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.
Sovaldi (Sofosbuvir)
Hepatitis C Virus Nucleotide Analog NS5B Polymerase Inhibitor
Found on the formularies of 192 of 5499 Medicare Part D plans in this dataset · Tiers 1–5 · prior authorization on 93 plans (48%) · quantity limits on 25 (13%), 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 |
|---|---|---|---|---|
| Community Care's Partnership Program (HMO D-SNP) (H2034-001) (WI) | Tier 1 | Yes | No | None |
| CalOptima Health OneCare Complete (HMO D-SNP) (H5433-001) (CA) | Tier 2 | Yes | No | 28 per 28 days |
| Kaiser Permanente Senior Advantage LA, Orange Co. (HMO) (H0524-003) (CA) | Tier 5 | No | No | None |
| Kaiser Permanente Senior Advantage Enhanced Solano (HMO) (H0524-008) (CA) | Tier 5 | No | No | None |
| Kaiser Permanente Senior Advantage Inland Empire (HMO) (H0524-015) (CA) | Tier 5 | No | No | None |
| Kaiser Permanente Sr Adv Enhanced Marin San Mateo (HMO) (H0524-031) (CA) | Tier 5 | No | No | None |
| Kaiser Permanente Senior Advantage Ventura (HMO) (H0524-034) (CA) | Tier 5 | No | No | None |
| Kaiser Permanente Senior Advantage Enhanced Kern (HMO) (H0524-035) (CA) | Tier 5 | No | No | None |
| Kaiser Permanente Senior Advantage Basic Kern (HMO) (H0524-036) (CA) | Tier 5 | No | No | None |
| Kaiser Permanente Senior Advantage San Diego (HMO) (H0524-037) (CA) | Tier 5 | No | No | None |
| Kaiser Permanente Sr Adv Enhanced Santa Clara (HMO) (H0524-039) (CA) | Tier 5 | No | No | None |
| Kaiser Permanente Senior Advantage Enhanced Stanis (HMO) (H0524-040) (CA) | Tier 5 | No | No | None |
| Kaiser Permanente Senior Advantage Basic Stanis (HMO) (H0524-041) (CA) | Tier 5 | No | No | None |
| Kaiser Permanente Senior Advantage Basic SnJoaq (HMO) (H0524-043) (CA) | Tier 5 | No | No | None |
| Kaiser Permanente Senior Advantage Basic Fresno (HMO) (H0524-046) (CA) | Tier 5 | No | No | None |
| Kaiser Permanente Sr Advantage Basic Sac., Sonoma (HMO) (H0524-051) (CA) | Tier 5 | No | No | None |
| Kaiser Permanente Senior Advantage Santa Cruz (HMO) (H0524-054) (CA) | Tier 5 | No | No | None |
| Kaiser Permanente Senior Advantage Basic Alameda (HMO) (H0524-059) (CA) | Tier 5 | No | No | None |
| Kaiser Permanente Senior Advantage Basic SF (HMO) (H0524-060) (CA) | Tier 5 | No | No | None |
| Kaiser Permanente Sr Adv Basic Contra Costa (HMO) (H0524-061) (CA) | Tier 5 | No | No | None |
| Kaiser Permanente Sr Adv Basic Santa Clara (HMO) (H0524-062) (CA) | Tier 5 | No | No | None |
| Kaiser Permanente Senior Advantage Basic Solano (HMO) (H0524-063) (CA) | Tier 5 | No | No | None |
| Kaiser Permanente Senior Advantage Basic San Mateo (HMO) (H0524-065) (CA) | Tier 5 | No | No | None |
| Kaiser Permanente Sr Advantage LA, Orange Value (HMO) (H0524-078) (CA) | Tier 5 | No | No | None |
| Kaiser Permanente Sr Advantage Inland Empire Value (HMO) (H0524-081) (CA) | Tier 5 | No | No | None |
One row per plan — showing 25 of 192 plans; 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=sofosbuvir