Medicare drug coverage
Cosentyx: 2027 Medicare Part D coverage
3,926 of 5,495 Part D plans (71%) list Cosentyx on their 2027 formulary, the plan's list of covered drugs (down 5 points from 2026). 97% of those require prior authorization, step therapy, or a quantity limit. Plan counts include both Medicare Advantage plans with drug coverage (5,172 MA-PD) and stand-alone drug plans (323 PDP).
License: a US government work, in the public domain (Public Domain Mark 1.0).
Data only, not plan advice. Confirm on Medicare.gov Plan Finder or 1-800-MEDICARE.
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.
2027 compared with 2026
Cosentyx is number 56 by total Medicare Part D spending in 2024 ($1.4 billion). Plans that list it most often put it on tier 5 (a tier is the cost level a plan puts a drug on; a lower tier usually costs less). Counts use 6 RxNorm products for this name.
| Measure | 2026 | 2027 | Change |
|---|---|---|---|
| Part D plans in the file | 5,518 | 5,495 | -23 |
| Plans that list it | 4,174 (76%) | 3,926 (71%) | -5 points |
| Prior authorization (of plans that list it) | 4,069 (97%) | 3,824 (97%) | no change |
| Step therapy (of plans that list it) | 0 (0%) | 0 (0%) | no change |
| Quantity limit (of plans that list it) | 3,804 (91%) | 3,560 (91%) | no change |
| Any of the three (of plans that list it) | 4,069 (97%) | 3,824 (97%) | no change |
| Not listed or restricted (of all plans) | 5,413 (98%) | 5,393 (98%) | no change |
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
Every 2027 stand-alone drug plan
Each stand-alone Part D plan (PDP) with Cosentyx's 2027 tier and limits. CMS files a PDP once per region, so one plan name can have several plan IDs; the row shows the tier and limits most of them use. Medicare Advantage drug plans are local: pick a state for its plan-by-plan table.
| Plan (PDP) | Plan IDs | 2027 tier | 2027 limits |
|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP) | 39 | Tier 5 | PA, QL |
| AARP Medicare Rx Saver from UHC (PDP) | 34 | Tier 5 | PA, QL |
| Blue Medicare Rx Enhanced (PDP) | 1 | Tier 5 | PA, QL |
| Blue Medicare Rx Standard (PDP) | 1 | Tier 5 | PA, QL |
| Blue MedicareRx Essentials (PDP) | 1 | Tier 5 | PA, QL |
| Blue MedicareRx Plus (PDP) | 1 | Tier 5 | PA, QL |
| Blue MedicareRx Premier (PDP) | 1 | Not listed | Not listed |
| Blue MedicareRx Value (PDP) | 1 | Tier 5 | PA, QL |
| Blue MedicareRx Value Plus (PDP) | 1 | Not listed | Not listed |
| Blue Shield Rx Enhanced (PDP) | 1 | Tier 5 | PA |
| Blue Shield Rx Plus (PDP) | 1 | Tier 5 | PA |
| BlueMedicare Complete Rx (PDP) | 1 | Tier 5 | PA, QL |
| BlueMedicare Premier Rx (PDP) | 2 | Not listed | Not listed (1 of 2 IDs) |
| BlueMedicare Value Rx (PDP) | 1 | Not listed | Not listed |
| BlueRx Enhanced Plus (PDP) | 1 | Tier 5 | PA, QL |
| BlueRx Essential (PDP) | 1 | Tier 5 | PA, QL |
| HealthSpring Assurance Rx (PDP) | 35 | Tier 5 | PA, QL |
| HealthSpring Extra Rx (PDP) | 2 | Tier 5 | PA, QL |
| HealthSpring Extra RX (PDP) | 3 | Tier 5 | PA, QL |
| Horizon Medicare Blue Rx Enhanced (PDP) | 1 | Tier 5 | PA, QL |
| Horizon Medicare Blue Rx Standard (PDP) | 1 | Tier 5 | PA, QL |
| Humana Basic Rx Plan (PDP) | 34 | Tier 5 | PA, QL |
| Humana Premier Rx Plan (PDP) | 34 | Tier 5 | PA, QL |
| Humana Value Rx Plan (PDP) | 34 | Tier 5 | PA, QL |
| MedicareBlue Rx Standard (PDP) | 1 | Tier 5 | PA, QL |
| Prescription Blue Premium (PDP) | 1 | Tier 5 | PA, QL |
| Prescription Blue Select (PDP) | 1 | Tier 5 | PA, QL |
| SilverScript Choice (PDP) | 20 | Not listed | Not listed |
| Wellcare Classic (PDP) | 34 | Tier 5 | PA, QL |
| Wellcare Value Script (PDP) | 34 | Tier 5 | PA, QL |
Source: CMS 2027 Part D formulary file (basic drugs and plan information), as of October 8, 2026. Publisher page
Source: CMS CY2027 landscape file (states and parent organizations), as of September 30, 2026. Publisher page
By dosage form
The 2027 formularies list Cosentyx by dosage form. A plan can cover one form and leave off or restrict another, so each form is counted on its own, across all 5,495 plans.
