FillMapProvidence Medicare Dual Plus (HMO D-SNP)

Does Providence Medicare Dual Plus (HMO D-SNP) cover aripiprazole?

Providence Medicare Dual Plus (HMO D-SNP)
H9047-043-0 · MA_LOCAL · Medicare Part D
aripiprazole
Your Extra Help level

Everyone on this plan has Medicare and Medicaid, which qualifies you for Extra Help automatically — so the figures below already use the statutory copays, not this plan’s published cost sharing. Nothing here is saved.

Full Extra Help: no deductible, and at most $5.10 generic or $12.65 brand-name per fill.

Optional. Some plans charge less at a preferred pharmacy. Enter your ZIP to see which pharmacies near you take this plan — pick yours and the price above is re-worked for it. Until you do, we show what a standard pharmacy costs. Nothing here is saved.

aripiprazoleunder Providence Medicare Dual Plus (HMO D-SNP)
Covered — some forms require prior authorization
3 of 18 covered forms have a condition attached. Your plan has to approve it first — your doctor’s office handles it.
What you'd pay
$0per 30-day fill

Part D caps what you pay out of pocket at $2,100 for 2026. Before that, you pay the full price until you have paid $615 this year.

This plan charges the same at every pharmacy in its network — where you fill it will not change this figure.

Amount limit applies — how much depends on the strength you are prescribed — the cap for each one is listed below. You can still fill it; more than that needs your plan's approval, which your doctor's office requests.
Tier
Tier 2
Approval first
Required
Try another first
No
Amount limit
Varies by strength
Talk to your pharmacist or doctor before acting on anything here. They can see your full history and this page cannot. Never start, stop, or switch a medication based on it. Coverage rules change and plans make exceptions — your pharmacy can check your exact benefit in seconds.As of Sep 16, 2026 · CMS Part D monthly PUF. Reference information, not medical advice and not a price.

Covered forms and strengths (18)

  • 1.5 ML aripiprazole 200 MG/ML Prefilled Syringe [Abilify]Tier 5
  • 2 ML aripiprazole 200 MG/ML Prefilled Syringe [Abilify]Tier 5
  • 2.4 ML aripiprazole 300 MG/ML Prefilled Syringe [Abilify]Tier 5
  • 3.2 ML aripiprazole 300 MG/ML Prefilled Syringe [Abilify]Tier 5
  • aripiprazole 1 MG/ML Oral SolutionTier 425 mL per 1 days
  • aripiprazole 10 MG Disintegrating Oral TabletTier 42 tablets per 1 days
  • aripiprazole 10 MG Oral Film [Opipza]Tier 5Approval first3 units per 1 days
  • aripiprazole 10 MG Oral TabletTier 2
  • aripiprazole 15 MG Disintegrating Oral TabletTier 42 tablets per 1 days
  • aripiprazole 15 MG Oral TabletTier 2
  • aripiprazole 2 MG Oral Film [Opipza]Tier 5Approval first1 unit per 1 days
  • aripiprazole 2 MG Oral TabletTier 2
  • aripiprazole 20 MG Oral TabletTier 2
  • aripiprazole 30 MG Oral TabletTier 2
  • aripiprazole 300 MG Injection [Abilify]Tier 5
  • aripiprazole 400 MG Injection [Abilify]Tier 5
  • aripiprazole 5 MG Oral Film [Opipza]Tier 5Approval first3 units per 1 days
  • aripiprazole 5 MG Oral TabletTier 2

← All coverage for aripiprazole