Ipilimumab
Specialty Drug
IPILIMUMAB is a monoclonal antibody. It is used to treat melanoma, a type of skin cancer. Compare CTLA-4 antagonists.
Ipilimumab Medicare Coverage
Overview
Does Medicare cover Yervoy?
Yes.
97% of Medicare Part D and Medicare
Advantage plans cover this drug.
How much is my Yervoy 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
$6638 – $7438
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
$31 – $7334
In the Typical co-pay stage, your deductible has been satisfied,
and Medicare pays the majority of your drug costs.
Co-Pay Range
$2248 – $3366
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
$332 – $374
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 Ipilimumab
Here are some ways that may lower the cost of your Yervoy prescription.
Find Your Ipilimumab 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 vial 50mg/10ml of Yervoy
| Medicare Plan Name | Average Co-Pay |
|---|---|
| AARP MedicareRx Preferred (PDP) | $2875 |
| AARP MedicareRx Saver Plus (PDP) | $1812 |
| AARP MedicareRx Walgreens (PDP) | $1792 |
| Aetna Medicare Rx Saver (PDP) | $1794 |
| Anthem Blue Cross MedicareRx Plus (PDP) | $2216 |
| Anthem MediBlue Essential (HMO) | $2125 |
| CareMore Value Plus (HMO) | $3931 |
| Cigna-HealthSpring Preferred (HMO) | $2024 |
| EnvisionRxPlus (PDP) | $1773 |
| Express Scripts Medicare - Choice (PDP) | $1602 |
| Express Scripts Medicare - Value (PDP) | $40 |
| First Health Part D Value Plus (PDP) | $2368 |
| Humana Enhanced (PDP) | $2224 |
| Humana Preferred Rx Plan (PDP) | $1685 |
| Humana Walmart Rx Plan (PDP) | $1685 |
| Kaiser Permanente Medicare Plus Std w/Part D (AB) (Cost) | $42 |
| MedicareBlue Rx Standard (PDP) | $1859 |
| SilverScript Plus (PDP) | $2425 |
| Symphonix Value Rx (PDP) | $1814 |
| TexanPlus Classic (HMO) | $6104 |
Don't see your Medicare plan above?
Find and configure your plan to see exact co-pay prices for your meds.
Ipilimumab Medicare Formulary Information & Restrictions
Are there any restrictions on coverage?
Some Medicare plans have restrictions on coverage of Yervoy 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 Yervoy typically on?
Tier 5
Medicare plans typically list Yervoy 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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