| Dosage form | Plans that list it | Restricted (of listing) | Most common tier |
|---|---|---|---|
| Auto-injector | 3,926 (71%) | 3,824 (97%) | Tier 5 |
| Injection | 0 (0%) | none list it | none list it |
| Prefilled syringe | 3,926 (71%) | 3,824 (97%) | Tier 5 |
Source: CMS 2027 Part D formulary file (basic drugs and plan information), as of October 8, 2026. Publisher page
Formulary tier
| Tier | 2026 plans | 2027 plans |
|---|---|---|
| Tier 1 | 138 (3%) | 106 (3%) |
| Tier 2 | 1 (<1%) | 0 (0%) |
| Tier 4 | 50 (1%) | 46 (1%) |
| Tier 5 | 3,985 (95%) | 3,774 (96%) |
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
Plan by plan, 2026 to 2027
4,380 plan IDs are in both files. 5 of them (<1%) added prior authorization, step therapy, or a quantity limit for Cosentyx, and 9 stopped listing it.
| Plan by plan | Plans |
|---|---|
| Same plan ID in both years | 4,380 |
| Listed it in 2026, not in 2027 | 9 (<1%) |
| Listed it in 2027, not in 2026 | 29 (1%) |
| Moved it to a higher tier | 33 (1%) |
| Added prior authorization | 0 (0%) |
| Added step therapy | 0 (0%) |
| Added a quantity limit | 5 (<1%) |
| Added at least one of the three | 5 (<1%) |
| Removed at least one of the three | 7 (<1%) |
| Plan IDs new in 2027 | 1,115 |
| 2026 plan IDs not in the 2027 file | 1,138 |
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
States from most to least restrictive
Share of 2027 Part D plans offered in each state that leave Cosentyx off the formulary or list it with prior authorization, step therapy, or a quantity limit. 41 states tie for the highest share, 100%; Maryland ranks last at 80%. States at the same share are ordered by the prior authorization or step therapy share; states equal on both shares share a rank, marked Tied.
| Rank | State | 2027 plans | Not listed or restricted | Prior auth or step therapy | Change from 2026 |
|---|---|---|---|---|---|
| Tied 1 | Montana | 27 | 100% | 100% | no change |
| Tied 1 | Wyoming | 13 | 100% | 100% | no change |
| 3 | Idaho | 45 | 100% | 93% | no change |
| 4 | Alaska | 9 | 100% | 89% | no change |
| Tied 5 | North Dakota | 26 | 100% | 88% | no change |
| Tied 5 | Wisconsin | 97 | 100% | 88% | no change |
| 7 | Minnesota | 63 | 100% | 87% | no change |
| Tied 8 | Nevada | 100 | 100% | 86% | no change |
| Tied 8 | Vermont | 14 | 100% | 86% | no change |
| Tied 10 | West Virginia | 70 | 100% | 81% | no change |
| Tied 10 | New Mexico | 68 | 100% | 81% | no change |
| 12 | Kentucky | 123 | 100% | 79% | no change |
| 13 | Michigan | 183 | 100% | 78% | no change |
| Tied 14 | Pennsylvania | 324 | 100% | 77% | no change |
| Tied 14 | South Dakota | 30 | 100% | 77% | no change |
| Tied 14 | Oklahoma | 81 | 100% | 77% | no change |
| Tied 17 | Massachusetts | 92 | 100% | 76% | no change |
| Tied 17 | New Hampshire | 25 | 100% | 76% | no change |
| Tied 17 | Rhode Island | 29 | 100% | 76% | no change |
| 20 | Maine | 52 | 100% | 75% | no change |
| Tied 21 | Delaware | 43 | 100% | 74% | no change |
| Tied 21 | South Carolina | 91 | 100% | 74% | no change |
| Tied 21 | Utah | 53 | 100% | 74% | no change |
| 24 | Texas | 412 | 100% | 73% | no change |
| Tied 25 | Mississippi | 105 | 100% | 72% | no change |
| Tied 25 | Louisiana | 126 | 100% | 72% | no change |
| 27 | New Jersey | 74 | 100% | 70% | no change |
| 28 | Arizona | 148 | 100% | 69% | no change |
| Tied 29 | Florida | 549 | 100% | 68% | no change |
| Tied 29 | Indiana | 140 | 100% | 68% | no change |
| Tied 29 | North Carolina | 177 | 100% | 68% | no change |
| Tied 32 | Iowa | 64 | 100% | 67% | no change |
| Tied 32 | Ohio | 173 | 100% | 67% | no change |
| Tied 32 | Nebraska | 51 | 100% | 67% | no change |
| 35 | Arkansas | 86 | 100% | 65% | no change |
| 36 | Tennessee | 157 | 100% | 64% | no change |
