1.5 ML fremanezumab-vfrm 150 MG/ML Prefilled Syringe [Ajovy]

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fremanezumab-vfrm

RxCUI: 2056700

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.
2.7%
Plan Coverage
138
Plans Covering
T2.9
Avg Tier
62.5%
Prior Auth Required

What the CMS Formulary Data Shows for 1.5 ML fremanezumab-vfrm 150 MG/ML Prefilled Syringe [Ajovy]

Per the CMS 2026 Part D formulary file, 1.5 ML fremanezumab-vfrm 150 MG/ML Prefilled Syringe [Ajovy] (RxNorm concept RXCUI 2056700, generic name fremanezumab-vfrm) appears on 8 distinct formulary files spanning 138 Medicare Part D plan offerings - 2.7% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.9.

Real-world access to 1.5 ML fremanezumab-vfrm 150 MG/ML Prefilled Syringe [Ajovy] depends on utilization management as much as tier placement: 62.5% of covering formularies require prior authorization. 0% require step therapy. 50% 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 1.5 ML fremanezumab-vfrm 150 MG/ML Prefilled Syringe [Ajovy] today.

Coverage Details

Formularies covering
8
Plans covering
138
Coverage rate
2.7%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
62.5% of formularies
Step therapy required
0% of formularies
Quantity limits
50% of formularies

Tier Distribution Across Plans

1 plans
Tier 1, Preferred Generic
1 plans
Tier 2, Generic
21 plans
Tier 3, Preferred Brand
77 plans
Tier 4, Non-Preferred

Medicare Advantage Plans (MA-PD) Covering 1.5 ML fremanezumab-vfrm 150 MG/ML Prefilled Syringe [Ajovy]

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

Plan Insurer Tier PA Premium States
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 T2 Yes $0 CA
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T3 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T3 No $0 NV
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T3 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T3 No $0 UT
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T3 No $0 NV
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T3 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T3 No $0 CO
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T3 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T3 No $0 CO
Select Health Medicare Flex (HMO) SELECTHEALTH, INC. T3 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T3 No $0 CO
Select Health Medicare Active (HMO) SELECTHEALTH, INC. T3 No $0 CO
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T3 No $0 NV
Select Health Medicare Wellness (HMO) SELECTHEALTH, INC. T3 No $0 NV
Healthy Mississippi Premier Advantage (HMO-POS) Healthy Mississippi, Inc. T3 No $0 MS
FHCP Medicare Classic (HMO) FLORIDA BLUE MEDICARE, INC. T3 Yes $0 FL
Aspire Health Protect (HMO) ASPIRE HEALTH PLAN T3 Yes $0 CA
Aspire Health Value (HMO) ASPIRE HEALTH PLAN T3 Yes $22.60 CA
Aspire Health Advantage (HMO) ASPIRE HEALTH PLAN T3 Yes $44.80 CA
FHCP Medicare Rx Plus (HMO-POS) FLORIDA BLUE MEDICARE, INC. T3 Yes $49.00 FL
Aspire Health Plus (HMO-POS) ASPIRE HEALTH PLAN T3 Yes $119.20 CA
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Solano (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Senior Advantage Inland Empire (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Sr Adv Enhanced Marin San Mateo (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Senior Advantage Ventura (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Kern (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Senior Advantage Basic Kern (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Senior Advantage San Diego (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Sr Adv Enhanced Santa Clara (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Stanis (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Senior Advantage Basic Stanis (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Senior Advantage Basic SnJoaq (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Senior Advantage Basic Fresno (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Sr Advantage Basic Sac., Sonoma (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Senior Advantage Santa Cruz (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Senior Advantage Basic Alameda (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Senior Advantage Basic SF (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Sr Adv Basic Contra Costa (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Sr Adv Basic Santa Clara (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Senior Advantage Basic Solano (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Senior Advantage Basic San Mateo (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Sr Advantage LA, Orange Value (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Sr Advantage Inland Empire Value (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Senior Advantage San Diego Value (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Senior Advantage Ventura Value (HMO) KAISER FOUNDATION HP, INC. T4 No $0 CA
Kaiser Permanente Senior Advantage Core DM (HMO) KAISER FOUNDATION HP OF CO T4 No $0 CO
Kaiser Permanente Dual Essential (HMO D-SNP) KAISER FOUNDATION HP OF CO T4 No $0 CO

Frequently Asked Questions

Is 1.5 ML fremanezumab-vfrm 150 MG/ML Prefilled Syringe [Ajovy] covered by Medicare Part D?

Yes, 1.5 ML fremanezumab-vfrm 150 MG/ML Prefilled Syringe [Ajovy] is covered by 138 Medicare Part D plans (2.7% of all Part D formularies).

What tier is 1.5 ML fremanezumab-vfrm 150 MG/ML Prefilled Syringe [Ajovy] on Medicare Part D plans?

1.5 ML fremanezumab-vfrm 150 MG/ML Prefilled Syringe [Ajovy] averages Tier 2.9 across Part D plans, ranging from Tier 1 to Tier 4.

Does 1.5 ML fremanezumab-vfrm 150 MG/ML Prefilled Syringe [Ajovy] require prior authorization?

62.5% of Part D formularies require prior authorization for 1.5 ML fremanezumab-vfrm 150 MG/ML Prefilled Syringe [Ajovy]. Step therapy: 0%. Quantity limits: 50%.

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