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.
Actonel (Risedronate)
Found on the formularies of 4867 of 5499 Medicare Part D plans in this dataset · Tiers 1–5 · prior authorization on 1 plans (0%) · step therapy on 301 (6%) · quantity limits on 3887 (80%), 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 |
|---|---|---|---|---|
| Hamaspik Medicare Choice (HMO D-SNP) (H0034-002) (NY) | Tier 1 | No | No | 4 per 28 days |
| MetroPlus UltraCare (HMO D-SNP) (H0423-007) (NY) | Tier 1 | No | Yes | None |
| Aetna Medicare Signature (HMO) (H0523-022) (CA) | Tiers 1–4 | No | No | 4 per 28 days |
| Aetna Medicare Signature (HMO) (H0523-065) (CA) | Tiers 1–4 | No | No | 4 per 28 days |
| Aetna Medicare Signature Extra (HMO-POS) (H0523-070) (CA) | Tiers 1–4 | No | No | 4 per 28 days |
| Aetna Medicare Prime (HMO-POS) (H0523-073) (CA) | Tiers 1–4 | No | No | 4 per 28 days |
| Aetna Medicare Prime (HMO-POS) (H0523-075) (CA) | Tiers 1–4 | No | No | 4 per 28 days |
| Aetna Medicare Prime (HMO-POS) (H0523-085) (CA) | Tiers 1–4 | No | No | 4 per 28 days |
| Aetna Medicare Signature Extra (HMO) (H0523-086) (CA) | Tiers 1–4 | No | No | 4 per 28 days |
| Aetna Medicare Prime (HMO-POS) (H0523-088) (CA) | Tiers 1–4 | No | No | 4 per 28 days |
| Aetna Medicare Signature Extra (HMO) (H0523-089) (CA) | Tiers 1–4 | No | No | 4 per 28 days |
| Aetna Medicare Signature Extra (HMO) (H0523-091) (CA) | Tiers 1–4 | No | No | 4 per 28 days |
| Aetna Medicare Signature Extra (HMO) (H0523-092) (CA) | Tiers 1–4 | No | No | 4 per 28 days |
| Aetna Medicare Signature Care (HMO-POS) (H0628-001) (OH) | Tiers 1–4 | No | No | 4 per 28 days |
| Aetna Medicare Signature Extra (HMO-POS) (H0628-003) (OH) | Tiers 1–4 | No | No | 4 per 28 days |
| Aetna Medicare Signature Care (HMO-POS) (H0628-005) (OH) | Tiers 1–4 | No | No | 4 per 28 days |
| Aetna Medicare Signature Extra (HMO-POS) (H0628-007) (KY) | Tiers 1–4 | No | No | 4 per 28 days |
| Aetna Medicare Signature (HMO-POS) (H0628-008) (KY) | Tiers 1–4 | No | No | 4 per 28 days |
| Aetna Medicare Signature (HMO-POS) (H0628-010) (KY) | Tiers 1–4 | No | No | 4 per 28 days |
| Aetna Medicare HIDE (HMO D-SNP) (H0628-012) (KY) | Tiers 1–4 | No | No | 4 per 28 days |
| Aetna Medicare Dual Care (HMO D-SNP) (H0628-013) (OH) | Tiers 1–4 | No | No | 4 per 28 days |
| Aetna Medicare Signature Care (HMO-POS) (H0628-017) (OH) | Tiers 1–4 | No | No | 4 per 28 days |
| Aetna Medicare Signature (HMO-POS) (H0628-021) (OH) | Tiers 1–4 | No | No | 4 per 28 days |
| Aetna Medicare Signature (HMO-POS) (H0628-024) (KY) | Tiers 1–4 | No | No | 4 per 28 days |
| Aetna Medicare Chronic Care (HMO C-SNP) (H0628-036) (OH) | Tiers 1–4 | No | No | 4 per 28 days |
One row per plan — showing 25 of 4867 plans; a Yes means the flag applies to at least one form/strength on that plan.
Acquisition cost (NADAC): $12.81755/unit — price effective 08/19/2026
Source: CMS Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — data current through 2026-08-31 (CMS release 2026-08-26, refreshed monthly) · NADAC price effective 08/19/2026 (per-NDC last change, not a data-staleness date). 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=risedronate