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.
DEXTENZA (Dexamethasone)
Corticosteroid
Found on the formularies of 5499 of 5499 Medicare Part D plans in this dataset · Tiers 1–4 · prior authorization on 29 plans (1%) · quantity limits on 100 (2%), 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 |
|---|---|---|---|---|
| Hamaspik Medicare Choice (HMO D-SNP) (H0034-002) (NY) | Tier 1 | No | No | None |
| MetroPlus UltraCare (HMO D-SNP) (H0423-007) (NY) | Tier 1 | No | No | None |
| Anthem Select (HMO-POS) (H0544-058) (CA) | Tiers 1–2 | No | No | None |
| Anthem Medicare Advantage (HMO-POS) (H0544-061) (CA) | Tiers 1–2 | No | No | None |
| Anthem Medicare Advantage (HMO-POS) (H0544-062) (CA) | Tiers 1–2 | No | No | None |
| Anthem Medicare Advantage (HMO-POS) (H0544-063) (CA) | Tiers 1–2 | No | No | None |
| Anthem Select (HMO-POS) (H0544-066) (CA) | Tiers 1–2 | No | No | None |
| Anthem Select (HMO-POS) (H0544-069) (CA) | Tiers 1–2 | No | No | None |
| Anthem Select (HMO-POS) (H0544-091) (CA) | Tiers 1–2 | No | No | None |
| Anthem Medicare Advantage (HMO-POS) (H0544-096) (CA) | Tiers 1–2 | No | No | None |
| Anthem Select (HMO-POS) (H0544-098) (CA) | Tiers 1–2 | No | No | None |
| Anthem Medicare Advantage (HMO-POS) (H0544-108) (CA) | Tiers 1–2 | No | No | None |
| AmeriHealth Caritas VIP Care (HMO D-SNP) (H0738-001) (DE) | Tiers 1–2 | No | No | None |
| AmeriHealth Caritas VIP Care Choice (HMO D-SNP) (H0738-002) (DE) | Tiers 1–2 | No | No | None |
| Mass General Brigham SCO (HMO D-SNP) (H0777-001) (MA) | Tier 1 | No | No | None |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) (H1225-003) (MD) | Tier 1 | No | No | None |
| Wellpoint Medicare Advantage (HMO-POS) (H1423-009) (AZ) | Tiers 1–2 | No | No | None |
| CCA One Care (HMO D-SNP) (H1486-001) (MA) | Tier 1 | No | No | None |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) (H1587-001) (AR) | Tier 1 | No | No | None |
| Mass General Brigham One Care (HMO D-SNP) (H1611-001) (MA) | Tier 1 | No | No | None |
| Astiva Health Savings Plan (HMO) (H1993-001) (CA) | Tiers 1–2 | No | No | None |
| Astiva Health C-SNP Deluxe (HMO C-SNP) (H1993-007) (CA) | Tiers 1–2 | No | No | None |
| Astiva Health Savings Plan - NorCal (HMO) (H1993-011) (CA) | Tiers 1–2 | No | No | None |
| Astiva Health Premier Plan - NorCal (HMO) (H1993-012) (CA) | Tiers 1–2 | No | No | None |
| Astiva Health Premier Plan (HMO) (H1993-015) (CA) | Tiers 1–2 | No | No | None |
One row per plan — showing 25 of 5499 plans; a Yes means the flag applies to at least one form/strength on that plan.
Acquisition cost (NADAC): $13.19869/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=dexamethasone