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.
WAYRILZ (Rilzabrutinib)
Kinase Inhibitor
Found on the formularies of 19 of 5499 Medicare Part D plans in this dataset · Tiers 1–5 · prior authorization on 19 plans (100%) · quantity limits on 9 (47%), 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 |
|---|---|---|---|---|
| NaviCare (HMO D-SNP) (H8928-001) (MA) | Tier 1 | Yes | No | 60 per 30 days |
| Health First Rewards H1099-014 (HMO) (FL) | Tier 5 | Yes | No | None |
| Health First SunSaver H1099-016 (HMO) (FL) | Tier 5 | Yes | No | None |
| Health First Complete Care H1099-023 (HMO) (FL) | Tier 5 | Yes | No | None |
| Health First Emerald Plus H1099-024 (HMO) (FL) | Tier 5 | Yes | No | None |
| Health First Premier Access H1099-025 (HMO-POS) (FL) | Tier 5 | Yes | No | None |
| Health First Emerald Plus H1099-026 (HMO) (FL) | Tier 5 | Yes | No | None |
| Health First Premier Access H1099-027 (HMO-POS) (FL) | Tier 5 | Yes | No | None |
| Health First Emerald Plus H1099-028 (HMO) (FL) | Tier 5 | Yes | No | None |
| CareOregon Advantage Plus (HMO D-SNP) (H5859-001) (OR) | Tier 5 | Yes | No | 2 per 1 days |
| Fallon Medicare Plus Orange (HMO) (H9001-038) (MA) | Tier 5 | Yes | No | 60 per 30 days |
| Health First Value H1099-006 (HMO) (FL) | Tier 5 | Yes | No | None |
| Health First Classic H1099-001 (HMO-POS) (FL) | Tier 5 | Yes | No | None |
| Fallon Medicare Plus Green (HMO) (H9001-030) (segment 15) (MA) | Tier 5 | Yes | No | 60 per 30 days |
| Fallon Medicare Plus Green (HMO) (H9001-030) (segment 16) (MA) | Tier 5 | Yes | No | 60 per 30 days |
| Fallon Medicare Plus Green (HMO) (H9001-030) (segment 18) (MA) | Tier 5 | Yes | No | 60 per 30 days |
| Fallon Medicare Plus Blue (HMO) (H9001-031) (segment 15) (MA) | Tier 5 | Yes | No | 60 per 30 days |
| Fallon Medicare Plus Blue (HMO) (H9001-031) (segment 16) (MA) | Tier 5 | Yes | No | 60 per 30 days |
| Fallon Medicare Plus Blue (HMO) (H9001-031) (segment 18) (MA) | Tier 5 | Yes | No | 60 per 30 days |
One row per plan; 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=rilzabrutinib