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.
Dexilant (Dexlansoprazole)
Proton Pump Inhibitor
Found on the formularies of 2213 of 5499 Medicare Part D plans in this dataset · Tiers 1–4 · step therapy on 67 (3%) · quantity limits on 2174 (98%), 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 |
| Tufts Health One Care (HMO D-SNP) (H5314-001) (MA) | Tier 1 | No | No | None |
| Tufts Health One Care CW (HMO D-SNP) (H5314-002) (MA) | Tier 1 | No | No | None |
| Platino Blindao (HMO D-SNP) (H5774-028) (PR) | Tier 1 | No | Yes | 30.00 per 30 days |
| Platino Enlace (HMO D-SNP) (H5774-035) (PR) | Tier 1 | No | Yes | 30.00 per 30 days |
| PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 1) (PR) | Tier 1 | No | Yes | 30.00 per 30 days |
| PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 2) (PR) | Tier 1 | No | Yes | 30.00 per 30 days |
| PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 3) (PR) | Tier 1 | No | Yes | 30.00 per 30 days |
| PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 4) (PR) | Tier 1 | No | Yes | 30.00 per 30 days |
| PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 5) (PR) | Tier 1 | No | Yes | 30.00 per 30 days |
| PLATINO PLUS (HMO D-SNP) (H5774-043) (segment 1) (PR) | Tier 1 | No | Yes | 30.00 per 30 days |
| PLATINO PLUS (HMO D-SNP) (H5774-043) (segment 2) (PR) | Tier 1 | No | Yes | 30.00 per 30 days |
| PLATINO PLUS (HMO D-SNP) (H5774-043) (segment 3) (PR) | Tier 1 | No | Yes | 30.00 per 30 days |
| PLATINO PLUS (HMO D-SNP) (H5774-043) (segment 4) (PR) | Tier 1 | No | Yes | 30.00 per 30 days |
| PLATINO PLUS (HMO D-SNP) (H5774-043) (segment 5) (PR) | Tier 1 | No | Yes | 30.00 per 30 days |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) (H5932-001) (PA) | Tier 1 | No | Yes | 30 per 30 days |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) (H5932-012) (PA) | Tier 1 | No | Yes | 30 per 30 days |
| Highmark Health Options Duals (HMO D-SNP) (H6224-001) (WV) | Tier 1 | No | Yes | 30 per 30 days |
| Highmark Health Options Duals (HMO D-SNP) (H7710-001) (DE) | Tier 1 | No | Yes | 30 per 30 days |
| Tufts Health Plan Senior Care Options (HMO D-SNP) (H8330-001) (MA) | Tier 1 | No | No | None |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) (H8330-002) (MA) | Tier 1 | No | No | None |
| NaviCare (HMO D-SNP) (H8928-001) (MA) | Tier 1 | No | No | 30 per 30 days |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) (H5932-013) (PA) | Tier 1 | No | Yes | 30 per 30 days |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) (H5932-009) (PA) | Tier 1 | No | Yes | 30 per 30 days |
One row per plan — showing 25 of 2213 plans; a Yes means the flag applies to at least one form/strength on that plan.
Acquisition cost (NADAC): $3.96641/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=dexlansoprazole