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.

DROXIA (Hydroxyurea)

Antimetabolite

On Part D plan formularies

Found on the formularies of 5499 of 5499 Medicare Part D plans in this dataset · Tiers 1–5 · prior authorization on 679 plans (12%), 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 5499 of 5499 Medicare Part D plans in this dataset (Tiers 1–5). Check your specific plan for its tier and copay — a low tier does not always beat a discount card.
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PlanTierPrior AuthStep TherapyQty Limit
Hamaspik Medicare Choice (HMO D-SNP) (H0034-002) (NY) Tier 1 No No None
MetroPlus UltraCare (HMO D-SNP) (H0423-007) (NY) Tier 1 No No None
Mass General Brigham SCO (HMO D-SNP) (H0777-001) (MA) Tier 1 No No None
Humana Dual Integrated (HMO D-SNP) (H0963-001) (MI) Tiers 1–4 No No None
CareOne Plus (HMO-POS) (H1019-001) (FL) Tiers 1–4 No No None
CareOne Plus (HMO) (H1019-006) (FL) Tiers 1–4 No No None
CareNeeds Platinum (HMO D-SNP) (H1019-023) (FL) Tiers 1–4 No No None
CareOne Plus (HMO-POS) (H1019-043) (FL) Tiers 1–4 No No None
CareOne Plus (HMO-POS) (H1019-057) (FL) Tiers 1–4 No No None
CareFree Giveback (HMO) (H1019-065) (FL) Tiers 1–4 No No None
CareNeeds Plus (HMO D-SNP) (H1019-073) (FL) Tiers 1–4 No No None
CareFree Platinum Giveback (HMO) (H1019-094) (FL) Tiers 1–4 No No None
CareOne Plus (HMO) (H1019-103) (segment 1) (FL) Tiers 1–4 No No None
CareOne Plus (HMO) (H1019-103) (segment 2) (FL) Tiers 1–4 No No None
CareFree Platinum Giveback (HMO) (H1019-104) (segment 1) (FL) Tiers 1–4 No No None
CareFree Platinum Giveback (HMO) (H1019-104) (segment 2) (FL) Tiers 1–4 No No None
CareComplete Platinum (HMO C-SNP) (H1019-109) (FL) Tiers 1–4 No No None
CareOne Plus (HMO) (H1019-113) (FL) Tiers 1–4 No No None
CareBreeze Platinum (HMO C-SNP) (H1019-118) (FL) Tiers 1–4 No No None
CareComplete Platinum (HMO C-SNP) (H1019-121) (FL) Tiers 1–4 No No None
CareBreeze Platinum (HMO C-SNP) (H1019-123) (FL) Tiers 1–4 No No None
CareBreeze Platinum (HMO-POS C-SNP) (H1019-124) (FL) Tiers 1–4 No No None
CareComplete Platinum (HMO-POS C-SNP) (H1019-130) (FL) Tiers 1–4 No No None
CareFree Giveback (HMO) (H1019-134) (FL) Tiers 1–4 No No None
CareFree Platinum Giveback (HMO-POS) (H1019-135) (FL) Tiers 1–4 No No None

One row per plan — showing 25 of 5499 plans; a Yes means the flag applies to at least one form/strength on that plan.

Acquisition cost (NADAC): $6.22986/unit — price effective 08/19/2026

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 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

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