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.
JANUMET (Sitagliptin and Metformin)
Dipeptidyl Peptidase 4 Inhibitor
Found on the formularies of 5235 of 5499 Medicare Part D plans in this dataset · Tiers 1–6 · prior authorization on 7 plans (0%) · quantity limits on 5113 (98%), 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 | 60 per 30 days |
| MetroPlus UltraCare (HMO D-SNP) (H0423-007) (NY) | Tier 1 | No | No | 60 per 30 days |
| Mass General Brigham SCO (HMO D-SNP) (H0777-001) (MA) | Tier 1 | No | No | 60 per 30 days |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) (H1225-003) (MD) | Tier 1 | No | No | 60 per 30 days |
| CCA One Care (HMO D-SNP) (H1486-001) (MA) | Tier 1 | No | No | 60 per 30 days |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) (H1587-001) (AR) | Tier 1 | No | No | 60 per 30 days |
| Mass General Brigham One Care (HMO D-SNP) (H1611-001) (MA) | Tier 1 | No | No | 60 per 30 days |
| Select Health Medicare Essential (HMO) (H1994-001) (UT) | Tiers 1–3 | No | No | 60 per 30 days |
| Select Health Medicare Essential (HMO) (H1994-012) (NV) | Tiers 1–3 | No | No | 60 per 30 days |
| Select Health Medicare Dual (HMO D-SNP) (H1994-015) (UT) | Tiers 1–3 | No | No | 60 per 30 days |
| Select Health Medicare Essential (HMO) (H1994-017) (UT) | Tiers 1–3 | No | No | 60 per 30 days |
| Select Health Medicare + Kroger (HMO) (H1994-021) (NV) | Tiers 1–3 | No | No | 60 per 30 days |
| Select Health Medicare + Kroger (HMO) (H1994-022) (UT) | Tiers 1–3 | No | No | 60 per 30 days |
| Select Health Medicare Essential (HMO) (H1994-027) (CO) | Tiers 1–3 | No | No | 60 per 30 days |
| Select Health Medicare Essential (HMO) (H1994-029) (CO) | Tiers 1–3 | No | No | 60 per 30 days |
| Select Health Medicare + Kroger (HMO) (H1994-030) (CO) | Tiers 1–3 | No | No | 60 per 30 days |
| Select Health Medicare Flex (HMO) (H1994-031) (CO) | Tiers 1–3 | No | No | 60 per 30 days |
| Select Health Medicare + Kroger (HMO) (H1994-034) (CO) | Tiers 1–3 | No | No | 60 per 30 days |
| Select Health Medicare Active (HMO) (H1994-035) (CO) | Tiers 1–3 | No | No | 60 per 30 days |
| Select Health Medicare Dual (HMO D-SNP) (H1994-040) (NV) | Tiers 1–3 | No | No | 60 per 30 days |
| Select Health Medicare Wellness (HMO) (H1994-044) (NV) | Tiers 1–3 | No | No | 60 per 30 days |
| Alameda Alliance Wellness (HMO D-SNP) (H2035-001) (CA) | Tier 1 | No | No | 60 per 30 days |
| Senior Whole Health SCO (HMO D-SNP) (H2224-001) (MA) | Tier 1 | No | No | 60 per 30 days |
| Senior Whole Health SCO NHC (HMO D-SNP) (H2224-003) (MA) | Tier 1 | No | No | 60 per 30 days |
| CCA Senior Care Options (HMO D-SNP) (H2225-001) (MA) | Tier 1 | No | No | 60 per 30 days |
One row per plan — showing 25 of 5235 plans; a Yes means the flag applies to at least one form/strength on that plan.
Acquisition cost (NADAC): $5.01947/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=sitagliptin-and-metformin