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.
BAFIERTAM (Monomethyl)
Found on the formularies of 2285 of 5499 Medicare Part D plans in this dataset · Tiers 1–5 · prior authorization on 1470 plans (64%) · step therapy on 815 (36%) · quantity limits on 2279 (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.
| Plan | Tier | Prior Auth | Step Therapy | Qty Limit |
|---|---|---|---|---|
| MetroPlus UltraCare (HMO D-SNP) (H0423-007) (NY) | Tier 1 | Yes | No | 120 per 30 days |
| Mass General Brigham SCO (HMO D-SNP) (H0777-001) (MA) | Tier 1 | Yes | No | 120 per 30 days |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) (H1225-003) (MD) | Tier 1 | Yes | No | 120 per 30 days |
| CCA One Care (HMO D-SNP) (H1486-001) (MA) | Tier 1 | Yes | No | 120 per 30 days |
| Mass General Brigham One Care (HMO D-SNP) (H1611-001) (MA) | Tier 1 | Yes | No | 120 per 30 days |
| Alameda Alliance Wellness (HMO D-SNP) (H2035-001) (CA) | Tier 1 | Yes | No | None |
| Senior Whole Health SCO (HMO D-SNP) (H2224-001) (MA) | Tier 1 | Yes | No | 120 per 30 days |
| Senior Whole Health SCO NHC (HMO D-SNP) (H2224-003) (MA) | Tier 1 | Yes | No | 120 per 30 days |
| CCA Senior Care Options (HMO D-SNP) (H2225-001) (MA) | Tier 1 | Yes | No | 120 per 30 days |
| IMCare Classic (HMO D-SNP) (H2417-001) (MN) | Tier 1 | Yes | No | 120 per 30 days |
| SeniorCare Complete (HMO D-SNP) (H2419-001) (MN) | Tier 1 | Yes | No | None |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) (H3347-007) (NY) | Tier 1 | Yes | No | 120 per 30 days |
| Healthfirst CompleteCare (HMO D-SNP) (H3359-034) (NY) | Tier 1 | Yes | No | 120 per 30 days |
| Molina One Care (HMO D-SNP) (H4371-001) (MA) | Tier 1 | Yes | No | 120 per 30 days |
| Mercy Care Advantage (HMO D-SNP) (H5580-001) (AZ) | Tier 1 | Yes | No | 120 per 30 days |
| Mercy Care Advantage (HMO D-SNP) (H5580-004) (AZ) | Tier 1 | Yes | No | 120 per 30 days |
| Mercy Care Advantage (HMO D-SNP) (H5580-005) (AZ) | Tier 1 | Yes | No | 120 per 30 days |
| Health Choice Pathway (HMO D-SNP) (H5587-002) (AZ) | Tier 1 | Yes | No | 120 per 30 days |
| AbilityCare (HMO D-SNP) (H5703-001) (MN) | Tier 1 | Yes | No | None |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) (H5932-001) (PA) | Tier 1 | Yes | No | 120 per 30 days |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) (H5932-012) (PA) | Tier 1 | Yes | No | 120 per 30 days |
| Highmark Health Options Duals (HMO D-SNP) (H6224-001) (WV) | Tier 1 | Yes | No | 120 per 30 days |
| Highmark Health Options Duals (HMO D-SNP) (H7710-001) (DE) | Tier 1 | Yes | No | 120 per 30 days |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) (H9986-004) (segment 1) (FL) | Tier 1 | Yes | No | 120 per 30 days |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) (H9986-004) (segment 2) (FL) | Tier 1 | Yes | No | 120 per 30 days |
One row per plan — showing 25 of 2285 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=monomethyl