Medicare drug coverage

Orenitram: 2027 Medicare Part D coverage

1,983 of 5,495 Part D plans (36%) list Orenitram on their 2027 formulary, the plan's list of covered drugs (down 3 points from 2026). 100% 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.

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2027 compared with 2026

Orenitram is number 176 by total Medicare Part D spending in 2024 ($230 million). Plans that list it most often put it on tier 4 (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.

Orenitram Part D coverage, 2026 and 2027
Measure20262027Change
Part D plans in the file5,5185,495-23
Plans that list it2,134 (39%)1,983 (36%)-3 points
Prior authorization (of plans that list it)2,134 (100%)1,983 (100%)no change
Step therapy (of plans that list it)0 (0%)0 (0%)no change
Quantity limit (of plans that list it)99 (5%)86 (4%)-1 point
Any of the three (of plans that list it)2,134 (100%)1,983 (100%)no change
Not listed or restricted (of all plans)5,518 (100%)5,495 (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

Every 2027 stand-alone drug plan

Each stand-alone Part D plan (PDP) with Orenitram'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.

Orenitram on every 2027 stand-alone Part D plan
Plan (PDP)Plan IDs2027 tier2027 limits
AARP Medicare Rx Preferred from UHC (PDP)39Tier 4PA
AARP Medicare Rx Saver from UHC (PDP)34Tier 4PA
Blue Medicare Rx Enhanced (PDP)1Tier 4PA
Blue Medicare Rx Standard (PDP)1Tier 4PA
Blue MedicareRx Essentials (PDP)1Tier 4PA
Blue MedicareRx Plus (PDP)1Tier 4PA
Blue MedicareRx Premier (PDP)1Not listedNot listed
Blue MedicareRx Value (PDP)1Tier 4PA
Blue MedicareRx Value Plus (PDP)1Not listedNot listed
Blue Shield Rx Enhanced (PDP)1Not listedNot listed
Blue Shield Rx Plus (PDP)1Not listedNot listed
BlueMedicare Complete Rx (PDP)1Tier 4PA
BlueMedicare Premier Rx (PDP)2Not listedNot listed (1 of 2 IDs)
BlueMedicare Value Rx (PDP)1Not listedNot listed
BlueRx Enhanced Plus (PDP)1Tier 4PA
BlueRx Essential (PDP)1Tier 4PA
HealthSpring Assurance Rx (PDP)35Tier 4PA
HealthSpring Extra Rx (PDP)2Tier 4PA
HealthSpring Extra RX (PDP)3Tier 4PA
Horizon Medicare Blue Rx Enhanced (PDP)1Tier 4PA
Horizon Medicare Blue Rx Standard (PDP)1Tier 4PA
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)1Tier 4PA
Prescription Blue Premium (PDP)1Tier 4PA, QL
Prescription Blue Select (PDP)1Tier 4PA, QL
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

By dosage form

The 2027 formularies list Orenitram by dosage form. A plan can cover one form and leave off or restrict another, so each form is counted on its own, across all 5,495 plans.

Orenitram by dosage form, 2027
Dosage formPlans that list itRestricted (of listing)Most common tier
Extended release oral tablet1,983 (36%)1,983 (100%)Tier 4
Pack1,648 (30%)1,648 (100%)Tier 5

Source: CMS 2027 Part D formulary file (basic drugs and plan information), as of October 8, 2026. Publisher page

Formulary tier

Orenitram formulary tier, 2026 and 2027
Tier2026 plans2027 plans
Tier 134 (2%)25 (1%)
Tier 21 (<1%)0 (0%)
Tier 339 (2%)57 (3%)
Tier 42,060 (97%)1,901 (96%)

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 Orenitram, and 9 stopped listing it.

