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.

Aubagio (Teriflunomide)

Pyrimidine Synthesis Inhibitor

On Part D plan formularies — with restrictions

Found on the formularies of 4294 of 5499 Medicare Part D plans in this dataset · Tiers 1–5 · prior authorization on 3163 plans (74%) · quantity limits on 4067 (95%), 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 4294 of 5499 Medicare Part D plans in this dataset, but prior authorization appears on 3163 of those 4294 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
Mass General Brigham SCO (HMO D-SNP) (H0777-001) (MA) Tier 1 Yes No None
FHCP Medicare Classic (HMO) (H1035-040) (FL) Tier 1 Yes No None
Mass General Brigham One Care (HMO D-SNP) (H1611-001) (MA) Tier 1 Yes No None
Community Care's Partnership Program (HMO D-SNP) (H2034-001) (WI) Tier 1 No No None
Alameda Alliance Wellness (HMO D-SNP) (H2035-001) (CA) Tier 1 Yes No 30 per 30 days
SeniorCare Complete (HMO D-SNP) (H2419-001) (MN) Tier 1 Yes No 30 per 30 days
Sentara Community Complete Select (HMO D-SNP) (H2563-020) (VA) Tier 1 Yes No 30 per 30 days
Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) (H3127-001) (MI) Tier 1 Yes No 30 per 30 days
PruittHealth Premier D-SNP (HMO D-SNP) (H3291-002) (GA) Tier 1 No No 30 per 30 days
Simpra Advantage Dual Care (PPO D-SNP) (H4091-002) (AL) Tier 1 No No 30 per 30 days
HAP CareSource MI Coordinated Health (HMO D-SNP) (H4193-001) (MI) Tier 1 Yes No 30 per 30 days
Sentara Community Complete (HMO D-SNP) (H4499-001) (VA) Tier 1 Yes No 30 per 30 days
Tufts Health One Care (HMO D-SNP) (H5314-001) (MA) Tier 1 No No None
Tufts Health One Care CW (HMO D-SNP) (H5314-002) (MA) Tier 1 No No None
CalOptima Health OneCare Complete (HMO D-SNP) (H5433-001) (CA) Tier 1 Yes No 30 per 30 days
AbilityCare (HMO D-SNP) (H5703-001) (MN) Tier 1 Yes No 30 per 30 days
Platino Blindao (HMO D-SNP) (H5774-028) (PR) Tier 1 No No 30.00 per 30 days
Platino Enlace (HMO D-SNP) (H5774-035) (PR) Tier 1 No No 30.00 per 30 days
PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 1) (PR) Tier 1 No No 30.00 per 30 days
PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 2) (PR) Tier 1 No No 30.00 per 30 days
PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 3) (PR) Tier 1 No No 30.00 per 30 days
PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 4) (PR) Tier 1 No No 30.00 per 30 days
PLATINO ADVANCE (HMO D-SNP) (H5774-041) (segment 5) (PR) Tier 1 No No 30.00 per 30 days
PLATINO PLUS (HMO D-SNP) (H5774-043) (segment 1) (PR) Tier 1 No No 30.00 per 30 days
PLATINO PLUS (HMO D-SNP) (H5774-043) (segment 2) (PR) Tier 1 No No 30.00 per 30 days

One row per plan — showing 25 of 4294 plans; a Yes means the flag applies to at least one form/strength on that plan.

Acquisition cost (NADAC): $0.24153/unit — price effective 08/19/2026

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) · 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

Machine access — this tool is available as structured data for AI assistants and agents:
GET https://insurewith.ai/tools/drug-coverage/data.json?drug=teriflunomide
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