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.
Calcipotriene and Betamethasone Dipropionate (Calcipotriene, Betamethasone Dipropionate)
Vitamin D Analog
Found on the formularies of 829 of 5499 Medicare Part D plans in this dataset · Tiers 1–5 · prior authorization on 699 plans (84%) · quantity limits on 678 (82%), 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 |
|---|---|---|---|---|
| MetroPlus UltraCare (HMO D-SNP) (H0423-007) (NY) | Tier 1 | Yes | No | 120 per 30 days |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) (H1225-003) (MD) | Tier 1 | Yes | No | 120 per 30 days |
| CCA One Care (HMO D-SNP) (H1486-001) (MA) | Tier 1 | Yes | No | 120 per 30 days |
| Senior Whole Health SCO (HMO D-SNP) (H2224-001) (MA) | Tier 1 | Yes | No | 120 per 30 days |
| Senior Whole Health SCO NHC (HMO D-SNP) (H2224-003) (MA) | Tier 1 | Yes | No | 120 per 30 days |
| CCA Senior Care Options (HMO D-SNP) (H2225-001) (MA) | Tier 1 | Yes | No | 120 per 30 days |
| IMCare Classic (HMO D-SNP) (H2417-001) (MN) | Tier 1 | Yes | No | 120 per 30 days |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) (H3347-007) (NY) | Tier 1 | Yes | No | 120 per 30 days |
| Healthfirst CompleteCare (HMO D-SNP) (H3359-034) (NY) | Tier 1 | Yes | No | 120 per 30 days |
| Molina One Care (HMO D-SNP) (H4371-001) (MA) | Tier 1 | Yes | No | 120 per 30 days |
| Mercy Care Advantage (HMO D-SNP) (H5580-001) (AZ) | Tier 1 | Yes | No | 120 per 30 days |
| Mercy Care Advantage (HMO D-SNP) (H5580-004) (AZ) | Tier 1 | Yes | No | 120 per 30 days |
| Mercy Care Advantage (HMO D-SNP) (H5580-005) (AZ) | Tier 1 | Yes | No | 120 per 30 days |
| Health Choice Pathway (HMO D-SNP) (H5587-002) (AZ) | Tier 1 | Yes | No | 120 per 30 days |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) (H9986-004) (segment 1) (FL) | Tier 1 | Yes | No | 120 per 30 days |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) (H9986-004) (segment 2) (FL) | Tier 1 | Yes | No | 120 per 30 days |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) (H9986-004) (segment 3) (FL) | Tier 1 | Yes | No | 120 per 30 days |
| Florida Complete Care (HMO I-SNP) (H9986-001) (FL) | Tier 1 | Yes | No | 120 per 30 days |
| Florida Complete Care- In The Community (HMO-POS I-SNP) (H9986-002) (FL) | Tier 1 | Yes | No | 120 per 30 days |
| Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) (H3347-002) (NY) | Tier 1 | Yes | No | 120 per 30 days |
| VIVA Medicare Extra Value (HMO D-SNP) (H0154-012) (AL) | Tier 1 | Yes | No | 120 per 30 days |
| VIVA Medicare Extra Care (HMO D-SNP) (H0154-019) (AL) | Tier 1 | Yes | No | 120 per 30 days |
| Elderplan Advantage For Nursing Home Residents (HMO-POS I-SNP) (H3347-003) (NY) | Tier 1 | Yes | No | 120 per 30 days |
| MetroPlus Platinum Plan (HMO) (H0423-004) (NY) | Tier 1 | Yes | No | 120 per 30 days |
| Blue MedicareRx Value Plus (PDP) (S2893-001) | Tier 4 | Yes | No | 120 per 30 days |
One row per plan — showing 25 of 829 plans; a Yes means the flag applies to at least one form/strength on that plan.
Acquisition cost (NADAC): $1.47851/unit — price effective 08/19/2026
Source: CMS Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — data current through 2026-08-31 (CMS release 2026-08-26, refreshed monthly) · NADAC price effective 08/19/2026 (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=calcipotriene-betamethasone-dipropionate