Medicare drug coverage

Ingrezza: 2027 Medicare Part D coverage

1,925 of 5,495 Part D plans (35%) list Ingrezza on their 2027 formulary, the plan's list of covered drugs (down 15 points from 2026). 95% 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.

2027 compared with 2026

Ingrezza is number 26 by total Medicare Part D spending in 2024 ($2 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 9 RxNorm products for this name.

Ingrezza Part D coverage, 2026 and 2027
Measure	2026	2027	Change
Part D plans in the file	5,518	5,495	-23
Plans that list it	2,748 (50%)	1,925 (35%)	-15 points
Prior authorization (of plans that list it)	2,649 (96%)	1,829 (95%)	-1 point
Step therapy (of plans that list it)	0 (0%)	0 (0%)	no change
Quantity limit (of plans that list it)	2,604 (95%)	1,781 (93%)	-2 points
Any of the three (of plans that list it)	2,649 (96%)	1,829 (95%)	-1 point
Not listed or restricted (of all plans)	5,419 (98%)	5,399 (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

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.

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Formulary tier

Ingrezza formulary tier, 2026 and 2027
Tier	2026 plans	2027 plans
Tier 1	117 (4%)	49 (3%)
Tier 2	2 (0%)	1 (0%)
Tier 4	47 (2%)	44 (2%)
Tier 5	2,582 (94%)	1,831 (95%)

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 Ingrezza, and 557 stopped listing it.

Ingrezza: plans in both 2026 and 2027
Plan by plan	Plans
Same plan ID in both years	4,380
Listed it in 2026, not in 2027	557 (13%)
Listed it in 2027, not in 2026	89 (2%)
Moved it to a higher tier	15 (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	1 (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 Ingrezza off the formulary or list it with prior authorization, step therapy, or a quantity limit. 42 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 Ingrezza, 2027
Rank	State	2027 plans	Not listed or restricted	Prior auth or step therapy	Change from 2026
1	Nevada	100	100%	54%	no change
2	Wisconsin	97	100%	47%	no change
3	New Mexico	68	100%	46%	no change
Tied 4	Ohio	173	100%	44%	no change
Tied 4	Indiana	140	100%	44%	no change
6	Arizona	148	100%	43%	no change
Tied 7	Maine	52	100%	42%	no change
Tied 7	North Dakota	26	100%	42%	no change
Tied 7	Iowa	64	100%	42%	no change
10	Rhode Island	29	100%	41%	no change
Tied 11	Texas	412	100%	40%	no change
Tied 11	Delaware	43	100%	40%	no change
Tied 13	Kentucky	123	100%	39%	no change
Tied 13	Louisiana	126	100%	39%	no change
Tied 15	New Jersey	74	100%	38%	no change
Tied 15	Idaho	45	100%	38%	no change
17	Connecticut	54	100%	37%	no change
18	Mississippi	105	100%	35%	no change
19	North Carolina	177	100%	34%	no change
Tied 20	Alaska	9	100%	33%	no change
Tied 20	Nebraska	51	100%	33%	no change
Tied 20	Oklahoma	81	100%	33%	no change
Tied 23	New Hampshire	25	100%	32%	no change
Tied 23	Minnesota	63	100%	32%	no change
Tied 23	Missouri	171	100%	32%	no change
Tied 26	Florida	549	100%	31%	no change
Tied 26	South Carolina	91	100%	31%	no change
Tied 28	Utah	53	100%	30%	no change
Tied 28	South Dakota	30	100%	30%	no change
Tied 28	West Virginia	70	100%	30%	no change
Tied 31	Massachusetts	92	100%	29%	no change
Tied 31	Illinois	133	100%	29%	no change
33	Arkansas	86	100%	28%	no change
34	New York	215	100%	27%	no change
35	Kansas	84	100%	25%	no change
36	Wyoming	13	100%	23%	no change
37	Vermont	14	100%	21%	no change
38	Tennessee	157	100%	20%	no change
39	Montana	27	100%	19%	no change
40	Pennsylvania	324	100%	18%	no change
Tied 41	Alabama	115	100%	15%	no change
Tied 41	Michigan	183	100%	15%	no change
43	Washington	114	97%	41%	-1 point
44	Oregon	92	96%	36%	no change
45	Virginia	145	96%	34%	no change
46	Georgia	151	95%	28%	no change
47	Colorado	106	90%	26%	+3 points
48	California	397	88%	49%	no change
49	Hawaii	50	88%	20%	no change
50	District of Columbia	21	86%	38%	-2 points
51	Maryland	49	80%	14%	-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 Ingrezza off or restrict it.

Ingrezza coverage by parent organization, 2027
Parent organization	2027 plans ↑	List it	Restrict it (of listing)	Not listed or restricted	Change from 2026
AIDS Healthcare Foundation	1	100%	100%	100%	no change
Alameda Alliance for Health	1	100%	100%	100%	no change
AllCare Health, Inc.	1	100%	100%	100%	no change
AlohaCare	1	100%	100%	100%	no change
BCBS MN, MT, NE, ND, WY, Wellmark IA and SD	1	0%	none list it	100%	no change
CareOregon, Inc.	1	100%	100%	100%	no change
Contra Costa Health Services	1	100%	100%	100%	no change
DLP Marquette Health Plan, LLC	1	100%	100%	100%	no change
Health Plan of San Mateo	1	100%	100%	100%	no change
IMPERIAL COUNTY LOCAL HEALTH AUTHORITY	1	100%	100%	100%	no change
INLAND EMPIRE HEALTH PLAN	1	100%	100%	100%	no change
Itasca County	1	0%	none list it	100%	no change
Kern Health Systems (KHS)	1	100%	100%	100%	no change
Local Initiative Health Authority for LA County	1	0%	none list it	100%	no change
Muscogee Creek Nation	1	0%	none list it	100%	new in 2027
Orange County Health Authority	1	100%	100%	100%	no change
SAN FRANCISCO HEALTH AUTHORITY	1	100%	100%	100%	no change
SAN JOAQUIN COUNTY HEALTH COMMISSION	1	100%	100%	100%	no change
SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH	1	100%	100%	100%	no change
SANTA CLARA COUNTY HEALTH AUTHORITY	1	100%	100%	100%	no change
SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN	1	100%	100%	100%	no change
Samaritan Health Services, Inc.	1	0%	none list it	100%	no change
The Schroer Group, Inc.	1	100%	100%	100%	no change
Ventura County Medi-Cal Managed Care Commission	1	0%	none list it	100%	no change
BayCare Health System, Inc.	2	0%	none list it	100%	no change

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

2027 compared with 2026

For pharmacies and agencies: check a whole drug list against 2027 formularies.

Formulary tier

Plan by plan, 2026 to 2027

States from most to least restrictive

By parent organization

Near it by Part D spending

About this data

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