Medicare drug coverage
Actemra in Idaho: 2027 Part D coverage
No 2027 formulary of the 45 Part D plans offered in Idaho lists Actemra, per the CMS 2027 formulary file (each plan's list of covered drugs). Nationally, 132 of 5,495 plans list it in 2027. Plan counts include both Medicare Advantage plans with drug coverage (37 MA-PD) and stand-alone drug plans (8 PDP).
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For pharmacies and agencies: check a whole drug list against 2027 formularies.
Upload your patient list or your book of clients and Rivvi checks each drug against the CMS 2027 formulary files, plan by plan, so you see tier changes and new limits before the next refill or open enrollment. Free to start. HIPAA BAA included.
Every 2027 plan in Idaho
Each Part D plan offered in Idaho, with Actemra's 2026 and 2027 tier and its 2027 limits. A tier is the cost level a plan puts a drug on; a lower tier usually costs less. Enter a ZIP to see only the plans offered in that county.
PA is prior authorization (the plan must approve it first), ST is step therapy (try another drug first), and QL is a quantity limit. D-SNP, C-SNP, and I-SNP are Special Needs Plans: for people with both Medicare and Medicaid, with certain chronic conditions, or who live in a nursing home or need that level of care. Plans are listed by plan ID.
| Plan | Plan ID | Type | 2026 tier | 2027 tier | 2027 PA / ST / QL | Change |
|---|---|---|---|---|---|---|
| UHC Nursing Home Plan ID-F1 (PPO I-SNP) | H0710-074-000 | MA-PD (PPO I-SNP) | New plan ID | Not listed | Not listed | New plan ID in 2027 |
| True Blue Rx 32PSP (HMO) | H1350-032-000 | MA-PD (HMO) | Not listed | Not listed | Not listed | Not listed either year |
| True Blue Rx 33 (HMO) | H1350-033-000 | MA-PD (HMO) | Not listed | Not listed | Not listed | Not listed either year |
| True Blue Rx 34 (HMO) | H1350-034-000 | MA-PD (HMO) | Not listed | Not listed | Not listed | Not listed either year |
| True Blue Rx 35PSP (HMO) | H1350-035-000 | MA-PD (HMO) | Not listed | Not listed | Not listed | Not listed either year |
| True Blue Rx 36 (HMO) | H1350-036-000 | MA-PD (HMO) | Not listed | Not listed | Not listed | Not listed either year |
| True Blue Rx 37 (HMO) | H1350-037-000 | MA-PD (HMO) | Not listed | Not listed | Not listed | Not listed either year |
| UHC Complete Care Support ID-1A (PPO C-SNP) | H2001-050-000 | MA-PD (PPO C-SNP) | Not listed | Not listed | Not listed | Not listed either year |
| AARP Medicare Advantage from UHC ID-0001 (PPO) | H2406-044-000 | MA-PD (PPO) | Not listed | Not listed | Not listed | Not listed either year |
| AARP Medicare Advantage from UHC ID-0003 (PPO) | H2406-065-000 | MA-PD (PPO) | Not listed | Not listed | Not listed | Not listed either year |
| Humana Gold Plus H2486-005 (HMO) | H2486-005-000 | MA-PD (HMO) | Not listed | Not listed | Not listed | Not listed either year |
| St. Luke's Advantage Rx 01 (HMO) | H3012-001-000 | MA-PD (HMO) | New plan ID | Not listed | Not listed | New plan ID in 2027 |
| St. Luke's Advantage Rx 02 (HMO) | H3012-002-000 | MA-PD (HMO) | New plan ID | Not listed | Not listed | New plan ID in 2027 |
| St. Luke's Advantage Rx 03 (HMO) | H3012-003-000 | MA-PD (HMO) | New plan ID | Not listed | Not listed | New plan ID in 2027 |
| PacificSource Medicare River Select Rx (HMO-POS) | H3864-049-000 | MA-PD (HMO-POS) | New plan ID | Not listed | Not listed | New plan ID in 2027 |
| UHC Dual Complete ID-Y1 (HMO-POS D-SNP) | H4032-001-000 | MA-PD (HMO-POS D-SNP) | Not listed | Not listed | Not listed | Not listed either year |
