Drug Coverage Lookup
See how a prescription drug is placed across Medicare Part D plan formularies — tier, prior authorization, step therapy, and quantity limits, counted per unique plan.
EPIDUO (Adapalene and Benzoyl Peroxide)
Retinoid
Found on the formularies of 327 of 5499 Medicare Part D plans in this dataset · Tiers 1–4 · prior authorization on 45 plans (14%) · step therapy on 15 (5%) · quantity limits on 12 (4%), counting a plan when at least one form/strength carries the flag.
This is dataset-wide formulary placement (data current through 2026-08-31) — check your specific plan for its current coverage and restrictions.
| Plan | Tier | Prior Auth | Step Therapy | Qty Limit |
|---|---|---|---|---|
| Mass General Brigham SCO (HMO D-SNP) (H0777-001) (MA) | Tier 1 | No | No | None |
| Mass General Brigham One Care (HMO D-SNP) (H1611-001) (MA) | Tier 1 | No | No | None |
| Alameda Alliance Wellness (HMO D-SNP) (H2035-001) (CA) | Tier 1 | No | No | None |
| SeniorCare Complete (HMO D-SNP) (H2419-001) (MN) | Tier 1 | No | No | None |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) (H4093-004) (PA) | Tier 1 | No | No | None |
| Provider Partners North Carolina Community Plan (HMO I-SNP) (H4439-002) (NC) | Tier 1 | No | No | None |
| Provider Partners Indiana Community Plan (HMO I-SNP) (H4444-002) (IN) | Tier 1 | No | No | None |
| AbilityCare (HMO D-SNP) (H5703-001) (MN) | Tier 1 | No | No | None |
| Platino Blindao (HMO D-SNP) (H5774-028) (PR) | Tier 1 | Yes | No | None |
| Platino Enlace (HMO D-SNP) (H5774-035) (PR) | Tier 1 | Yes | No | None |
| PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 1) (PR) | Tier 1 | Yes | No | None |
| PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 2) (PR) | Tier 1 | Yes | No | None |
| PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 3) (PR) | Tier 1 | Yes | No | None |
| PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 4) (PR) | Tier 1 | Yes | No | None |
| PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 5) (PR) | Tier 1 | Yes | No | None |
| PLATINO PLUS (HMO D-SNP) (H5774-043) (segment 1) (PR) | Tier 1 | Yes | No | None |
| PLATINO PLUS (HMO D-SNP) (H5774-043) (segment 2) (PR) | Tier 1 | Yes | No | None |
| PLATINO PLUS (HMO D-SNP) (H5774-043) (segment 3) (PR) | Tier 1 | Yes | No | None |
| PLATINO PLUS (HMO D-SNP) (H5774-043) (segment 4) (PR) | Tier 1 | Yes | No | None |
| PLATINO PLUS (HMO D-SNP) (H5774-043) (segment 5) (PR) | Tier 1 | Yes | No | None |
| Provider Partners Maryland Community Plan (HMO I-SNP) (H8067-003) (MD) | Tier 1 | No | No | None |
| Provider Partners Missouri Community Plan (HMO I-SNP) (H9191-004) (MO) | Tier 1 | No | No | None |
| Provider Partners Texas Advantage Plan (HMO I-SNP) (H4054-001) (TX) | Tier 1 | No | No | None |
| Provider Partners Illinois Advantage Plan (HMO I-SNP) (H3800-001) (IL) | Tier 1 | No | No | None |
| Provider Partners Maryland Advantage Plan (HMO I-SNP) (H8067-001) (MD) | Tier 1 | No | No | None |
One row per plan — showing 25 of 327 plans; a Yes means the flag applies to at least one form/strength on that plan.
Acquisition cost (NADAC): $0.3873/unit — price effective 10/21/2026
Source: CMS Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — data current through 2026-08-31 (CMS release 2026-08-26, refreshed monthly) · a newer CMS release may be available — this dataset is more than 2 months old · NADAC price effective 10/21/2026 (per-NDC last change, not a data-staleness date). Dataset-wide plan-year formulary placement, not a guarantee of your individual benefit — confirm with your plan or pharmacist.
Data: CMS Monthly Part D formulary files · FDA/RxNorm drug identity · CMS NADAC pricing — CMS Part D formulary data current through 2026-08-31 · source
GET https://insurewith.ai/tools/drug-coverage/data.json?drug=adapalene-and-benzoyl-peroxide