Medicare drug coverage

Januvia: 2027 Medicare Part D coverage

956 of 5,495 Part D plans (17%) list Januvia on their 2027 formulary, down 73 points from 2026. 86% of those require prior authorization, step therapy, or a quantity limit.

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2027 compared with 2026

Januvia is number 12 by total Medicare Part D spending in 2024 ($3.8 billion). Plans that list it most often put it on tier 3. Counts use 4 RxNorm products for this name.

Januvia Part D coverage, 2026 and 2027
Measure20262027Change
Part D plans in the file5,5185,495-23
Plans that list it4,968 (90%)956 (17%)-73 points
Prior authorization (of plans that list it)7 (0%)7 (1%)+1 point
Step therapy (of plans that list it)0 (0%)91 (10%)+10 points
Quantity limit (of plans that list it)4,801 (97%)823 (86%)-11 points
Any of the three (of plans that list it)4,801 (97%)823 (86%)-11 points
Not listed or restricted (of all plans)5,351 (97%)5,362 (98%)+1 point

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

Januvia formulary tier, 2026 and 2027
Tier2026 plans2027 plans
Tier 1131 (3%)23 (2%)
Tier 238 (1%)268 (28%)
Tier 34,760 (96%)665 (70%)
Tier 59 (0%)0 (0%)
Tier 630 (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. 102 of them (2%) added prior authorization, step therapy, or a quantity limit for Januvia, and 3,211 stopped listing it.

Januvia: plans in both 2026 and 2027
Plan by planPlans
Same plan id in both years4,380
Listed it in 2026, not in 20273,211 (73%)
Listed it in 2027, not in 202618 (0%)
Moved it to a higher tier11 (0%)
Added prior authorization0 (0%)
Added step therapy83 (2%)
Added a quantity limit19 (0%)
Added at least one of the three102 (2%)
Removed at least one of the three1 (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 Januvia off the formulary or list it with prior authorization, step therapy, or a quantity limit. Pennsylvania ranks first at 100%, with 23% of its plans using prior authorization or step therapy; Maryland ranks last at 80%. Ties break on the prior authorization or step therapy share.

States from most to least restrictive for Januvia, 2027
RankState2027 plansNot listed or restrictedPrior auth or step therapyChange from 2026
1Pennsylvania324100%23%no change
2West Virginia70100%13%no change
3Delaware43100%12%no change
4Alaska9100%0%no change
5Alabama115100%0%no change
6Arkansas86100%0%no change
7Arizona148100%0%no change
8Connecticut54100%0%+4 points
9Florida549100%0%+1 point
10Iowa64100%0%no change
11Idaho45100%0%no change
12Illinois133100%0%no change
13Indiana140100%0%no change
14Kansas84100%0%no change
15Kentucky123100%0%no change
16Louisiana126100%0%no change
17Massachusetts92100%0%+23 points
18Maine52100%0%no change
19Michigan183100%0%no change
20Minnesota63100%0%no change
21Missouri171100%0%no change
22Mississippi105100%0%no change
23Montana27100%0%no change
24North Carolina177100%0%no change
25North Dakota26100%0%no change
26Nebraska51100%0%no change
27New Hampshire25100%0%no change
28New Jersey74100%0%no change
29New Mexico68100%0%no change
30Ohio173100%0%no change
31Oklahoma81100%0%no change
32Rhode Island29100%0%no change
33South Carolina91100%0%no change
34South Dakota30100%0%no change
35Tennessee157100%0%no change
36Texas412100%0%no change
37Utah53100%0%no change
38Vermont14100%0%no change
39Wisconsin97100%0%no change
40Wyoming13100%0%no change
41Nevada10097%0%-3 points
42Virginia14596%0%no change
43Oregon9296%0%no change
44Georgia15195%0%no change
45New York21590%5%+1 point
46Colorado10690%0%+3 points
47Hawaii5088%0%+1 point
48California39788%0%no change
49Washington11486%0%+1 point
50District of Columbia2186%0%-2 points
51Maryland4980%0%-5 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 Januvia off or restrict it.

Januvia coverage by parent organization, 2027
Parent organization2027 plans ↓List itRestrict it (of listing)Not listed or restrictedChange from 2026Plans that added a restriction
Humana Inc.8840%none list it100%no change0
UnitedHealth Group, Inc.8500%100%100%no change0
Devoted Health, Inc.7280%none list it100%no change0
CVS Health Corporation6330%none list it100%no change0
Elevance Health, Inc.2940%none list it100%no change0
Centene Corporation268100%100%100%no change0
Health Care Service Corporation2310%none list it100%no change0
Kaiser Foundation Health Plan, Inc.112100%0%0%no change0
Highmark Health98100%100%100%no change83
SCAN Group85100%100%100%no change0
Alignment Healthcare USA, LLC77100%100%100%no change0
Guidewell Mutual Holding Corporation550%none list it100%no change0
Blue Cross Blue Shield of Michigan Mutual Ins. Co.43100%100%100%no change0
Molina Healthcare, Inc.430%none list it100%no change0
Corewell Health400%none list it100%no change0
Zing Health Consolidator, Inc3656%100%100%no change0
CAPITAL BLUE CROSS350%none list it100%no change0
Medica Holding Company310%none list it100%no change0
UPMC Health System300%none list it100%no change0
Universal Health Services, Inc.290%none list it100%no change0
MHH Healthcare, L.P.260%none list it100%no change0
Independence Health Group, Inc.25100%100%100%no change0
Point32Health, Inc.23100%100%100%+100 points19
BlueCross BlueShield of Tennessee220%none list it100%no change0
California Physicians' Service220%none list it100%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

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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

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