Medicare drug coverage
Epclusa in Pennsylvania: 2027 Part D coverage
32 of 324 Part D plans offered in Pennsylvania (10%) list Epclusa on their 2027 formulary, down 30 points from 2026. 100% of those require prior authorization, step therapy, or a quantity limit.
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Pennsylvania compared with the nation
100% of the 324 Part D plans offered in Pennsylvania leave Epclusa off the 2027 formulary or restrict it, against 98% nationally (2 points higher). Pennsylvania ranks 11 of 51 from most to least restrictive. A plan offered in several states counts in each.
Epclusa in every state and by parent organization
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
2027 compared with 2026
| Measure | 2026 | 2027 | Change |
|---|---|---|---|
| Part D plans in the file | 319 | 324 | +5 |
| Plans that list it | 127 (40%) | 32 (10%) | -30 points |
| Prior authorization (of plans that list it) | 127 (100%) | 32 (100%) | no change |
| Step therapy (of plans that list it) | 0 (0%) | 0 (0%) | no change |
| Quantity limit (of plans that list it) | 61 (48%) | 32 (100%) | +52 points |
| Any of the three (of plans that list it) | 127 (100%) | 32 (100%) | no change |
| Not listed or restricted (of all plans) | 319 (100%) | 324 (100%) | 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
Formulary tier
| Tier | 2026 plans | 2027 plans |
|---|---|---|
| Tier 5 | 127 (100%) | 32 (100%) |
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
| Plan by plan | Plans |
|---|---|
| Same plan id in both years | 268 |
| Listed it in 2026, not in 2027 | 80 (30%) |
| Listed it in 2027, not in 2026 | 0 (0%) |
| Moved it to a higher 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 | 56 |
| 2026 plan ids not in the 2027 file | 51 |
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
Run it in Rivvi
Which 2027 plans near you dropped or restricted Epclusa?
Tier changes and new prior auth, step therapy or quantity limits, plan by plan, before open enrollment.
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Epclusa 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
- California88% restrict or leave off, no changeCA
- Colorado90% restrict or leave off, +3 pointsCO
- Connecticut100% restrict or leave off, no changeCT
- Delaware100% restrict or leave off, no changeDE
- District of Columbia86% restrict or leave off, -2 pointsDC
- Florida100% restrict or leave off, no changeFL
- Georgia95% restrict or leave off, no changeGA
- Hawaii88% restrict or leave off, +1 pointHI
- Idaho100% restrict or leave off, no changeID
- 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
- Maryland80% restrict or leave off, -5 pointsMD
- 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
- Oregon96% restrict or leave off, no changeOR
- 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
- Virginia96% restrict or leave off, no changeVA
- Washington97% 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
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
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