Medicare drug coverage

Lumigan: 2027 Medicare Part D coverage

3,873 of 5,495 Part D plans (70%) list Lumigan on their 2027 formulary, down 21 points from 2026. 28% of those require prior authorization, step therapy, or a quantity limit.

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2027 compared with 2026

Lumigan is number 74 by total Medicare Part D spending in 2024 ($647 million). Plans that list it most often put it on tier 3. Counts use 3 RxNorm products for this name.

Lumigan Part D coverage, 2026 and 2027
Measure20262027Change
Part D plans in the file5,5185,495-23
Plans that list it5,063 (92%)3,873 (70%)-21 points
Prior authorization (of plans that list it)0 (0%)782 (20%)+20 points
Step therapy (of plans that list it)1 (0%)1 (0%)no change
Quantity limit (of plans that list it)1,704 (34%)1,084 (28%)-6 points
Any of the three (of plans that list it)1,705 (34%)1,085 (28%)-6 points
Not listed or restricted (of all plans)2,160 (39%)2,707 (49%)+10 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

Formulary tier

Lumigan formulary tier, 2026 and 2027
Tier2026 plans2027 plans
Tier 1119 (2%)39 (1%)
Tier 251 (1%)37 (1%)
Tier 34,893 (97%)3,000 (77%)
Tier 40 (0%)797 (21%)

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. 722 of them (16%) added prior authorization, step therapy, or a quantity limit for Lumigan, and 933 stopped listing it.

Lumigan: plans in both 2026 and 2027
Plan by planPlans
Same plan id in both years4,380
Listed it in 2026, not in 2027933 (21%)
Listed it in 2027, not in 20265 (0%)
Moved it to a higher tier723 (17%)
Added prior authorization697 (16%)
Added step therapy0 (0%)
Added a quantity limit25 (1%)
Added at least one of the three722 (16%)
Removed at least one of the three6 (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 Lumigan off the formulary or list it with prior authorization, step therapy, or a quantity limit. Vermont ranks first at 86%, with 29% of its plans using prior authorization or step therapy; Connecticut ranks last at 30%. Ties break on the prior authorization or step therapy share.

States from most to least restrictive for Lumigan, 2027
RankState2027 plansNot listed or restrictedPrior auth or step therapyChange from 2026
1Vermont1486%29%+16 points
2Montana2781%52%+9 points
3Alaska978%0%+11 points
4Wyoming1377%15%+30 points
5Minnesota6375%0%+21 points
6California39771%7%+26 points
7North Dakota2669%0%+33 points
8South Dakota3067%0%+30 points
9Pennsylvania32463%8%+8 points
10West Virginia7063%21%no change
11South Carolina9162%23%+23 points
12Wisconsin9761%18%+9 points
13Nevada10059%16%+11 points
14Oregon9259%12%+12 points
15Georgia15158%22%+26 points
16Delaware4356%9%+20 points
17Mississippi10555%21%+21 points
18Arkansas8653%22%+22 points
19Louisiana12653%27%+16 points
20Oklahoma8153%25%-4 points
21Maryland4953%8%-6 points
22District of Columbia2152%5%+8 points
23New Hampshire2552%24%+12 points
24North Carolina17752%15%+12 points
25Nebraska5151%10%+11 points
26Kentucky12350%33%+5 points
27Michigan18349%8%+4 points
28Washington11449%14%+2 points
29Florida54949%21%+13 points
30Arizona14849%14%+16 points
31New Jersey7449%12%+19 points
32Colorado10648%15%+3 points
33Utah5347%23%+4 points
34Iowa6447%9%+8 points
35Texas41247%17%+11 points
36Illinois13345%20%+14 points
37Rhode Island2945%0%+6 points
38Maine5244%23%+15 points
39Virginia14543%29%+4 points
40Alabama11543%15%+10 points
41Idaho4542%18%+8 points
42Ohio17342%12%+11 points
43Kansas8440%19%+6 points
44Missouri17139%19%+8 points
45Hawaii5038%10%-2 points
46New York21537%3%+1 point
47Massachusetts9236%4%+6 points
48Indiana14034%20%no change
49New Mexico6834%16%-8 points
50Tennessee15731%12%+7 points
51Connecticut5430%7%+11 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 Lumigan off or restrict it.

Lumigan 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.88488%100%100%no change697
UnitedHealth Group, Inc.85096%0%4%no change0
Devoted Health, Inc.728100%0%0%no change0
CVS Health Corporation633100%0%0%no change0
Elevance Health, Inc.294100%8%8%+2 points0
Centene Corporation2680%none list it100%+80 points0
Health Care Service Corporation2310%none list it100%+81 points0
Kaiser Foundation Health Plan, Inc.1120%none list it100%no change0
Highmark Health98100%100%100%no change0
SCAN Group850%none list it100%+100 points0
Alignment Healthcare USA, LLC770%none list it100%no change0
Guidewell Mutual Holding Corporation550%none list it100%no change0
Blue Cross Blue Shield of Michigan Mutual Ins. Co.43100%0%0%no change0
Molina Healthcare, Inc.43100%0%0%no change0
Corewell Health400%none list it100%no change0
Zing Health Consolidator, Inc36100%0%0%no change0
CAPITAL BLUE CROSS350%none list it100%no change0
Medica Holding Company310%none list it100%+86 points0
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%44%44%+44 points9
Point32Health, Inc.23100%0%0%no change0
BlueCross BlueShield of Tennessee22100%0%0%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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