0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym]

Verify with CMS →

filgrastim-aafi

RxCUI: 2057205

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
48.5%
Plan Coverage
2,459
Plans Covering
T3.9
Avg Tier
76.7%
Prior Auth Required

What the CMS Formulary Data Shows for 0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym]

Per the CMS 2026 Part D formulary file, 0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym] (RxNorm concept RXCUI 2057205, generic name filgrastim-aafi) appears on 176 distinct formulary files spanning 2,459 Medicare Part D plan offerings - 48.5% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 3.9.

Real-world access to 0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym] depends on utilization management as much as tier placement: 76.7% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.

Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym] today.

Coverage Details

Formularies covering
176
Plans covering
2,459
Coverage rate
48.5%
Tier range
Tier 1 – Tier 5
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
76.7% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

Tier Distribution Across Plans

89 plans
Tier 1, Preferred Generic
11 plans
Tier 3, Preferred Brand

Medicare Advantage Plans (MA-PD) Covering 0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym]

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Sentara Community Complete Select (HMO D-SNP) SENTARA HEALTH PLANS T1 Yes $0 VA
Sentara Community Complete (HMO D-SNP) SENTARA HEALTH PLANS T1 Yes $0 VA
ElderServe MAP (HMO D-SNP) ELDERSERVE HEALTH, INC. T1 Yes $0 NY
Cooperative Advantage (HMO D-SNP) GROUP HEALTH COOPERATIVE OF EAU CLAIRE T1 Yes $0 WI
Longevity Health Plan (PPO I-SNP) LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP T1 Yes $0 NJ
Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) UPPER PENINSULA HEALTH PLAN, LLC T1 Yes $0 MI
CareSource Dual Advantage (HMO D-SNP) CARESOURCE GEORGIA CO. T1 Yes $0 GA
HAP CareSource MI Coordinated Health (HMO D-SNP) HAP CARESOURCE T1 Yes $0 MI
PruittHealth Premier D-SNP (HMO D-SNP) PRUITTHEALTH PREMIER, INC. T1 No $0 GA
Simpra Advantage Dual Care (PPO D-SNP) SIMPRA ADVANTAGE, INC. T1 No $0 AL
CareAdvantage (HMO D-SNP) SAN MATEO HEALTH COMMISSION T1 No $0 CA
Gold Coast Health Plan Total Care Advantage (HMO D-SNP) Ventura County Medi-Cal Managed Care Commission T1 Yes $0 CA
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) Health Care Service Corporation T1 Yes $0 NM
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) Health Care Service Corporation T1 Yes $0 NM
SecureBlue (HMO D-SNP) HMO Minnesota T1 Yes $0 MN
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 Yes $0 NY
Elevate Medicare Choice (HMO D-SNP) DENVER HEALTH MEDICAL PLAN, INC. T1 Yes $0 CO
AllCare Advantage Redwood Rx (HMO D-SNP) ALLCARE HEALTH PLAN, INC. T1 Yes $0 OR
PrimeWest Senior Health Complete (HMO D-SNP) PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE T1 Yes $0 MN
Prime Health Complete (HMO D-SNP) PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE T1 Yes $0 MN
Alterwood Advantage Dual Secure (HMO D-SNP) ALTERWOOD ADVANTAGE, INC. T1 Yes $0 MD
Nascentia Dual Advantage (HMO D-SNP) VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK T1 Yes $0 NY
Abilis Health Community (HMO I-SNP) SIGNATURE ADVANTAGE, LLC T1 Yes $0 KY, TN
Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) ARKANSAS SUPERIOR SELECT, INC. T1 Yes $0 AR
Community Care's Partnership Program (HMO D-SNP) COMMUNITY CARE HEALTH PLAN, INC. T1 Yes $0 WI
CalOptima Health OneCare Complete (HMO D-SNP) ORANGE COUNTY HEALTH AUTHORITY T1 Yes $0 CA
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF FLORIDA, INC. T1 Yes $4.80 FL
Senior Care (HMO I-SNP) ALIGN SENIOR CARE FLORIDA, INC. T1 No $4.80 FL
ProCare Advantage (HMO-POS I-SNP) PROCARE ADVANTAGE, LLC T1 No $4.80 TX
ProCare Advantage - Kidney Care (HMO-POS C-SNP) PROCARE ADVANTAGE, LLC T1 No $4.80 TX
American Health Advantage of Florida (HMO I-SNP) AMERICAN HEALTH PLAN OF FL, INC. T1 No $4.80 FL
SECUR Advantage (HMO I-SNP) SECUR INC T1 No $4.80 FL
SECUR Enhanced (HMO I-SNP) SECUR INC T1 No $4.80 FL
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) HCSC INSURANCE SERVICES COMPANY T1 Yes $4.80 TX
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T1 Yes $4.80 FL
Texas Independence Health Plan, Inc. (HMO I-SNP) TEXAS INDEPENDENCE HEALTH PLAN, INC. T1 Yes $4.80 TX
Texas Independence Community Plan (HMO I-SNP) TEXAS INDEPENDENCE HEALTH PLAN, INC. T1 Yes $4.80 TX
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) GHS INSURANCE COMPANY T1 Yes $5.00 OK
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF MICHIGAN, INC. T1 Yes $8.80 MI
Senior Care (HMO I-SNP) ALIGN SENIOR CARE MI, LLC T1 No $8.80 MI
Tribute Select (HMO-POS I-SNP) ARKANSAS SUPERIOR SELECT, INC. T1 Yes $8.90 AR
AgeRight Advantage Health Plan (HMO I-SNP) MARQUIS ADVANTAGE, INC. T1 No $10.50 OR, WA
ATRIO Special Needs Plan (HMO D-SNP) ATRIO HEALTH PLANS T1 Yes $10.50 OR
ATRIO Special Needs Plan (HMO D-SNP) ATRIO HEALTH PLANS T1 Yes $10.50 OR
Senior Care (HMO I-SNP) ALIGN SENIOR CARE CALIFORNIA INC. T1 No $12.00 CA
Liberty Medicare Dual Plan (HMO D-SNP) LIBERTY ADVANTAGE, LLC T1 No $14.70 NC
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF ILLINOIS, INC. T1 Yes $15.20 IL
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF ARIZONA T1 Yes $17.00 AZ
WellSense Added Value (HMO) BOSTON MEDICAL CENTER HEALTH PLAN, INC. T1 Yes $21.70 NH
KeyCare Advantage (HMO I-SNP) ISNP VENTURES, LLC T1 No $23.20 MD

Frequently Asked Questions

Is 0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym] covered by Medicare Part D?

Yes, 0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym] is covered by 2,459 Medicare Part D plans (48.5% of all Part D formularies).

What tier is 0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym] on Medicare Part D plans?

0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym] averages Tier 3.9 across Part D plans, ranging from Tier 1 to Tier 5.

Does 0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym] require prior authorization?

76.7% of Part D formularies require prior authorization for 0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym]. Step therapy: 0%. Quantity limits: 0%.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial