Medicare drug coverage

Gammaked: 2027 Medicare Part D coverage

1,343 of 5,495 Part D plans (24%) list Gammaked on their 2027 formulary, the plan's list of covered drugs (down 10 points from 2026). 92% 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

Gammaked is number 150 by total Medicare Part D spending in 2024 ($270 million). 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.

Gammaked Part D coverage, 2026 and 2027
Measure20262027Change
Part D plans in the file5,5185,495-23
Plans that list it1,873 (34%)1,343 (24%)-10 points
Prior authorization (of plans that list it)1,758 (94%)1,231 (92%)-2 points
Step therapy (of plans that list it)0 (0%)0 (0%)no change
Quantity limit (of plans that list it)0 (0%)0 (0%)no change
Any of the three (of plans that list it)1,758 (94%)1,231 (92%)-2 points
Not listed or restricted (of all plans)5,403 (98%)5,383 (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 Gammaked'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.

Gammaked on every 2027 stand-alone Part D plan
Plan (PDP)Plan IDs2027 tier2027 limits
AARP Medicare Rx Preferred from UHC (PDP)39Not listedNot listed
AARP Medicare Rx Saver from UHC (PDP)34Not listedNot listed
Blue Medicare Rx Enhanced (PDP)1Not listedNot listed
Blue Medicare Rx Standard (PDP)1Not listedNot listed
Blue MedicareRx Essentials (PDP)1Not listedNot listed
Blue MedicareRx Plus (PDP)1Not listedNot listed
Blue MedicareRx Premier (PDP)1Tier 5PA
Blue MedicareRx Value (PDP)1Not listedNot listed
Blue MedicareRx Value Plus (PDP)1Tier 5PA
Blue Shield Rx Enhanced (PDP)1Not listedNot listed
Blue Shield Rx Plus (PDP)1Not listedNot listed
BlueMedicare Complete Rx (PDP)1Not listedNot listed
BlueMedicare Premier Rx (PDP)2Tier 5PA (1 of 2 IDs)
BlueMedicare Value Rx (PDP)1Tier 5PA
BlueRx Enhanced Plus (PDP)1Not listedNot listed
BlueRx Essential (PDP)1Not listedNot listed
HealthSpring Assurance Rx (PDP)35Not listedNot listed
HealthSpring Extra Rx (PDP)2Not listedNot listed
HealthSpring Extra RX (PDP)3Not listedNot listed
Horizon Medicare Blue Rx Enhanced (PDP)1Not listedNot listed
Horizon Medicare Blue Rx Standard (PDP)1Not listedNot listed
Humana Basic Rx Plan (PDP)34Not listedNot listed
Humana Premier Rx Plan (PDP)34Not listedNot listed
Humana Value Rx Plan (PDP)34Not listedNot listed
MedicareBlue Rx Standard (PDP)1Not listedNot listed
Prescription Blue Premium (PDP)1Not listedNot listed
Prescription Blue Select (PDP)1Not listedNot listed
SilverScript Choice (PDP)20Not listedNot listed
Wellcare Classic (PDP)34Not listedNot listed
Wellcare Value Script (PDP)34Not listedNot 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

Formulary tier

Gammaked formulary tier, 2026 and 2027
Tier2026 plans2027 plans
Tier 130 (2%)18 (1%)
Tier 21 (<1%)0 (0%)
Tier 43 (<1%)0 (0%)
Tier 51,819 (97%)1,325 (99%)
Tier 620 (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. 0 of them (0%) added prior authorization, step therapy, or a quantity limit for Gammaked, and 567 stopped listing it.

Gammaked: plans in both 2026 and 2027
Plan by planPlans
Same plan ID in both years4,380
Listed it in 2026, not in 2027567 (13%)
Listed it in 2027, not in 202612 (<1%)
Moved it to a higher tier7 (<1%)
Added prior authorization0 (0%)
Added step therapy0 (0%)
Added a quantity limit0 (0%)
Added at least one of the three0 (0%)
Removed at least one of the three0 (0%)
Plan IDs new in 20271,115
2026 plan IDs not in the 2027 file1,138

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 Gammaked 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.

States from most to least restrictive for Gammaked, 2027
RankState2027 plansNot listed or restrictedPrior auth or step therapyChange from 2026
1Tennessee157100%53%no change
2Alabama115100%50%no change
3New York215100%33%no change
Tied 4Arizona148100%29%no change
Tied 4Illinois133100%29%no change
6Pennsylvania324100%28%no change
Tied 7North Carolina177100%27%no change
Tied 7Arkansas86100%27%no change
Tied 7Ohio173100%27%no change
Tied 10Connecticut54100%26%no change
Tied 10Mississippi105100%26%no change
12Florida549100%25%no change
13New Hampshire25100%24%no change
14Indiana140100%23%no change
Tied 15South Carolina91100%22%no change
Tied 15Texas412100%22%no change
Tied 17Missouri171100%21%no change
Tied 17Utah53100%21%no change
Tied 17Massachusetts92100%21%no change
20Nebraska51100%20%no change
Tied 21New Mexico68100%19%no change
Tied 21Delaware43100%19%no change
Tied 21Oklahoma81100%19%no change
24Louisiana126100%18%no change
25Iowa64100%17%no change
Tied 26Maine52100%15%no change
Tied 26Michigan183100%15%no change
Tied 28Vermont14100%14%no change
Tied 28Rhode Island29100%14%no change
Tied 28New Jersey74100%14%no change
Tied 31Kansas84100%13%no change
Tied 31Kentucky123100%13%no change
33Idaho45100%7%no change
34Wisconsin97100%4%no change
35Minnesota63100%2%no change
Tied 36Alaska9100%0%no change
Tied 36Montana27100%0%no change
Tied 36North Dakota26100%0%no change
Tied 36South Dakota30100%0%no change
Tied 36West Virginia70100%0%no change
Tied 36Wyoming13100%0%no change
42Nevada10097%5%-3 points
43Oregon9296%30%no change
44Virginia14596%14%no change
45Georgia15195%25%no change
46Colorado10690%30%+3 points
47Hawaii5088%48%no change
48California39788%3%no change
49Washington11486%23%+1 point
50District of Columbia2186%5%-2 points
51Maryland4980%41%-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 Gammaked off or restrict it.

Gammaked coverage by parent organization, 2027
Parent organization2027 plans ↑List itRestrict it (of listing)Not listed or restrictedChange from 2026Plans that added a restriction
AIDS Healthcare Foundation10%none list it100%no change0
Alameda Alliance for Health10%none list it100%no change0
AllCare Health, Inc.10%none list it100%no change0
AlohaCare10%none list it100%no change0
BCBS MN, MT, NE, ND, WY, Wellmark IA and SD10%none list it100%no change0
CareOregon, Inc.1100%100%100%no change0
Contra Costa Health Services10%none list it100%no change0
DLP Marquette Health Plan, LLC10%none list it100%no change0
Health Plan of San Mateo10%none list it100%no change0
IMPERIAL COUNTY LOCAL HEALTH AUTHORITY10%none list it100%no change0
INLAND EMPIRE HEALTH PLAN10%none list it100%no change0
Itasca County1100%100%100%no change0
Kern Health Systems (KHS)10%none list it100%no change0
Local Initiative Health Authority for LA County10%none list it100%no change0
Muscogee Creek Nation10%none list it100%new in 20270
Orange County Health Authority10%none list it100%no change0
SAN FRANCISCO HEALTH AUTHORITY10%none list it100%no change0
SAN JOAQUIN COUNTY HEALTH COMMISSION10%none list it100%no change0
SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH10%none list it100%no change0
SANTA CLARA COUNTY HEALTH AUTHORITY10%none list it100%no change0
SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN10%none list it100%no change0
Samaritan Health Services, Inc.10%none list it100%no change0
The Schroer Group, Inc.10%none list it100%no change0
Ventura County Medi-Cal Managed Care Commission10%none list it100%no change0
BayCare Health System, Inc.2100%100%100%no change0

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

Try it on your own data today.

Free to start. Most teams are using it the same day.