Orenitram: plans in both 2026 and 2027
Plan by planPlans
Same plan ID in both years4,380
Listed it in 2026, not in 20279 (<1%)
Listed it in 2027, not in 202649 (1%)
Moved it to a higher tier2 (<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 Orenitram off the formulary or list it with prior authorization, step therapy, or a quantity limit. All 51 states are at 100%. 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 Orenitram, 2027
RankState2027 plansNot listed or restrictedPrior auth or step therapyChange from 2026
1North Dakota26100%69%no change
2Minnesota63100%68%no change
3Massachusetts92100%66%no change
4Idaho45100%62%no change
Tied 5South Dakota30100%60%no change
Tied 5Michigan183100%60%no change
7Rhode Island29100%59%no change
8New Mexico68100%53%no change
Tied 9Wisconsin97100%46%no change
Tied 9Wyoming13100%46%no change
Tied 11Ohio173100%39%no change
Tied 11Nebraska51100%39%no change
Tied 11New Jersey74100%39%no change
Tied 11Texas412100%39%no change
Tied 11Virginia145100%39%no change
Tied 16North Carolina177100%38%no change
Tied 16District of Columbia21100%38%no change
Tied 16Iowa64100%38%no change
Tied 19Indiana140100%37%no change
Tied 19Nevada100100%37%no change
Tied 21Florida549100%36%no change
Tied 21New York215100%36%no change
Tied 21Arizona148100%36%no change
Tied 24South Carolina91100%35%no change
Tied 24Delaware43100%35%no change
Tied 24Maine52100%35%no change
Tied 27Utah53100%34%no change
Tied 27Alabama115100%34%no change
Tied 29Alaska9100%33%no change
Tied 29Pennsylvania324100%33%no change
Tied 29Kentucky123100%33%no change
Tied 32California397100%32%no change
Tied 32New Hampshire25100%32%no change
Tied 32Tennessee157100%32%no change
Tied 32Georgia151100%32%no change
Tied 36Colorado106100%31%no change
Tied 36Oklahoma81100%31%no change
Tied 36Washington114100%31%no change
Tied 39Connecticut54100%30%no change
Tied 39Montana27100%30%no change
Tied 39Mississippi105100%30%no change
42Kansas84100%29%no change
43Missouri171100%25%no change
Tied 44Arkansas86100%24%no change
Tied 44Illinois133100%24%no change
46Oregon92100%22%no change
Tied 47Louisiana126100%21%no change
Tied 47Vermont14100%21%no change
Tied 47West Virginia70100%21%no change
Tied 50Maryland49100%20%no change
Tied 50Hawaii50100%20%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

By parent organization

164 parent organizations offer 2027 Part D plans. Humana Inc. has the most, 884, and 100% of them leave Orenitram off or restrict it.

Orenitram coverage by parent organization, 2027
Parent organization2027 plans ↓List itRestrict it (of listing)Not listed or restrictedChange from 2026Plans that added a restriction
Health First Shared Services, Inc.60%none list it100%no change0
Independent Health Association, Inc.6100%100%100%no change0
LifeBridge Health, Inc.60%none list it100%no change0
The Health Plan of West Virginia, Inc.60%none list it100%no change0
UNICO Services, Inc.60%none list it100%no change0
Verda Healthcare, Inc.60%none list it100%no change0
Blue Cross & Blue Shield of Rhode Island5100%100%100%no change0
BlueCross BlueShield of Alabama5100%100%100%no change0
CareFirst, Inc.50%none list it100%no change0
General Catalyst Group Management Holdings LP50%none list it100%new in 20270
Harris County Hospital District50%none list it100%no change0
Independent Living Systems, LLC5100%100%100%no change0
Mass General Brigham Incorporated5100%100%100%no change0
PacificSource50%none list it100%no change0
SNP Holdings, LLC50%none list it100%no change0
USAble Mutual Insurance Company50%none list it100%no change0
Chapters CareNu Inc40%none list it100%no change0
Chinese Hospital Association40%none list it100%no change0
El Paso County Hospital District40%none list it100%no change0
Elderplan, Inc.40%none list it100%no change0
Horizon Mutual Holdings, Inc4100%100%100%no change0
LMC Family Holdings, LLC40%none list it100%no change0
Montage Health40%none list it100%no change0
St Francis Health System & St John Health System40%none list it100%no change0
Associated Care Ventures, Inc.30%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

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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