on the formulary and does not require prior authorization.

Below is the average retail cost and your co-pay for Nucala in New York. You can also see if each plan requires prior authorization, step therapy or has drug quantity limits. Please check the formulary for different brand and generic drug names. Every Medicare Advantage Plan will vary in coverage, co-pays, costs and premiums. This chart can help you sort through different plan details to find a Medicare Advantage Plan in Bronx with the best coverage and the cheapest prices for your medications in New York.



Proprietary Name:Nucala
Generic Name:Mepolizumab
Drug Package:1 Syringe In 1 Carton > 1 Ml In 1 Syringe
Drug Strength:100mg/mL
Substance:Mepolizumab
Dosage Form:Injection, Solution
Route:Subcutaneous
Labeler:Glaxosmithkline Llc
Pen Name:Human Prescription Drug
NDC#00173089201
RX#2170993
Days Supply:30
Coverage Phase:Initial Coverage
Plan Year:2023
County:Bronx





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Medicare Advantage Coverage for Nucala in New York


Click the Plan Name for More Details
Click the header to sort
Plan
Name ⇅
Tier
Level
Your
Cost
Preferred
Cost
Non
Preferred
Cost
Mail
Limit
Amt/
Days
Prior
Auth
Y/N
Step
Therapy
Y/N
Avg
Unit
Cost
(x30)
AARP Medicare Advantage Plan 1

5NA29%29%/YN$3,499.54
($104,986.33)
AARP Medicare Advantage Plan 2

5NA28%28%/YN$3,499.54
($104,986.33)
AgeWell New York LiveWell

5NA27%NA/YN$3,352.75
($100,582.58)
Centers Plan for Medicare Advantage Care

5NA25%NA/YN$3,338.85
($100,165.49)
Empire MediBlue Extra Select

525%25%NA/YN$3,725.85
($111,775.37)
Empire MediBlue HealthPlus

527%27%NA/YN$3,725.85
($111,775.37)
Empire MediBlue HealthPlus Select

527%27%NA/YN$3,725.85
($111,775.37)
Empire MediBlue Plus

527%27%NA/YN$3,725.85
($111,775.37)
Empire MediBlue Select

527%27%NA/YN$3,725.85
($111,775.37)
Humana Gold Plus H3533-027

5NA26%26%/YN$3,558.11
($106,743.41)
Humana Gold Plus H3533-032

5NA29%29%/YN$3,558.11
($106,743.41)
HumanaChoice H5970-024

5NA27%27%/YN$3,558.11
($106,743.41)
UnitedHealthcare Medicare Advantage Choice Plan 1

5NA29%29%/YN$3,543.80
($106,314.01)
UnitedHealthcare Medicare Advantage Choice Plan 3

5NA31%31%/YN$3,543.80
($106,314.01)
UnitedHealthcare Medicare Advantage Choice Plan 4

5NA33%33%/YN$3,543.80
($106,314.01)
VNS Health EasyCare

5NA25%NA/YN$3,304.16
($99,124.75)


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SNP Prescription Drug Cost for Nucala

Click the Plan Name for More Details about that Plan
Click the header to sort
Plan
Name ⇅
Tier
Level
Cost
Preferred
Cost
Non
Preferred
Cost
Amt
Mail
Limit
Days/
Amt
Prior
Auth
Y/N
Step
Therapy
Y/N
Avg
Unit
Cost
(x30)
AgeWell New York Advantage Plus

