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.

FILSUVEZ (Birch Triterpenes)

On Part D plan formularies — with restrictions

Found on the formularies of 177 of 5499 Medicare Part D plans in this dataset · Tiers 1–5 · prior authorization on 177 plans (100%) · quantity limits on 50 (28%), 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.

Found on the formularies of 177 of 5499 Medicare Part D plans in this dataset, but prior authorization appears on 177 of those 177 plans (for at least one form/strength). Check your specific plan for its current rules, and learn what your prescriber needs to submit.

How prior authorization works →

Plan	Tier	Prior Auth	Step Therapy	Qty Limit
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) (H5932-001) (PA)	Tier 1	Yes	No	702 per 30 days
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) (H5932-012) (PA)	Tier 1	Yes	No	702 per 30 days
Highmark Health Options Duals (HMO D-SNP) (H6224-001) (WV)	Tier 1	Yes	No	702 per 30 days
Highmark Health Options Duals (HMO D-SNP) (H7710-001) (DE)	Tier 1	Yes	No	702 per 30 days
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) (H5932-013) (PA)	Tier 1	Yes	No	702 per 30 days
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) (H5932-009) (PA)	Tier 1	Yes	No	702 per 30 days
Highmark Health Options Duals Select (HMO D-SNP) (H7710-002) (DE)	Tier 1	Yes	No	702 per 30 days
CalOptima Health OneCare Complete (HMO D-SNP) (H5433-001) (CA)	Tier 2	Yes	No	None
Select Health Medicare Essential (HMO) (H1994-001) (UT)	Tier 5	Yes	No	None
Select Health Medicare Essential (HMO) (H1994-012) (NV)	Tier 5	Yes	No	None
Select Health Medicare Dual (HMO D-SNP) (H1994-015) (UT)	Tier 5	Yes	No	None
Select Health Medicare Essential (HMO) (H1994-017) (UT)	Tier 5	Yes	No	None
Select Health Medicare + Kroger (HMO) (H1994-021) (NV)	Tier 5	Yes	No	None
Select Health Medicare + Kroger (HMO) (H1994-022) (UT)	Tier 5	Yes	No	None
Select Health Medicare Essential (HMO) (H1994-027) (CO)	Tier 5	Yes	No	None
Select Health Medicare Essential (HMO) (H1994-029) (CO)	Tier 5	Yes	No	None
Select Health Medicare + Kroger (HMO) (H1994-030) (CO)	Tier 5	Yes	No	None
Select Health Medicare Flex (HMO) (H1994-031) (CO)	Tier 5	Yes	No	None
Select Health Medicare + Kroger (HMO) (H1994-034) (CO)	Tier 5	Yes	No	None
Select Health Medicare Active (HMO) (H1994-035) (CO)	Tier 5	Yes	No	None
Select Health Medicare Dual (HMO D-SNP) (H1994-040) (NV)	Tier 5	Yes	No	None
Select Health Medicare Wellness (HMO) (H1994-044) (NV)	Tier 5	Yes	No	None
HAP Medicare Explore (PPO) (H2322-011) (MI)	Tier 5	Yes	No	None
HAP Medicare Prime (PPO) (H2322-016) (MI)	Tier 5	Yes	No	None
HAP Medicare Connect (HMO) (H2354-015) (MI)	Tier 5	Yes	No	None

One row per plan — showing 25 of 177 plans; a Yes means the flag applies to at least one form/strength on that plan.

For benefits professionals

Plan sponsors and advisors: formulary-placement and utilization analysis across plans.

For benefits teams: plan formulary analysis →

Source: CMS Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — data current through 2026-08-31 (CMS release 2026-08-26, refreshed monthly). 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

Machine access — this tool is available as structured data for AI assistants and agents:
GET https://insurewith.ai/tools/drug-coverage/data.json?drug=birch-triterpenes