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.

NUZYRA (Omadacycline)

Tetracycline-class Antibacterial

On Part D plan formularies — with restrictions

Found on the formularies of 2950 of 5499 Medicare Part D plans in this dataset · Tiers 1–6 · prior authorization on 1124 plans (38%) · quantity limits on 1591 (54%), 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 2950 of 5499 Medicare Part D plans in this dataset, but prior authorization appears on 1124 of those 2950 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 →
PlanTierPrior AuthStep TherapyQty Limit
MetroPlus UltraCare (HMO D-SNP) (H0423-007) (NY) Tier 1 No No 30 per 14 days
Mass General Brigham SCO (HMO D-SNP) (H0777-001) (MA) Tier 1 No No None
Johns Hopkins Advantage MD D-SNP (HMO D-SNP) (H1225-003) (MD) Tier 1 No No 30 per 14 days
CCA One Care (HMO D-SNP) (H1486-001) (MA) Tier 1 No No 30 per 14 days
Mass General Brigham One Care (HMO D-SNP) (H1611-001) (MA) Tier 1 No No None
Senior Whole Health SCO (HMO D-SNP) (H2224-001) (MA) Tier 1 No No 30 per 14 days
Senior Whole Health SCO NHC (HMO D-SNP) (H2224-003) (MA) Tier 1 No No 30 per 14 days
CCA Senior Care Options (HMO D-SNP) (H2225-001) (MA) Tier 1 No No 30 per 14 days
IMCare Classic (HMO D-SNP) (H2417-001) (MN) Tier 1 No No 30 per 14 days
Elderplan Plus Long-Term Care (HMO-POS D-SNP) (H3347-007) (NY) Tier 1 No No 30 per 14 days
Healthfirst CompleteCare (HMO D-SNP) (H3359-034) (NY) Tier 1 No No 30 per 14 days
Molina One Care (HMO D-SNP) (H4371-001) (MA) Tier 1 No No 30 per 14 days
Mercy Care Advantage (HMO D-SNP) (H5580-001) (AZ) Tier 1 No No 30 per 14 days
Mercy Care Advantage (HMO D-SNP) (H5580-004) (AZ) Tier 1 No No 30 per 14 days
Mercy Care Advantage (HMO D-SNP) (H5580-005) (AZ) Tier 1 No No 30 per 14 days
Health Choice Pathway (HMO D-SNP) (H5587-002) (AZ) Tier 1 No No 30 per 14 days
NaviCare (HMO D-SNP) (H8928-001) (MA) Tier 1 No No None
Florida Complete Care-Duals VIP (HMO-POS D-SNP) (H9986-004) (segment 1) (FL) Tier 1 No No 30 per 14 days
Florida Complete Care-Duals VIP (HMO-POS D-SNP) (H9986-004) (segment 2) (FL) Tier 1 No No 30 per 14 days
Florida Complete Care-Duals VIP (HMO-POS D-SNP) (H9986-004) (segment 3) (FL) Tier 1 No No 30 per 14 days
Florida Complete Care (HMO I-SNP) (H9986-001) (FL) Tier 1 No No 30 per 14 days
Florida Complete Care- In The Community (HMO-POS I-SNP) (H9986-002) (FL) Tier 1 No No 30 per 14 days
Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) (H3347-002) (NY) Tier 1 No No 30 per 14 days
VIVA Medicare Extra Value (HMO D-SNP) (H0154-012) (AL) Tier 1 No No 30 per 14 days
VIVA Medicare Extra Care (HMO D-SNP) (H0154-019) (AL) Tier 1 No No 30 per 14 days

One row per plan — showing 25 of 2950 plans; 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=omadacycline
InsureWith Assistant
Hi! I can help you understand drug coverage, formulary tiers, prior authorization, and more. What would you like to know?