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.

STEGLUJAN (Ertugliflozin and Sitagliptin)

On Part D plan formularies — with restrictions

Found on the formularies of 8 of 5499 Medicare Part D plans in this dataset · Tier 4 · prior authorization on 8 plans (100%) · quantity limits on 8 (100%), 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 8 of 5499 Medicare Part D plans in this dataset, but prior authorization appears on 8 of those 8 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 →

Plan	Tier	Prior Auth	Step Therapy	Qty Limit
Network Health Select (PPO) (H5215-008) (WI)	Tier 4	Yes	No	30 per 30 days
Network Health Go (PPO) (H5215-009) (WI)	Tier 4	Yes	No	30 per 30 days
Network Health Anywhere (PPO) (H5215-010) (WI)	Tier 4	Yes	No	30 per 30 days
Network Health Choice (PPO) (H5215-011) (WI)	Tier 4	Yes	No	30 per 30 days
Network Health Zero (PPO) (H5215-012) (WI)	Tier 4	Yes	No	30 per 30 days
Network Health Cares (PPO D-SNP) (H5215-007) (WI)	Tier 4	Yes	No	30 per 30 days
Network Health PlusRx (PPO) (H5215-002) (WI)	Tier 4	Yes	No	30 per 30 days
Network Health PremierRx (PPO) (H5215-005) (WI)	Tier 4	Yes	No	30 per 30 days

One row per plan; a Yes means the flag applies to at least one form/strength on that plan.

Acquisition cost (NADAC): $17.40907/unit — price effective 06/18/2025

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) · NADAC price effective 06/18/2025 (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

Machine access — this tool is available as structured data for AI assistants and agents:
GET https://insurewith.ai/tools/drug-coverage/data.json?drug=ertugliflozin-and-sitagliptin