Medicare drug coverage
Entresto: 2027 Medicare Part D coverage
2,507 of 5,495 Part D plans (46%) list Entresto on their 2027 formulary, the plan's list of covered drugs (down 53 points from 2026). 71% 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).
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2027 compared with 2026
Entresto is number 11 by total Medicare Part D spending in 2024 ($4 billion). Plans that list it most often put it on tier 3 (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 | 5,517 (>99%) | 2,507 (46%) | -53 points |
| Prior authorization (of plans that list it) | 98 (2%) | 91 (4%) | +2 points |
| Step therapy (of plans that list it) | 0 (0%) | 0 (0%) | no change |
| Quantity limit (of plans that list it) | 4,642 (84%) | 1,789 (71%) | -13 points |
| Any of the three (of plans that list it) | 4,642 (84%) | 1,789 (71%) | -13 points |
| Not listed or restricted (of all plans) | 4,643 (84%) | 4,777 (87%) | +3 points |
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 Entresto'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 | Not listed | Not listed |
| AARP Medicare Rx Saver from UHC (PDP) | 34 | Not listed | Not listed |
| Blue Medicare Rx Enhanced (PDP) | 1 | Not listed | Not listed |
| Blue Medicare Rx Standard (PDP) | 1 | Not listed | Not listed |
| Blue MedicareRx Essentials (PDP) | 1 | Not listed | Not listed |
| Blue MedicareRx Plus (PDP) | 1 | Not listed | Not listed |
| Blue MedicareRx Premier (PDP) | 1 | Tier 3 | QL |
| Blue MedicareRx Value (PDP) | 1 | Not listed | Not listed |
| Blue MedicareRx Value Plus (PDP) | 1 | Tier 3 | QL |
| Blue Shield Rx Enhanced (PDP) | 1 | Not listed | Not listed |
| Blue Shield Rx Plus (PDP) | 1 | Not listed | Not listed |
| BlueMedicare Complete Rx (PDP) | 1 | Not listed | Not listed |
| BlueMedicare Premier Rx (PDP) | 2 | Tier 3 | QL (1 of 2 IDs) |
| BlueMedicare Value Rx (PDP) | 1 | Tier 3 | QL |
| BlueRx Enhanced Plus (PDP) | 1 | Not listed | Not listed |
| BlueRx Essential (PDP) | 1 | Not listed | Not listed |
| HealthSpring Assurance Rx (PDP) | 35 | Tier 3 | QL |
| HealthSpring Extra Rx (PDP) | 2 | Tier 3 | QL |
| HealthSpring Extra RX (PDP) | 3 | Tier 3 | QL |
| Horizon Medicare Blue Rx Enhanced (PDP) | 1 | Not listed | Not listed |
| Horizon Medicare Blue Rx Standard (PDP) | 1 | Not listed | Not listed |
| Humana Basic Rx Plan (PDP) | 34 | Not listed | Not listed |
| Humana Premier Rx Plan (PDP) | 34 | Not listed | Not listed |
| Humana Value Rx Plan (PDP) | 34 | Not listed | Not listed |
| MedicareBlue Rx Standard (PDP) | 1 | Not listed | Not listed |
| Prescription Blue Premium (PDP) | 1 | Tier 3 | QL |
| Prescription Blue Select (PDP) | 1 | Tier 3 | QL |
| SilverScript Choice (PDP) | 20 | Tier 3 | None |
| Wellcare Classic (PDP) | 34 | Not listed | Not listed |
| Wellcare Value Script (PDP) | 34 | Not listed | Not listed |
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 Entresto 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 |
|---|---|---|---|
| Oral pellet | 2,507 (46%) | 1,789 (71%) | Tier 3 |
| Oral tablet | 36 (1%) | 36 (100%) | Tier 4 |
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 | 163 (3%) | 37 (1%) |
| Tier 2 | 52 (1%) | 38 (2%) |
| Tier 3 | 5,281 (96%) | 2,298 (92%) |
| Tier 4 | 0 (0%) | 134 (5%) |
| Tier 6 | 21 (<1%) | 0 (0%) |
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. 3 of them (<1%) added prior authorization, step therapy, or a quantity limit for Entresto, and 2,554 stopped listing it.