5NA$0NA/YN$3,352.75
($100,582.58)
AgeWell New York CareWell

5NA25%NA/YN$3,352.73
($100,581.95)
AgeWell New York FeelWell

5NA$0NA/YN$3,352.75
($100,582.58)
Centers Plan for Dual Coverage Care

1NA15%NA/YN$3,341.42
($100,242.54)
Centers Plan for Medicaid Advantage Plus

1NA$0NA/YN$3,365.49
($100,964.76)
Centers Plan for Nursing Home Care

1NA25%NA/YN$3,359.31
($100,779.36)
Empire MediBlue Dual Advantage

525%25%NA/YN$3,725.85
($111,775.37)
Empire MediBlue Dual Advantage Select

525%25%NA/YN$3,725.85
($111,775.37)
Empire MediBlue HealthPlus Dual Connect

525%25%NA/YN$3,725.85
($111,775.37)
Empire MediBlue HealthPlus Dual Plus

525%25%NA/YN$3,725.85
($111,775.37)
Hamaspik Medicare Choice

1NA15%NA/YN$3,291.20
($98,735.94)
Hamaspik Medicare Select

1NA15%NA/YN$3,286.34
($98,590.26)
Humana Gold Plus SNP-DE H3533-034

5NA$0NA/YN$3,558.11
($106,743.41)
HumanaChoice SNP-DE H5970-026

5NA$0NA/YN$3,558.11
($106,743.41)
Longevity Health Plan

1NA25%NA/YN$3,201.11
($96,033.17)
RiverSpring MAP

1NA15%NA/YN$3,280.74
($98,422.22)
RiverSpring Star

1NA25%NA/YN$3,280.74
($98,422.22)
UnitedHealthcare Assisted Living Plan

5NA33%33%/YN$3,548.77
($106,463.00)
UnitedHealthcare Dual Complete Plan 1

5NA$0NA/YN$3,550.11
($106,503.31)
UnitedHealthcare Dual Complete Plan 2

5NA$0NA/YN$3,550.11
($106,503.31)
UnitedHealthcare Nursing Home Plan 1

5NA25%NA/YN$3,534.38
($106,031.46)
UnitedHealthcare Nursing Home Plan 2

5NA25%NA/YN$3,534.16
($106,024.67)
VillageCareMAX Medicare Health Advantage

1NA15%NA/YN$3,228.24
($96,847.25)
VillageCareMAX Medicare Total Advantage

1NA$0NA/YN$3,228.24
($96,847.25)
VNS Health EasyCare Plus

1NA15%NA/YN$3,304.16
($99,124.75)
VNS Health Total

5NA25%NA/YN$3,304.16
($99,124.75)


Do any Medicare Advantage Plans Cover Nucala? Yes, 43 Medicare Advantage Plans cover this drug in New York.

How much does Nucala Cost? $3,477.20, the average retail cost in New York is $3,477.20 per unit or $104,315.99 for a 30-day supply at in-area pharmacies.

What Tier is Nucala? Tier 5, most Advantage Plans list Nucala on Tier 5 on their formulary. Usually, the higher the tier, the more you have to pay for the medication.

Do I need Prior Authorization for Nucala? Yes, the majority of Medicare Prescription Plans do require prior authorization from your doctor for Nucala.



Additional Notes by Medicare Help:

Most plans have 4 levels of coverage. The exception is the $0 Deductible Plans.
1.Pre-Deductable: Before you reach the plans deductible. Some plans offer select Pre-deductible drug Coverage
2.Initial Coverage: (ICL) After you reach the plans deductible but before the Initial Coverage limit.
3.Coverage Gap: (AKA Donut Hole) After you reach the plans ICL but before the Catastrophic of $7550 in 2022.
4.Catastrophic: Anything over $7550 you will receive a significant increase in coverage.

Formulary Definitions:

Tier Level: Medicare drug plans place drugs into different "tiers" on their formularies. Drugs in each tier have a different cost. A drug in a lower tier will generally cost you less.
Cost Preferred: Your Cost for the Drug at the Providers In Network Preferred Pharmacy. As a Percent of the total drug cost or a flat rate.
Cost Non Preferred: Your Cost for the Prescription Drug at a Non-Preferred Pharmacy. As a Percent of the total drug cost or a flat rate.
Cost Mail: Your Cost for Prescription Drugs through a Mail Order Pharmacy. As a Percent of the total drug cost or a flat rate.
Quantity Limit Amount/Days: Certain drugs have a Quantity Limit. That means the plan will only cover the drug up to a designated quantity or amount. If your prescribing doctor feels it is necessary to exceed the set limit, he or she must get prior approval before the higher quantity will be covered.
Prior Authorization: Certain Drugs require you or your doctor to get prior authorization in order to be covered. Usually just an additional form. If you dont get approval, the plan may not cover the drug.
Step Therapy: Means you must first try one drug to treat your medical condition before the plan will cover another drug for the same condition. If you have already tried other drugs or your doctor thinks they are not right for you, you and your doctor can ask the plan to cover this drug.
Avg Unit Cost: Average unit cost (e.g. per pill) for specified days supply at in-area retail pharmacies. A pharmacy is considered in-area when it is geographically located in the service area.




What if a drug I need is not listed?

Please check the formulary for different brand and generic names. If you still cannot locate your drugs, your plan may not offer coverage. Talk to your doctor first about changing your prescription to a drug on your plans formulary. If this is not an option, you can request an exception to have the plan review its coverage decision based on your individual circumstances.

Last updated on
Source:CMS Formulary Data Q4 2022
Source:NDC Directory by FDA.gov

**We make every attempt to keep our information accurate. But please check with the plan providers to verify all information.

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