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.
Vyvanse (Lisdexamfetamine Dimesylate)
Found on the formularies of 2710 of 5499 Medicare Part D plans in this dataset · Tiers 1–4 · prior authorization on 275 plans (10%) · step therapy on 27 (1%) · quantity limits on 1704 (63%), 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 | No | No | 30 per 30 days |
| Mass General Brigham SCO (HMO D-SNP) (H0777-001) (MA) | Tier 1 | No | No | 60 per 30 days |
| Mass General Brigham One Care (HMO D-SNP) (H1611-001) (MA) | Tier 1 | No | No | 60 per 30 days |
| SecureBlue (HMO D-SNP) (H2425-001) (MN) | Tier 1 | No | No | 30 per 30 days |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) (H3251-029) (NM) | Tier 1 | No | No | 30 per 30 days |
| PruittHealth Premier D-SNP (HMO D-SNP) (H3291-002) (GA) | Tier 1 | No | No | None |
| Simpra Advantage Dual Care (PPO D-SNP) (H4091-002) (AL) | Tier 1 | No | No | None |
| CareAdvantage (HMO D-SNP) (H6019-001) (CA) | Tier 1 | No | No | 30 per 30 days |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) (H8634-009) (NM) | Tier 1 | No | No | 30 per 30 days |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) (H9623-001) (CA) | Tier 1 | No | No | 30 per 30 days |
| SECUR Advantage (HMO I-SNP) (H3048-001) (FL) | Tier 1 | No | No | None |
| SECUR Enhanced (HMO I-SNP) (H3048-002) (FL) | Tier 1 | No | No | None |
| ProCare Advantage (HMO-POS I-SNP) (H3467-001) (TX) | Tier 1 | No | No | None |
| ProCare Advantage - Kidney Care (HMO-POS C-SNP) (H3467-002) (TX) | Tier 1 | No | No | None |
| American Health Advantage of Florida (HMO I-SNP) (H6652-001) (FL) | Tier 1 | No | No | None |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) (H9706-002) (TX) | Tier 1 | No | No | 30 per 30 days |
| Senior Care (HMO I-SNP) (H9917-001) (FL) | Tier 1 | No | No | None |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) (H8554-003) (OK) | Tier 1 | No | No | 30 per 30 days |
| Senior Care (HMO I-SNP) (H6832-001) (MI) | Tier 1 | No | No | None |
| AgeRight Advantage Health Plan (HMO I-SNP) (H1372-001) (OR,WA) | Tier 1 | No | No | None |
| Senior Care (HMO I-SNP) (H3274-001) (CA) | Tier 1 | No | No | None |
| Liberty Medicare Dual Plan (HMO D-SNP) (H6351-005) (NC) | Tier 1 | No | No | None |
| KeyCare Advantage (HMO I-SNP) (H6959-001) (MD) | Tier 1 | No | No | None |
| American Health Advantage of Mississippi (HMO I-SNP) (H9909-001) (MS) | Tier 1 | No | No | None |
| Senior Care (HMO I-SNP) (H2185-001) (VA) | Tier 1 | No | No | None |
One row per plan — showing 25 of 2710 plans; a Yes means the flag applies to at least one form/strength on that plan.
Acquisition cost (NADAC): $2.54212/unit — price effective 10/21/2026
Source: CMS Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — data current through 2026-08-31 (CMS release 2026-08-26, refreshed monthly) · a newer CMS release may be available — this dataset is more than 2 months old · NADAC price effective 10/21/2026 (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=lisdexamfetamine-dimesylate