| Plan by plan | Plans |
|---|---|
| Same plan ID in both years | 4,380 |
| Listed it in 2026, not in 2027 | 2,554 (58%) |
| Listed it in 2027, not in 2026 | 0 (0%) |
| Moved it to a higher tier | 112 (3%) |
| Added prior authorization | 0 (0%) |
| Added step therapy | 0 (0%) |
| Added a quantity limit | 3 (<1%) |
| Added at least one of the three | 3 (<1%) |
| Removed at least one of the three | 0 (0%) |
| 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 Entresto off the formulary or list it with prior authorization, step therapy, or a quantity limit. 6 states tie for the highest share, 100%; Massachusetts ranks last at 61%. 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 | Hawaii | 50 | 100% | 0% | +15 points |
| Tied 1 | Idaho | 45 | 100% | 0% | +6 points |
| Tied 1 | Montana | 27 | 100% | 0% | +6 points |
| Tied 1 | New Hampshire | 25 | 100% | 0% | +8 points |
| Tied 1 | Vermont | 14 | 100% | 0% | +8 points |
| Tied 1 | Wyoming | 13 | 100% | 0% | +5 points |
| 7 | Maryland | 49 | 98% | 0% | +17 points |
| 8 | Oregon | 92 | 97% | 0% | +16 points |
| Tied 9 | Washington | 114 | 95% | 0% | +16 points |
| Tied 9 | Arizona | 148 | 95% | 0% | +2 points |
| Tied 11 | New Mexico | 68 | 94% | 0% | +3 points |
| Tied 11 | California | 397 | 94% | 0% | +14 points |
| Tied 11 | Tennessee | 157 | 94% | 0% | no change |
| Tied 14 | Michigan | 183 | 93% | 0% | +1 point |
| Tied 14 | Wisconsin | 97 | 93% | 0% | +2 points |
| Tied 16 | Oklahoma | 81 | 91% | 0% | -2 points |
| Tied 16 | Indiana | 140 | 91% | 0% | no change |
| Tied 16 | Colorado | 106 | 91% | 0% | +14 points |
| Tied 19 | Louisiana | 126 | 90% | 0% | +3 points |
| Tied 19 | Alabama | 115 | 90% | 0% | +2 points |
| Tied 19 | Maine | 52 | 90% | 0% | +3 points |
| Tied 19 | Rhode Island | 29 | 90% | 0% | +3 points |
| Tied 19 | Virginia | 145 | 90% | 0% | +4 points |
| Tied 24 | Kentucky | 123 | 89% | 0% | -1 point |
| Tied 24 | Alaska | 9 | 89% | 0% | no change |
| Tied 24 | Minnesota | 63 | 89% | 0% | +1 point |
| Tied 24 | Utah | 53 | 89% | 0% | +3 points |
| 28 | Pennsylvania | 324 | 88% | 21% | no change |
| Tied 29 | North Dakota | 26 | 88% | 0% | -3 points |
| Tied 29 | North Carolina | 177 | 88% | 0% | -1 point |
| Tied 29 | Ohio | 173 | 88% | 0% | +2 points |
| Tied 29 | Mississippi | 105 | 88% | 0% | +2 points |
| Tied 29 | Florida | 549 | 88% | 0% | +2 points |
| 34 | Delaware | 43 | 86% | 7% | no change |
| Tied 35 | Nebraska | 51 | 86% | 0% | -3 points |
| Tied 35 | Georgia | 151 | 86% | 0% | +7 points |
| Tied 35 | District of Columbia | 21 | 86% | 0% | +10 points |
| 38 | South Carolina | 91 | 85% | 0% | +1 point |
| Tied 39 | Iowa | 64 | 84% | 0% | -4 points |
| Tied 39 | Texas | 412 | 84% | 0% | -2 points |
| Tied 39 | Illinois | 133 | 84% | 0% | +2 points |
| 42 | Arkansas | 86 | 83% | 0% | -3 points |
| 43 | West Virginia | 70 | 81% | 11% | -7 points |
| 44 | New York | 215 | 81% | 5% | +3 points |
| 45 | Connecticut | 54 | 80% | 0% | +1 point |
| 46 | New Jersey | 74 | 78% | 0% | -2 points |
| Tied 47 | South Dakota | 30 | 77% | 0% | -6 points |
| Tied 47 | Missouri | 171 | 77% | 0% | -2 points |
| 49 | Nevada | 100 | 76% | 0% | -1 point |
| 50 | Kansas | 84 | 73% | 0% | -2 points |
| 51 | Massachusetts | 92 | 61% | 0% | -3 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 Entresto 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 | 0% | none list it | 100% | no change | 0 |
| Community Health Group | 2 | 0% | none list it | 100% | no change | 0 |
| Community Health Plan of Washington | 2 | 100% | 100% | 100% | no change | 0 |
| Denver Health and Hospital Authority | 2 | 0% | none list it | 100% | no change | 0 |
| Elevance Health, Inc. & BCBSMA & BCBSRI & BCBSVT | 2 | 100% | 100% | 100% | no change | 0 |
| Elite Health Systems, Inc. | 2 | 0% | none list it | 100% | no change | 0 |
| Group Health Cooperative of Eau Claire | 2 | 100% | 100% | 100% | no change | 0 |
| Hamaspik of Rockland County, Inc. | 2 | 0% | none list it | 100% | no change | 0 |
| ISNP Holdings, LLC | 2 | 0% | none list it | 100% | no change | 0 |
| Kansas Superior Select | 2 | 0% | none list it | 100% | no change | 0 |
| Missouri Healthcare Advisors, LLC | 2 | 0% | none list it | 100% | no change | 0 |
| MultiCare Health Systems | 2 | 0% | none list it | 100% | new in 2027 | 0 |
| NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND | 2 | 100% | 100% | 100% | no change | 0 |
| PrimeWest Rural MN Health Care Access Initiative | 2 | 0% | none list it | 100% | no change | 0 |
| Regency ISNP Holdings LLC | 2 | 0% | none list it | 100% | no change | 0 |
| Select Founders, LLC | 2 | 0% | none list it | 100% | no change | 0 |
| Sentara Health Care (SHC) | 2 | 0% | none list it | 100% | no change | 0 |
| South Country Health Alliance | 2 | 0% | none list it | 100% | no change | 0 |
| The Regents of the University of California | 2 | 0% | none list it | 100% | no change | 0 |
| Troy Holdings, Inc. | 2 | 0% | none list it | 100% | no change | 0 |
| Associated Care Ventures, Inc. | 3 | 0% | none list it | 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 | 0% | none list it | 100% | no change | 0 |
| Blue Cross Blue Shield of Nebraska | 3 | 0% | none list it | 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