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.

Qbrexza (Glycopyrronium)

On Part D plan formularies — with restrictions

Found on the formularies of 9 of 5499 Medicare Part D plans in this dataset · Tiers 2–4 · prior authorization on 9 plans (100%) · quantity limits on 8 (89%), 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 9 of 5499 Medicare Part D plans in this dataset, but prior authorization appears on 9 of those 9 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
CalOptima Health OneCare Complete (HMO D-SNP) (H5433-001) (CA)	Tier 2	Yes	No	None
CareAdvantage (HMO D-SNP) (H6019-001) (CA)	Tier 2	Yes	No	30 per 30 days
CareOregon Advantage Plus (HMO D-SNP) (H5859-001) (OR)	Tier 4	Yes	No	1 per 1 days
Keystone 65 Select Rx (HMO) (H3952-049) (PA)	Tier 4	Yes	No	30 per 30 days
Keystone 65 Preferred Rx (HMO) (H3952-045) (PA)	Tier 4	Yes	No	30 per 30 days
Keystone 65 Select Rx (HMO) (H3952-051) (PA)	Tier 4	Yes	No	30 per 30 days
Keystone 65 Preferred Rx (HMO) (H3952-020) (PA)	Tier 4	Yes	No	30 per 30 days
Personal Choice 65 Rx (PPO) (H3909-001) (PA)	Tier 4	Yes	No	30 per 30 days
Personal Choice 65 Rx (PPO) (H3909-009) (PA)	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.

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=glycopyrronium