Specialty Drug
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Cayston Medicare Coverage

Overview

Does Medicare cover Cayston?

Yes.
90% of Medicare Part D and Medicare Advantage plans cover this drug.

How much is my Cayston 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
$7822 – $8665
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
$1955 – $8544
In the Typical co-pay stage, your deductible has been satisfied, and Medicare pays the majority of your drug costs.
Co-Pay Range
$2782 – $3921
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
$391 – $436
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 Cayston

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

Patient Assistance Program
Call Cayston Access Program to get more information on how they can financially assist you.
Patient Assistance Program
Save at least $5 per month on your prescription.
Fill a 90-Day Supply to Save
You may be able to lower your total cost by filling a greater quantity at one time.

Find Your Cayston 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 1 28-day supply (84 vials) of Cayston 75mg/vial

Medicare Plan Name Average Co-Pay
AARP MedicareRx Preferred (PDP) $3338
AARP MedicareRx Saver Plus (PDP) $2102
AARP MedicareRx Walgreens (PDP) $2086
Aetna Medicare Rx Saver (PDP) $2099
Anthem Blue Cross MedicareRx Plus (PDP) $2710
Anthem MediBlue Essential (HMO) $2546
CareMore Value Plus (HMO) $4622
Cigna-HealthSpring Preferred (HMO) $2389
EnvisionRxPlus (PDP) $2063
Express Scripts Medicare - Choice (PDP) $2132
Express Scripts Medicare - Value (PDP) $2050
First Health Part D Value Plus (PDP) $2771
Humana Enhanced (PDP) $2663
Humana Preferred Rx Plan (PDP) $2017
Humana Walmart Rx Plan (PDP) $2017
Kaiser Permanente Medicare Plus Std w/Part D (AB) (Cost) $2768
MedicareBlue Rx Standard (PDP) $2166
SilverScript Plus (PDP) $2857
Symphonix Value Rx (PDP) $2101
TexanPlus Classic (HMO) $7073
Don't see your Medicare plan above?

Find and configure your plan to see exact co-pay prices for your meds.

Cayston Medicare Formulary Information & Restrictions

Are there any restrictions on coverage?

Some Medicare plans have restrictions on coverage of Cayston 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 Cayston typically on?

Tier 5

Medicare plans typically list Cayston 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.
GoodRx is not sponsored by or affiliated with any of the pharmacies identified in its price comparisons. All trademarks, brands, logos and copyright images are property of their respective owners and rights holders and are used solely to represent the products of these rights holders. This information is for informational purposes only and is not meant to be a substitute for professional medical advice, diagnosis or treatment. GoodRx is not offering advice, recommending or endorsing any specific prescription drug, pharmacy or other information on the site. GoodRx provides no warranty for any of the pricing data or other information. Please seek medical advice before starting, changing or terminating any medical treatment.
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