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.

Trulance (Plecanatide)

Guanylate Cyclase-C Agonist

On Part D plan formularies

Found on the formularies of 1670 of 5499 Medicare Part D plans in this dataset · Tiers 1–4 · prior authorization on 16 plans (1%) · step therapy on 6 (0%) · quantity limits on 1259 (75%), 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 1670 of 5499 Medicare Part D plans in this dataset (Tiers 1–4). Check your specific plan for its tier and copay — a low tier does not always beat a discount card.
Compare cash & discount prices →
PlanTierPrior AuthStep TherapyQty Limit
CCA One Care (HMO D-SNP) (H1486-001) (MA) Tier 1 No No 30 per 30 days
Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) (H1587-001) (AR) Tier 1 No No 30 per 30 days
Alameda Alliance Wellness (HMO D-SNP) (H2035-001) (CA) Tier 1 No No 30 per 30 days
CCA Senior Care Options (HMO D-SNP) (H2225-001) (MA) Tier 1 No No 30 per 30 days
Abilis Health Community (HMO I-SNP) (H2400-002) (KY,TN) Tier 1 No No 30 per 30 days
PrimeWest Senior Health Complete (HMO D-SNP) (H2416-001) (MN) Tier 1 No No 30 per 30 days
SeniorCare Complete (HMO D-SNP) (H2419-001) (MN) Tier 1 No No 30 per 30 days
Prime Health Complete (HMO D-SNP) (H2926-001) (MN) Tier 1 No No 30 per 30 days
Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) (H3127-001) (MI) Tier 1 No No 30 per 30 days
PruittHealth Premier D-SNP (HMO D-SNP) (H3291-002) (GA) Tier 1 No No 30 per 30 days
AllCare Advantage Redwood Rx (HMO D-SNP) (H3810-023) (OR) Tier 1 No No 30 per 30 days
Simpra Advantage Dual Care (PPO D-SNP) (H4091-002) (AL) Tier 1 No No 30 per 30 days
HAP CareSource MI Coordinated Health (HMO D-SNP) (H4193-001) (MI) Tier 1 No No 30 per 30 days
Elevate Medicare Choice (HMO D-SNP) (H5608-001) (CO) Tier 1 No No 30 per 30 days
AbilityCare (HMO D-SNP) (H5703-001) (MN) Tier 1 No No 30 per 30 days
ElderServe MAP (HMO D-SNP) (H6776-002) (NY) Tier 1 No No 30 per 30 days
Cooperative Advantage (HMO D-SNP) (H7598-003) (WI) Tier 1 No No 30 per 30 days
CareSource Dual Advantage (HMO D-SNP) (H8390-015) (GA) Tier 1 No No 30 per 30 days
Nascentia Dual Advantage (HMO D-SNP) (H9066-003) (NY) Tier 1 No No 30 per 30 days
Alterwood Advantage Dual Secure (HMO D-SNP) (H9306-004) (MD) Tier 1 No No 30 per 30 days
Longevity Health Plan (PPO I-SNP) (H9942-002) (NJ) Tier 1 No No 30 per 30 days
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) (H1526-004) (FL) Tier 1 No No 30 per 30 days
Longevity Health Plan (HMO I-SNP) (H1644-001) (FL) Tier 1 No No 30 per 30 days
SECUR Advantage (HMO I-SNP) (H3048-001) (FL) Tier 1 No No 30 per 30 days
SECUR Enhanced (HMO I-SNP) (H3048-002) (FL) Tier 1 No No 30 per 30 days

One row per plan — showing 25 of 1670 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=plecanatide
InsureWith Assistant
Hi! I can help you understand drug coverage, formulary tiers, prior authorization, and more. What would you like to know?