Compare Medicare formulary restrictions.
Select a drug and plan. View tier, prior authorization, step therapy, quantity limits, and changes between CMS releases.
PlanTierPAStepQty limitPeriod delta
Banner Medicare Advantage Dual (HMO D-SNP)AZ · H4931-007 · Banner - University Care Advantage · formulary 00026442
Tier 3
YES
NO
6 units / 28 days
No field change in compared periods
AARP Medicare Advantage from UHC CA-0024 (PPO)CA · H0294-032 · Unitedhealthcare Insurance Company · formulary 00026002
Tier 3
NO
NO
3 units / 28 days
Prior authorization removedChanged since prior period
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)CA · H0524-003 · Kaiser Foundation Hp, Inc. · formulary 00026405
Tier 4
NO
NO
—
Prior authorization removedChanged since prior period
DEVOTED CORE 001 FL (HMO)FL · H1290-001 · Devoted Health Plan Of Florida, Inc. · formulary 00026120
Tier 3
YES
NO
6 units / 28 days
No field change in compared periods
Molina Medicare Choice Care (HMO)IL · H2715-003 · Molina Healthcare Of Illinois Inc · formulary 00026144
Tier 3
YES
NO
6 units / 28 days
No field change in compared periods
Blue Medicare PPO Enhanced (PPO)NC · H3404-003 · Blue Cross And Blue Shield Of North Carolina · formulary 00026205
Tier 3
YES
NO
6 units / 28 days
No field change in compared periods
EmblemHealth VIP Gold (HMO)NY · H3330-021 · Health Insurance Plan Of Greater New York · formulary 00026229
Tier 3
YES
NO
6 units / 28 days
No field change in compared periods
MedMutual Advantage Select (PPO)OH · H4497-001 · Medical Mutual Of Ohio · formulary 00026242
Tier 3
YES
NO
6 units / 28 days
No field change in compared periods
Providence Medicare Timber + Rx (HMO)OR · H9047-054 · Providence Health Assurance · formulary 00026069
Tier 3
YES
NO
0.11 units / 1 days
No field change in compared periods
Freedom Blue PPO Classic (PPO)PA · H3916-001 · Highmark Senior Health Company · formulary 00026017
Tier 3
YES
NO
3 units / 28 days
No field change in compared periods
Blue Cross Medicare Advantage Choice Premier (PPO)TX · H1666-003 · Hcsc Insurance Services Company · formulary 00026267
Tier 3
YES
NO
6 units / 28 days
No field change in compared periods
SOURCE PERIOD: 2026 Q1 · March 2026 release · PUBLISHED 2026-04-08 · Open CMS quarterly Part D source · Drug names normalized with RxNorm. Confirm current coverage with the plan.
27 published formulary changes
The loaded proof corpus contains 1,128 current drug-formulary records and 1,125 records from the prior CMS release.
Repatha for AARP Medicare Advantage from UHC CA-0024 (PPO): Prior authorization removed. Each result displays the CMS source fields and reporting period. Confirm current coverage with the plan.
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