| Tied 37 | Illinois | 133 | 100% | 60% | no change |
| Tied 37 | Kansas | 84 | 100% | 60% | no change |
| 39 | Missouri | 171 | 100% | 58% | no change |
| 40 | Alabama | 115 | 100% | 56% | no change |
| 41 | Connecticut | 54 | 100% | 54% | no change |
| 42 | Washington | 114 | 97% | 70% | -1 point |
| 43 | New York | 215 | 97% | 55% | no change |
| 44 | Virginia | 145 | 96% | 74% | no change |
| 45 | Oregon | 92 | 96% | 64% | no change |
| 46 | Georgia | 151 | 95% | 70% | no change |
| 47 | Colorado | 106 | 90% | 60% | +3 points |
| 48 | California | 397 | 88% | 79% | no change |
| 49 | Hawaii | 50 | 88% | 40% | no change |
| 50 | District of Columbia | 21 | 86% | 67% | -2 points |
| 51 | Maryland | 49 | 80% | 43% | -4 points |
Source: CMS CY2027 landscape file (states and parent organizations), as of September 30, 2026. Publisher page
Source: CMS 2027 Part D formulary file (basic drugs and plan information), as of October 8, 2026. Publisher page
By parent organization
164 parent organizations offer 2027 Part D plans. Humana Inc. has the most, 884, and 100% of them leave Cosentyx off or restrict it.
| Parent organization | 2027 plans ↑ | List it | Restrict it (of listing) | Not listed or restricted | Change from 2026 | Plans that added a restriction |
|---|---|---|---|---|---|---|
| BrightSpring Health Services, Inc. | 2 | 100% | 100% | 100% | no change | 0 |
| Community Health Group | 2 | 100% | 100% | 100% | no change | 0 |
| Community Health Plan of Washington | 2 | 100% | 100% | 100% | no change | 0 |
| Denver Health and Hospital Authority | 2 | 100% | 100% | 100% | no change | 0 |
| Elevance Health, Inc. & BCBSMA & BCBSRI & BCBSVT | 2 | 0% | none list it | 100% | no change | 0 |
| Elite Health Systems, Inc. | 2 | 100% | 100% | 100% | no change | 0 |
| Group Health Cooperative of Eau Claire | 2 | 100% | 100% | 100% | no change | 0 |
| Hamaspik of Rockland County, Inc. | 2 | 100% | 100% | 100% | no change | 0 |
| ISNP Holdings, LLC | 2 | 100% | 100% | 100% | no change | 0 |
| Kansas Superior Select | 2 | 100% | 100% | 100% | no change | 0 |
| Missouri Healthcare Advisors, LLC | 2 | 100% | 100% | 100% | no change | 0 |
| MultiCare Health Systems | 2 | 100% | 100% | 100% | new in 2027 | 0 |
| NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND | 2 | 0% | none list it | 100% | no change | 0 |
| PrimeWest Rural MN Health Care Access Initiative | 2 | 100% | 100% | 100% | no change | 0 |
| Regency ISNP Holdings LLC | 2 | 100% | 100% | 100% | no change | 0 |
| Select Founders, LLC | 2 | 100% | 100% | 100% | no change | 0 |
| Sentara Health Care (SHC) | 2 | 100% | 100% | 100% | no change | 0 |
| South Country Health Alliance | 2 | 100% | 100% | 100% | no change | 0 |
| The Regents of the University of California | 2 | 100% | 100% | 100% | no change | 0 |
| Troy Holdings, Inc. | 2 | 100% | 100% | 100% | no change | 0 |
| Associated Care Ventures, Inc. | 3 | 100% | 100% | 100% | no change | 0 |
| Aultman Health Foundation | 3 | 100% | 100% | 100% | no change | 0 |
| Banner Health | 3 | 100% | 100% | 100% | no change | 0 |
| Bexar County Hospital District | 3 | 100% | 100% | 100% | no change | 0 |
| Blue Cross Blue Shield of Nebraska | 3 | 100% | 100% | 100% | no change | 0 |
Source: CMS CY2027 landscape file (states and parent organizations), as of September 30, 2026. Publisher page
Source: CMS 2027 Part D formulary file (basic drugs and plan information), as of October 8, 2026. Publisher page
Near it by Part D spending
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 CY2027 landscape file (states and parent organizations), as of September 30, 2026. Publisher page
Source: CMS Medicare Part D Spending by Drug, 2024 data, as of June 25, 2026. Publisher page