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.

Klisyri (Tirbanibulin)

Microtubule Inhibitor

On Part D plan formularies — with restrictions

Found on the formularies of 578 of 5499 Medicare Part D plans in this dataset · Tiers 1–5 · prior authorization on 56 plans (10%) · step therapy on 403 (70%) · quantity limits on 407 (70%), 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 578 of 5499 Medicare Part D plans in this dataset, but prior authorization appears on 56 of those 578 plans (for at least one form/strength); step therapy on 403. 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
Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) (H1587-001) (AR) Tier 1 No Yes 5 per 5 days
Mass General Brigham One Care (HMO D-SNP) (H1611-001) (MA) Tier 1 Yes No None
Abilis Health Community (HMO I-SNP) (H2400-002) (KY,TN) Tier 1 No Yes 5 per 5 days
PrimeWest Senior Health Complete (HMO D-SNP) (H2416-001) (MN) Tier 1 No Yes 5 per 5 days
Prime Health Complete (HMO D-SNP) (H2926-001) (MN) Tier 1 No Yes 5 per 5 days
AllCare Advantage Redwood Rx (HMO D-SNP) (H3810-023) (OR) Tier 1 No Yes 5 per 5 days
Elevate Medicare Choice (HMO D-SNP) (H5608-001) (CO) Tier 1 No Yes 5 per 5 days
Nascentia Dual Advantage (HMO D-SNP) (H9066-003) (NY) Tier 1 No Yes 5 per 5 days
Alterwood Advantage Dual Secure (HMO D-SNP) (H9306-004) (MD) Tier 1 No Yes 5 per 5 days
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) (H1526-004) (FL) Tier 1 No Yes 5 per 5 days
Texas Independence Health Plan, Inc. (HMO I-SNP) (H5015-001) (TX) Tier 1 No Yes 5 per 5 days
Texas Independence Community Plan (HMO I-SNP) (H5015-002) (TX) Tier 1 No Yes 5 per 5 days
Tribute Select (HMO-POS I-SNP) (H1587-003) (AR) Tier 1 No Yes 5 per 5 days
ATRIO Special Needs Plan (HMO D-SNP) (H3814-007) (OR) Tier 1 No Yes 5 per 5 days
ATRIO Special Needs Plan (HMO D-SNP) (H3814-030) (OR) Tier 1 No Yes 5 per 5 days
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) (H4869-014) (AZ) Tier 1 No Yes 5 per 5 days
CommuniCare Advantage ISNP (HMO I-SNP) (H3727-002) (segment 2) (MD) Tier 1 No Yes 5 per 5 days
Alterwood Advantage Dual Value (HMO D-SNP) (H9306-007) (MD) Tier 1 No Yes 5 per 5 days
Valor Health Plan (HMO I-SNP) (H1119-001) (OH) Tier 1 No Yes 5 per 5 days
CommuniCare Advantage ISNP (HMO I-SNP) (H3727-002) (segment 3) (OH) Tier 1 No Yes 5 per 5 days
WV Senior Advantage (HMO I-SNP) (H9153-001) (WV) Tier 1 No Yes 5 per 5 days
Abilis Health (HMO I-SNP) (H2400-001) (KY,TN) Tier 1 No Yes 5 per 5 days
CommuniCare Advantage ISNP (HMO I-SNP) (H3727-002) (segment 1) (IN) Tier 1 No Yes 5 per 5 days
Nascentia Skilled Nursing Facility (HMO I-SNP) (H9066-002) (NY) Tier 1 No Yes 5 per 5 days

One row per plan — showing 25 of 578 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=tirbanibulin
InsureWith Assistant
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