| UHC Dual Complete ID-QV1 (HMO-POS D-SNP) | H4032-002-000 | MA-PD (HMO-POS D-SNP) | Not listed | Not listed | Not listed | Not listed either year |
| UHC Dual Complete ID-YL (HMO-POS D-SNP) | H4032-003-000 | MA-PD (HMO-POS D-SNP) | New plan ID | Not listed | Not listed | New plan ID in 2027 |
| American Health Advantage of Idaho (HMO I-SNP) | H4232-003-000 | MA-PD (HMO I-SNP) | Not listed | Not listed | Not listed | Not listed either year |
| AARP Medicare Advantage from UHC ID-0005 (HMO-POS) | H4604-012-000 | MA-PD (HMO-POS) | Not listed | Not listed | Not listed | Not listed either year |
| AARP Medicare Advantage from UHC ID-0006 (HMO-POS) | H4604-013-000 | MA-PD (HMO-POS) | Not listed | Not listed | Not listed | Not listed either year |
| AARP Medicare Advantage from UHC ID-0007 (HMO-POS) | H4604-014-000 | MA-PD (HMO-POS) | Not listed | Not listed | Not listed | Not listed either year |
| AARP Medicare Advantage from UHC ID-0008 (HMO-POS) | H4604-020-000 | MA-PD (HMO-POS) | Not listed | Not listed | Not listed | Not listed either year |
| AARP Medicare Advantage from UHC ID-0009 (HMO-POS) | H4604-022-000 | MA-PD (HMO-POS) | Not listed | Not listed | Not listed | Not listed either year |
| UHC Complete Care ID-12 (HMO-POS C-SNP) | H4604-024-000 | MA-PD (HMO-POS C-SNP) | Not listed | Not listed | Not listed | Not listed either year |
Data only, not plan advice. Confirm on Medicare.gov Plan Finder or 1-800-MEDICARE.
By dosage form
The 2027 formularies list Actemra by dosage form. A plan can cover one form and leave off or restrict another, so each form is counted on its own.
| Dosage form | Plans that list it | Restricted (of listing) | Most common tier |
|---|---|---|---|
| Auto-injector | 0 (0%) | none list it | none list it |
| Injection | 0 (0%) | none list it | none list it |
| Prefilled syringe | 0 (0%) | none list it | none list it |
Idaho compared with the nation
No Part D plan offered in Idaho lists Actemra on its 2027 formulary, so all 45 leave it off. Nationally, 132 of 5,495 plans list it, and 100% of all plans leave it off or restrict it. Actemra is on no 2027 formulary in 41 of 51 states, Idaho among them. A plan offered in several states counts in each.
2027 compared with 2026
| Measure | 2026 | 2027 | Change |
|---|---|---|---|
| Part D plans in the file | 50 | 45 | -5 |
| Plans that list it | 0 (0%) | 0 (0%) | no change |
| Prior authorization (of plans that list it) | 0 | 0 | no plans list it either year |
| Step therapy (of plans that list it) | 0 | 0 | no plans list it either year |
| Quantity limit (of plans that list it) | 0 | 0 | no plans list it either year |
| Any of the three (of plans that list it) | 0 | 0 | no plans list it either year |
| Not listed or restricted (of all plans) | 50 (100%) | 45 (100%) | no change |
Formulary tier
No plan lists Actemra in either year, so there is no tier to show.
Plan by plan, 2026 to 2027
| Plan by plan | Plans |
|---|---|
| Same plan ID in both years | 36 |
| Listed it in 2026, not in 2027 | 0 (0%) |
| Listed it in 2027, not in 2026 | 0 (0%) |
| Moved it to a higher tier | 0 (0%) |
| Moved it to a lower tier | 0 (0%) |
| Added prior authorization | 0 (0%) |
| Added step therapy | 0 (0%) |
| Added a quantity limit | 0 (0%) |
| Added at least one of the three | 0 (0%) |
| Removed at least one of the three | 0 (0%) |
| Plan IDs new in 2027 | 9 |
| 2026 plan IDs not in the 2027 file | 14 |
The CMS summary has no count of tier moves down, so "Moved it to a lower tier" is counted from the plan rows on this page: plans with the same plan ID in both years that list Actemra both years.
