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.

VYKAT XR (Diazoxide Choline)

On Part D plan formularies — with restrictions

Found on the formularies of 151 of 5499 Medicare Part D plans in this dataset · Tiers 1–5 · prior authorization on 36 plans (24%) · quantity limits on 20 (13%), 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 151 of 5499 Medicare Part D plans in this dataset, but prior authorization appears on 36 of those 151 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 →
PlanTierPrior AuthStep TherapyQty Limit
Mass General Brigham SCO (HMO D-SNP) (H0777-001) (MA) Tier 1 Yes No None
Mass General Brigham One Care (HMO D-SNP) (H1611-001) (MA) Tier 1 Yes No None
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) (H5932-001) (PA) Tier 1 Yes No 90 per 30 days
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) (H5932-012) (PA) Tier 1 Yes No 90 per 30 days
Highmark Health Options Duals (HMO D-SNP) (H6224-001) (WV) Tier 1 Yes No 90 per 30 days
Highmark Health Options Duals (HMO D-SNP) (H7710-001) (DE) Tier 1 Yes No 90 per 30 days
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) (H5932-013) (PA) Tier 1 Yes No 90 per 30 days
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) (H5932-009) (PA) Tier 1 Yes No 90 per 30 days
Highmark Health Options Duals Select (HMO D-SNP) (H7710-002) (DE) Tier 1 Yes No 90 per 30 days
CalOptima Health OneCare Complete (HMO D-SNP) (H5433-001) (CA) Tier 2 Yes No 90 per 30 days
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO) (H0524-003) (CA) Tier 5 No No None
Kaiser Permanente Senior Advantage Enhanced Solano (HMO) (H0524-008) (CA) Tier 5 No No None
Kaiser Permanente Senior Advantage Inland Empire (HMO) (H0524-015) (CA) Tier 5 No No None
Kaiser Permanente Sr Adv Enhanced Marin San Mateo (HMO) (H0524-031) (CA) Tier 5 No No None
Kaiser Permanente Senior Advantage Ventura (HMO) (H0524-034) (CA) Tier 5 No No None
Kaiser Permanente Senior Advantage Enhanced Kern (HMO) (H0524-035) (CA) Tier 5 No No None
Kaiser Permanente Senior Advantage Basic Kern (HMO) (H0524-036) (CA) Tier 5 No No None
Kaiser Permanente Senior Advantage San Diego (HMO) (H0524-037) (CA) Tier 5 No No None
Kaiser Permanente Sr Adv Enhanced Santa Clara (HMO) (H0524-039) (CA) Tier 5 No No None
Kaiser Permanente Senior Advantage Enhanced Stanis (HMO) (H0524-040) (CA) Tier 5 No No None
Kaiser Permanente Senior Advantage Basic Stanis (HMO) (H0524-041) (CA) Tier 5 No No None
Kaiser Permanente Senior Advantage Basic SnJoaq (HMO) (H0524-043) (CA) Tier 5 No No None
Kaiser Permanente Senior Advantage Basic Fresno (HMO) (H0524-046) (CA) Tier 5 No No None
Kaiser Permanente Sr Advantage Basic Sac., Sonoma (HMO) (H0524-051) (CA) Tier 5 No No None
Kaiser Permanente Senior Advantage Santa Cruz (HMO) (H0524-054) (CA) Tier 5 No No None

One row per plan — showing 25 of 151 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=diazoxide-choline
InsureWith Assistant
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