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.
Joenja (Leniolisib)
Found on the formularies of 226 of 5499 Medicare Part D plans in this dataset · Tiers 1–6 · prior authorization on 226 plans (100%) · quantity limits on 208 (92%), 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 |
|---|---|---|---|---|
| Mass General Brigham SCO (HMO D-SNP) (H0777-001) (MA) | Tier 1 | Yes | No | 60 per 30 days |
| Mass General Brigham One Care (HMO D-SNP) (H1611-001) (MA) | Tier 1 | Yes | No | 60 per 30 days |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) (H5932-001) (PA) | Tier 1 | Yes | No | 60 per 30 days |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) (H5932-012) (PA) | Tier 1 | Yes | No | 60 per 30 days |
| Highmark Health Options Duals (HMO D-SNP) (H6224-001) (WV) | Tier 1 | Yes | No | 60 per 30 days |
| Highmark Health Options Duals (HMO D-SNP) (H7710-001) (DE) | Tier 1 | Yes | No | 60 per 30 days |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) (H5932-013) (PA) | Tier 1 | Yes | No | 60 per 30 days |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) (H5932-009) (PA) | Tier 1 | Yes | No | 60 per 30 days |
| Highmark Health Options Duals Select (HMO D-SNP) (H7710-002) (DE) | Tier 1 | Yes | No | 60 per 30 days |
| CalOptima Health OneCare Complete (HMO D-SNP) (H5433-001) (CA) | Tier 2 | Yes | No | 60 per 30 days |
| HAP Medicare Explore (PPO) (H2322-011) (MI) | Tier 5 | Yes | No | None |
| HAP Medicare Prime (PPO) (H2322-016) (MI) | Tier 5 | Yes | No | None |
| HAP Medicare Connect (HMO) (H2354-015) (MI) | Tier 5 | Yes | No | None |
| HAP Medicare Complete Duals (HMO D-SNP) (H2354-025) (MI) | Tier 5 | Yes | No | None |
| HAP Medicare Superior (HMO) (H2354-028) (MI) | Tier 5 | Yes | No | None |
| Henry Ford Select (HMO) (H2354-029) (MI) | Tier 5 | Yes | No | None |
| Medicare BlueEssential (PPO) (H3335-053) (NY) | Tier 5 | Yes | No | 60 per 30 days |
| Medicare BlueActive (PPO) (H3335-055) (NY) | Tier 5 | Yes | No | 60 per 30 days |
| Medicare BlueVital (PPO) (H3335-061) (NY) | Tier 5 | Yes | No | 60 per 30 days |
| Univera SeniorChoice Basic (HMO) (H3351-017) (NY) | Tier 5 | Yes | No | 60 per 30 days |
| Univera SeniorChoice Extra (HMO) (H3351-020) (NY) | Tier 5 | Yes | No | 60 per 30 days |
| Medicare Blue Choice Core (HMO) (H3351-022) (NY) | Tier 5 | Yes | No | 60 per 30 days |
| Community Blue Medicare HMO Signature (HMO) (H3384-069) (segment 1) (NY) | Tier 5 | Yes | No | 60 per 30 days |
| Community Blue Medicare HMO Signature (HMO) (H3384-069) (segment 2) (NY) | Tier 5 | Yes | No | 60 per 30 days |
| Community Blue Medicare HMO Signature (HMO) (H3384-069) (segment 3) (NY) | Tier 5 | Yes | No | 60 per 30 days |
One row per plan — showing 25 of 226 plans; a Yes means the flag applies to at least one form/strength on that plan.
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
GET https://insurewith.ai/tools/drug-coverage/data.json?drug=leniolisib