Specialty Drug
INTERFERON Gamma-1b helps your immune system work better. In patients with chronic granulomatous disease, this medicine helps to fight infections. In children with osteoporosis, interferon gamma helps to slow the progression of the disease. Compare interferon gammas.

Actimmune Medicare Coverage

Overview

Does Medicare cover Actimmune?

Yes.
100% of Medicare Part D and Medicare Advantage plans cover this drug.

How much is my Actimmune co-pay with Medicare?

It depends. Which coverage stage are you in? Click on a tab below…

Deductible
Typical
Donut Hole
Post-Donut Hole
Co-Pay Range
$3839 – $4302
In the Deductible co-pay stage, you are responsible for the full cost of your prescriptions. Your Medicare deductible cannot exceed $360 in 2016.
Co-Pay Range
$960 – $4186
In the Typical co-pay stage, your deductible has been satisfied, and Medicare pays the majority of your drug costs.
Co-Pay Range
$1381 – $1947
In the Donut Hole (also called the Coverage Gap) stage, you’ll pay more for your prescriptions. In 2016, the Donut Hole begins once you’ve spent $3,310 in one year.
Co-Pay Range
$192 – $216
In the Post-Donut Hole (also called Catastrophic Coverage) stage, Medicare will cover most of your drug costs. In 2016, this stage begins once you have spent $4,850.
Want an exact price for your co-pay?

Ways to Save on Actimmune

Here are some ways that may lower the cost of your Actimmune prescription.

Patient Assistance Program
Call the number for your prescription to get more information on how they can financially assist you
Patient Assistance Program
Call to get more information on how they can financially assist you with your prescription.
Patient Assistance Program
Call to get more information on how they can financially assist you with your prescription.

Find Your Actimmune Medicare Co-Pay

Here are average co-pays for some of the most popular Medicare plans. Be sure to add your plan to see your specific co-pay. If a price is shown in red, GoodRx has found discount prices that are lower than your Medicare co-pay.

Average Co-Pay for 12 vials (0.5ml) of Actimmune 100mcg

Medicare Plan Name Average Co-Pay
AARP MedicareRx Preferred (PDP) $1664
AARP MedicareRx Saver Plus (PDP) $1049
AARP MedicareRx Walgreens (PDP) $1034
Aetna Medicare Rx Saver (PDP) $1033
Anthem Blue Cross MedicareRx Plus (PDP) $1345
Anthem MediBlue Essential (HMO) $1264
CareMore Value Plus (HMO) $2295
Cigna-HealthSpring Preferred (HMO) $1171
EnvisionRxPlus (PDP) $1026
Express Scripts Medicare - Choice (PDP) $1052
Express Scripts Medicare - Value (PDP) $1011
First Health Part D Value Plus (PDP) $1363
Humana Enhanced (PDP) $1288
Humana Preferred Rx Plan (PDP) $976
Humana Walmart Rx Plan (PDP) $976
Kaiser Permanente Medicare Plus Std w/Part D (AB) (Cost) $1414
MedicareBlue Rx Standard (PDP) $1075
SilverScript Plus (PDP) $1387
Symphonix Value Rx (PDP) $1049
TexanPlus Classic (HMO) $3330
Don't see your Medicare plan above?

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Actimmune Medicare Formulary Information & Restrictions

Are there any restrictions on coverage?

Some Medicare plans have restrictions on coverage of Actimmune that may include:

Prior Authorization

Most Medicare plans will require you to obtain their authorization before they will provide coverage for this prescription. You’ll need to contact your plan and they may require you to have your doctor fill out paperwork indicating why you need this prescription. If you do not receive authorization or don’t want to go through this process, you may want to consider using a GoodRx discount instead of Medicare to find the best price for this prescription.

What drug tier is Actimmune typically on?

Tier 5

Medicare plans typically list Actimmune in Tier 5 of their formulary. Tier 5 drugs are usually non-preferred brand-name drugs. Tier 5 drugs cost more than Tier 1, 2, 3 and 4 drugs.

Does your plan have restrictions?

See discount prices that can save you money when your Medicare plan doesn't work for you.

Medicare prices are provided by the Centers for Medicare and Medicaid Services (CMS). They are accurate as-of January 2017 and the information may be updated. If you encounter any issues, please let us know.
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