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.
Viberzi (Eluxadoline)
mu-Opioid Receptor Agonist
Found on the formularies of 571 of 5499 Medicare Part D plans in this dataset · Tiers 1–5 · prior authorization on 329 plans (58%) · quantity limits on 389 (68%), 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 | Yes | No | 60 per 30 days |
| SecureBlue (HMO D-SNP) (H2425-001) (MN) | Tier 1 | Yes | No | 60 per 30 days |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) (H3127-001) (MI) | Tier 1 | No | No | 60 per 30 days |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) (H3251-029) (NM) | Tier 1 | Yes | No | 60 per 30 days |
| HAP CareSource MI Coordinated Health (HMO D-SNP) (H4193-001) (MI) | Tier 1 | No | No | 60 per 30 days |
| Platino Blindao (HMO D-SNP) (H5774-028) (PR) | Tier 1 | Yes | No | None |
| Platino Enlace (HMO D-SNP) (H5774-035) (PR) | Tier 1 | Yes | No | None |
| PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 1) (PR) | Tier 1 | Yes | No | None |
| PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 2) (PR) | Tier 1 | Yes | No | None |
| PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 3) (PR) | Tier 1 | Yes | No | None |
| PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 4) (PR) | Tier 1 | Yes | No | None |
| PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 5) (PR) | Tier 1 | Yes | No | None |
| PLATINO PLUS (HMO D-SNP) (H5774-043) (segment 1) (PR) | Tier 1 | Yes | No | None |
| PLATINO PLUS (HMO D-SNP) (H5774-043) (segment 2) (PR) | Tier 1 | Yes | No | None |
| PLATINO PLUS (HMO D-SNP) (H5774-043) (segment 3) (PR) | Tier 1 | Yes | No | None |
| PLATINO PLUS (HMO D-SNP) (H5774-043) (segment 4) (PR) | Tier 1 | Yes | No | None |
| PLATINO PLUS (HMO D-SNP) (H5774-043) (segment 5) (PR) | Tier 1 | Yes | No | None |
| ElderServe MAP (HMO D-SNP) (H6776-002) (NY) | Tier 1 | No | No | 60 per 30 days |
| Cooperative Advantage (HMO D-SNP) (H7598-003) (WI) | Tier 1 | No | No | 60 per 30 days |
| CareSource Dual Advantage (HMO D-SNP) (H8390-015) (GA) | Tier 1 | No | No | 60 per 30 days |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) (H8634-009) (NM) | Tier 1 | Yes | No | 60 per 30 days |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) (H9623-001) (CA) | Tier 1 | Yes | No | 60 per 30 days |
| Longevity Health Plan (PPO I-SNP) (H9942-002) (NJ) | Tier 1 | No | No | 60 per 30 days |
| Longevity Health Plan (HMO I-SNP) (H1644-001) (FL) | Tier 1 | No | No | 60 per 30 days |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) (H9706-002) (TX) | Tier 1 | Yes | No | 60 per 30 days |
One row per plan — showing 25 of 571 plans; a Yes means the flag applies to at least one form/strength on that plan.
Acquisition cost (NADAC): $28.09213/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=eluxadoline