Actemra in other states
- Alabama100% restrict or leave off, no changeAL
- Alaska100% restrict or leave off, no changeAK
- Arizona100% restrict or leave off, no changeAZ
- Arkansas100% restrict or leave off, no changeAR
- California100% restrict or leave off, no changeCA
- Colorado100% restrict or leave off, no changeCO
- Connecticut100% restrict or leave off, no changeCT
- Delaware100% restrict or leave off, no changeDE
- District of Columbia100% restrict or leave off, no changeDC
- Florida100% restrict or leave off, no changeFL
- Georgia100% restrict or leave off, no changeGA
- Hawaii100% restrict or leave off, no changeHI
- Illinois100% restrict or leave off, no changeIL
- Indiana100% restrict or leave off, no changeIN
- Iowa100% restrict or leave off, no changeIA
- Kansas100% restrict or leave off, no changeKS
- Kentucky100% restrict or leave off, no changeKY
- Louisiana100% restrict or leave off, no changeLA
- Maine100% restrict or leave off, no changeME
- Maryland100% restrict or leave off, no changeMD
- Massachusetts100% restrict or leave off, no changeMA
- Michigan100% restrict or leave off, no changeMI
- Minnesota100% restrict or leave off, no changeMN
- Mississippi100% restrict or leave off, no changeMS
- Missouri100% restrict or leave off, no changeMO
- Montana100% restrict or leave off, no changeMT
- Nebraska100% restrict or leave off, no changeNE
- Nevada100% restrict or leave off, no changeNV
- New Hampshire100% restrict or leave off, no changeNH
- New Jersey100% restrict or leave off, no changeNJ
- New Mexico100% restrict or leave off, no changeNM
- New York100% restrict or leave off, no changeNY
- North Carolina100% restrict or leave off, no changeNC
- North Dakota100% restrict or leave off, no changeND
- Ohio100% restrict or leave off, no changeOH
- Oklahoma100% restrict or leave off, no changeOK
- Oregon100% restrict or leave off, no changeOR
- Pennsylvania100% restrict or leave off, no changePA
- Rhode Island100% restrict or leave off, no changeRI
- South Carolina100% restrict or leave off, no changeSC
- South Dakota100% restrict or leave off, no changeSD
- Tennessee100% restrict or leave off, no changeTN
- Texas100% restrict or leave off, no changeTX
- Utah100% restrict or leave off, no changeUT
- Vermont100% restrict or leave off, no changeVT
- Virginia100% restrict or leave off, no changeVA
- Washington100% restrict or leave off, no changeWA
- West Virginia100% restrict or leave off, no changeWV
- Wisconsin100% restrict or leave off, no changeWI
- Wyoming100% restrict or leave off, no changeWY
About this data
A plan here is one Part D plan as the CMS formulary files list it: contract, plan, and segment. That covers Medicare Advantage plans with drug coverage and stand-alone drug plans. A plan lists a drug when its formulary has a row for any RxNorm product of that name. When it has several, the row with the lowest tier is the one counted, and restricted means that row has prior authorization, step therapy, or a quantity limit.
A plan with no row for the drug counts as not listing it. That can be a product the file codes another way, so read a low count as a lookup result, not a coverage decision. A state counts every plan the CMS landscape file offers there. Parent organizations are named as CMS names them. The drug list is the top 200 by total Part D spending.
Source: CMS 2027 Part D formulary file (basic drugs and plan information), as of October 8, 2026. Publisher page
Source: CMS 2026 Part D formulary file (basic drugs and plan information), as of September 30, 2026. Publisher page
Source: CMS CY2027 landscape file (states and parent organizations), as of September 30, 2026. Publisher page
Source: CMS CY2026 landscape file, as of September 25, 2025. Publisher page
Source: CMS Medicare Part D Spending by Drug, 2024 data, as of June 25, 2026. Publisher page
Source: US Census Bureau 2020 ZCTA to county relationship file (ZIP lookup), as of December 9, 2021. Publisher page