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.

SIVEXTRO (Tedizolid)

On Part D plan formularies — with restrictions

Found on the formularies of 1698 of 5499 Medicare Part D plans in this dataset · Tiers 1–6 · prior authorization on 814 plans (48%) · quantity limits on 557 (33%), 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 1698 of 5499 Medicare Part D plans in this dataset, but prior authorization appears on 814 of those 1698 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
Hamaspik Medicare Choice (HMO D-SNP) (H0034-002) (NY) Tier 1 Yes No None
Community Care's Partnership Program (HMO D-SNP) (H2034-001) (WI) Tier 1 No No None
SecureBlue (HMO D-SNP) (H2425-001) (MN) Tier 1 Yes No None
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) (H3251-029) (NM) Tier 1 Yes No None
Platino Blindao (HMO D-SNP) (H5774-028) (PR) Tier 1 Yes No None
Platino Enlace (HMO D-SNP) (H5774-035) (PR) Tier 1 Yes No None
PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 1) (PR) Tier 1 Yes No None
PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 2) (PR) Tier 1 Yes No None
PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 3) (PR) Tier 1 Yes No None
PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 4) (PR) Tier 1 Yes No None
PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 5) (PR) Tier 1 Yes No None
PLATINO PLUS (HMO D-SNP) (H5774-043) (segment 1) (PR) Tier 1 Yes No None
PLATINO PLUS (HMO D-SNP) (H5774-043) (segment 2) (PR) Tier 1 Yes No None
PLATINO PLUS (HMO D-SNP) (H5774-043) (segment 3) (PR) Tier 1 Yes No None
PLATINO PLUS (HMO D-SNP) (H5774-043) (segment 4) (PR) Tier 1 Yes No None
PLATINO PLUS (HMO D-SNP) (H5774-043) (segment 5) (PR) Tier 1 Yes No None
Horizon NJ TotalCare (HMO D-SNP) (H8298-001) (NJ) Tier 1 Yes No None
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) (H8634-009) (NM) Tier 1 Yes No None
Gold Coast Health Plan Total Care Advantage (HMO D-SNP) (H9623-001) (CA) Tier 1 Yes No None
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) (H9706-002) (TX) Tier 1 Yes No None
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) (H8554-003) (OK) Tier 1 Yes No None
Hamaspik Medicare Select (HMO D-SNP) (H0034-001) (NY) Tier 1 Yes No None
CalOptima Health OneCare Complete (HMO D-SNP) (H5433-001) (CA) Tier 2 Yes No 6 per 30 days
Select Health Medicare Essential (HMO) (H1994-001) (UT) Tier 4 No No 6 per 30 days
Select Health Medicare Essential (HMO) (H1994-012) (NV) Tier 4 No No 6 per 30 days

One row per plan — showing 25 of 1698 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=tedizolid
InsureWith Assistant
Hi! I can help you understand drug coverage, formulary tiers, prior authorization, and more. What would you like to know?