Medicare Advantage Drug Cost for Rinvoq



There are 44 Medicare Advantage Plans with additional prescription drug coverage for Rinvoq available to residents in New Jersey. The average retail unit cost (e.g. per pill) for a 30-day supply at in-area retail pharmacies is $203.91 ($6,117.22). Rinvoq 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 Rinvoq in New Jersey. 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 Bergen with the best coverage and the cheapest prices for your medications in New Jersey.



Proprietary Name:Rinvoq
Generic Name:Upadacitinib
Drug Package:30 Tablet, Extended Release In 1 Bottle
Drug Strength:15mg/1
Substance:Upadacitinib
Dosage Form:Tablet, Extended Release
Route:Oral
Labeler:Abbvie Inc.
Pen Name:Human Prescription Drug
NDC#00074230630
RX#2196900
Days Supply:30
Coverage Phase:Initial Coverage
Plan Year:2023
County:Bergen





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Medicare Advantage Coverage for Rinvoq in New Jersey


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 Choice

5NA33%33%/YN$201.51
($6,045.41)
AARP Medicare Advantage Plan 1

5NA33%33%/YN$201.65
($6,049.60)
AARP Medicare Advantage Plan 2

5NA33%33%/YN$201.51
($6,045.22)
AARP Medicare Advantage Plan 3

5NA33%33%/YN$201.51
($6,045.22)
Aetna Medicare Elite 3

528%28%28%/YN$212.67
($6,380.16)
Aetna Medicare Explorer Elite

529%29%29%/YN$212.67
($6,380.16)
Aetna Medicare Explorer Elite 2

527%27%27%/YN$212.67
($6,380.16)
Aetna Medicare Explorer Premier

529%29%29%/YN$212.67
($6,380.16)
Aetna Medicare Explorer Premier Plus

529%29%29%/YN$212.67
($6,380.16)
Aetna Medicare Explorer Premier Plus

528%28%28%/YN$212.67
($6,380.16)
Aetna Medicare Premier

527%27%27%/YN$212.67
($6,380.16)
Aetna Medicare Prime Credit

527%27%27%/YN$212.67
($6,380.16)
Aetna Medicare Prime Premier

527%27%27%/YN$212.67
($6,380.16)
Aetna Medicare Prime Value

529%29%29%/YN$212.67
($6,380.16)
Amerivantage Balance

525%25%NA/YN$204.03
($6,120.87)
Amerivantage Choice

531%31%NA/YN$204.03
($6,120.87)
Amerivantage Classic

529%29%NA/YN$204.03
($6,120.87)
Braven Medicare Choice

5NA30%NA/YN$192.66
($5,779.65)
Braven Medicare Freedom

5NA30%NA/YN$192.66
($5,779.65)
Braven Medicare Plus

5NA30%NA/YN$192.69
($5,780.79)
Clover Health Choice

530%30%NA/YN$204.03
($6,120.87)
Clover Health Choice Value

525%25%NA/YN$204.03
($6,120.87)
Clover Health Classic

530%30%NA/YN$204.03
($6,120.87)
Clover Health Premier

525%25%NA/YN$204.03
($6,120.87)
Clover Health Premier Value

525%25%NA/YN$204.03
($6,120.87)
Clover Health Value

525%25%NA/YN$204.03
($6,120.87)
Humana Gold Plus H6622-063

5NA29%29%/YN$202.80
($6,083.98)
HumanaChoice H5216-169

5NA28%28%/YN$202.80
($6,083.98)
HumanaChoice H5216-170

5NA29%29%/YN$202.80
($6,083.98)
HumanaChoice H5216-172

5NA28%28%/YN$202.80
($6,083.98)
Wellcare Assist

525%25%25%/YN$199.56
($5,986.81)
Wellcare No Premium

527%27%27%/YN$204.03
($6,120.87)
Wellcare No Premium Focus

531%31%31%/YN$204.03
($6,120.87)


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SNP Prescription Drug Cost for Rinvoq

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)
Aetna Assure Premier Plus

5NA$0NA/YN$212.67
($6,380.16)
Amerivantage Dual Coordination

525%25%NA/YN$204.03
($6,120.87)
Amerivantage Dual Secure

525%25%NA/YN$204.03
($6,120.87)
Amerivantage ESRD Care

530%30%NA/YN$204.03
($6,120.87)
Horizon NJ TotalCare

1NA$0NA/YN$192.44
($5,773.09)
Longevity Health Plan

1NA25%NA/YN$183.37
($5,500.98)
UnitedHealthcare Assisted Living Plan

5NA33%33%/YN$201.35
($6,040.41)
UnitedHealthcare Dual Complete ONE

5NA$0NA/YN$201.51
($6,045.22)
UnitedHealthcare Nursing Home Plan

5NA25%NA/YN$201.40
($6,042.08)
UnitedHealthcare Nursing Home Plan

5NA25%NA/YN$201.56
($6,046.66)
Wellcare Dual Liberty

5NA25%25%/YN$199.56
($5,986.81)


Do any Medicare Advantage Plans Cover Rinvoq? Yes, 44 Medicare Advantage Plans cover this drug in New Jersey.

How much does Rinvoq Cost? $203.91, the average retail cost in New Jersey is $203.91 per unit or $6,117.22 for a 30-day supply at in-area pharmacies.

What Tier is Rinvoq? Tier 5, most Advantage Plans list Rinvoq 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 Rinvoq? Yes, the majority of Medicare Prescription Plans do require prior authorization from your doctor for Rinvoq.



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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