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.

REDEMPLO (Plozasiran)

APOC-III-directed RNA Interaction

On Part D plan formularies — with restrictions

Found on the formularies of 130 of 5499 Medicare Part D plans in this dataset · Tiers 1–5 · prior authorization on 130 plans (100%) · quantity limits on 130 (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.

Found on the formularies of 130 of 5499 Medicare Part D plans in this dataset, but prior authorization appears on 130 of those 130 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
Mass General Brigham SCO (HMO D-SNP) (H0777-001) (MA) Tier 1 Yes No 0.50 per 84 days
Mass General Brigham One Care (HMO D-SNP) (H1611-001) (MA) Tier 1 Yes No 0.50 per 84 days
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) (H5932-001) (PA) Tier 1 Yes No 0.5 per 90 days
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) (H5932-012) (PA) Tier 1 Yes No 0.5 per 90 days
Highmark Health Options Duals (HMO D-SNP) (H6224-001) (WV) Tier 1 Yes No 0.5 per 90 days
Highmark Health Options Duals (HMO D-SNP) (H7710-001) (DE) Tier 1 Yes No 0.5 per 90 days
NaviCare (HMO D-SNP) (H8928-001) (MA) Tier 1 Yes No 0.5 per 84 days
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) (H5932-013) (PA) Tier 1 Yes No 0.5 per 90 days
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) (H5932-009) (PA) Tier 1 Yes No 0.5 per 90 days
Highmark Health Options Duals Select (HMO D-SNP) (H7710-002) (DE) Tier 1 Yes No 0.5 per 90 days
CalOptima Health OneCare Complete (HMO D-SNP) (H5433-001) (CA) Tier 2 Yes No 0.5 per 90 days
Health First Rewards H1099-014 (HMO) (FL) Tier 5 Yes No 0.5 per 84 days
Health First SunSaver H1099-016 (HMO) (FL) Tier 5 Yes No 0.5 per 84 days
Health First Complete Care H1099-023 (HMO) (FL) Tier 5 Yes No 0.5 per 84 days
Health First Emerald Plus H1099-024 (HMO) (FL) Tier 5 Yes No 0.5 per 84 days
Health First Premier Access H1099-025 (HMO-POS) (FL) Tier 5 Yes No 0.5 per 84 days
Health First Emerald Plus H1099-026 (HMO) (FL) Tier 5 Yes No 0.5 per 84 days
Health First Premier Access H1099-027 (HMO-POS) (FL) Tier 5 Yes No 0.5 per 84 days
Health First Emerald Plus H1099-028 (HMO) (FL) Tier 5 Yes No 0.5 per 84 days
PriorityMedicare Key (HMO-POS) (H2320-022) (segment 1) (MI) Tier 5 Yes No 0.5 per 84 days
PriorityMedicare Key (HMO-POS) (H2320-022) (segment 2) (MI) Tier 5 Yes No 0.5 per 84 days
PriorityMedicare Key (HMO-POS) (H2320-022) (segment 3) (MI) Tier 5 Yes No 0.5 per 84 days
PriorityMedicare Key (HMO-POS) (H2320-022) (segment 4) (MI) Tier 5 Yes No 0.5 per 84 days
PriorityMedicare Key (HMO-POS) (H2320-022) (segment 5) (MI) Tier 5 Yes No 0.5 per 84 days
PriorityMedicare Smart Savings (HMO-POS) (H2320-032) (segment 1) (MI) Tier 5 Yes No 0.5 per 84 days

One row per plan — showing 25 of 130 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=plozasiran
InsureWith Assistant
Hi! I can help you understand drug coverage, formulary tiers, prior authorization, and more. What would you like to know?