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.

Aveed (Testosterone Undecanoate)

On Part D plan formularies — with restrictions

Found on the formularies of 18 of 5499 Medicare Part D plans in this dataset · Tiers 4–5 · prior authorization on 18 plans (100%), 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 18 of 5499 Medicare Part D plans in this dataset, but prior authorization appears on 18 of those 18 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 →

Plan	Tier	Prior Auth	Step Therapy	Qty Limit
Keystone 65 Select Rx (HMO) (H3952-049) (PA)	Tiers 4–5	Yes	No	None
Security Blue HMO-POS Standard (HMO-POS) (H3957-045) (segment 1) (PA)	Tier 4	Yes	No	None
Security Blue HMO-POS Standard (HMO-POS) (H3957-045) (segment 2) (PA)	Tier 4	Yes	No	None
Keystone 65 Preferred Rx (HMO) (H3952-045) (PA)	Tiers 4–5	Yes	No	None
Keystone 65 Select Rx (HMO) (H3952-051) (PA)	Tiers 4–5	Yes	No	None
Keystone 65 Preferred Rx (HMO) (H3952-020) (PA)	Tiers 4–5	Yes	No	None
Freedom Blue PPO Select (PPO) (H3916-024) (PA)	Tier 4	Yes	No	None
Security Blue HMO-POS Deluxe (HMO-POS) (H3957-046) (segment 1) (PA)	Tier 4	Yes	No	None
Security Blue HMO-POS Deluxe (HMO-POS) (H3957-046) (segment 2) (PA)	Tier 4	Yes	No	None
Freedom Blue PPO Standard (PPO) (H3916-015) (PA)	Tier 4	Yes	No	None
Personal Choice 65 Rx (PPO) (H3909-001) (PA)	Tiers 4–5	Yes	No	None
Personal Choice 65 Rx (PPO) (H3909-009) (PA)	Tiers 4–5	Yes	No	None
Freedom Blue PPO Select (PPO) (H3916-022) (PA)	Tier 4	Yes	No	None
Freedom Blue PPO Deluxe (PPO) (H3916-005) (PA)	Tier 4	Yes	No	None
Freedom Blue PPO Classic (PPO) (H3916-002) (PA)	Tier 4	Yes	No	None
Freedom Blue PPO Classic (PPO) (H3916-001) (PA)	Tier 4	Yes	No	None
Blue Rx PDP Complete (PDP) (S5593-003)	Tier 4	Yes	No	None
Blue Rx PDP Plus (PDP) (S5593-002)	Tier 4	Yes	No	None

One row per plan; a Yes means the flag applies to at least one form/strength on that plan.

Acquisition cost (NADAC): $8.96964/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=testosterone-undecanoate