Medicare drug coverage
Prezcobix in Illinois: 2027 Part D coverage
133 of 133 Part D plans offered in Illinois (100%) list Prezcobix on their 2027 formulary, the plan's list of covered drugs (the same share as 2026). 47% of those require prior authorization, step therapy, or a quantity limit. Plan counts include both Medicare Advantage plans with drug coverage (123 MA-PD) and stand-alone drug plans (10 PDP).
License: a US government work, in the public domain (Public Domain Mark 1.0).
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Every 2027 plan in Illinois
Each Part D plan offered in Illinois, with Prezcobix's 2026 and 2027 tier and its 2027 limits. A tier is the cost level a plan puts a drug on; a lower tier usually costs less. Enter a ZIP to see only the plans offered in that county.
PA is prior authorization (the plan must approve it first), ST is step therapy (try another drug first), and QL is a quantity limit. D-SNP, C-SNP, and I-SNP are Special Needs Plans: for people with both Medicare and Medicaid, with certain chronic conditions, or who live in a nursing home or need that level of care. Plans are listed by plan ID.
| Plan | Plan ID | Type | 2026 tier | 2027 tier | 2027 PA / ST / QL | Change |
|---|---|---|---|---|---|---|
| Humana Total Complete (HMO) | H0028-014-000 | MA-PD (HMO) | Tier 5 | Tier 5 | QL | No change |
| Humana Essentials Plus Giveback (HMO) | H0028-065-000 | MA-PD (HMO) | Tier 5 | Tier 5 | QL | No change |
| UHC Nursing Home Plan IL-F001 (PPO I-SNP) | H0710-039-000 | MA-PD (PPO I-SNP) | Tier 5 | Tier 5 | QL | No change |
| Aetna Medicare Signature (HMO-POS) | H1206-003-000 | MA-PD (HMO-POS) | Tier 5 | Tier 5 | None | No change |
| Aetna Medicare Prime Chronic Care (HMO C-SNP) | H1206-004-000 | MA-PD (HMO C-SNP) | Tier 5 | Tier 5 | None | No change |
| Aetna Medicare Signature Extra (HMO-POS) | H1206-008-000 | MA-PD (HMO-POS) | Tier 5 | Tier 5 | None | No change |
| Aetna Medicare Prime Extra Care (HMO) | H1206-010-000 | MA-PD (HMO) | New plan ID | Tier 5 | None | New plan ID in 2027 |
| Aetna Medicare Enhanced (HMO) | H1206-011-000 | MA-PD (HMO) | New plan ID | Tier 5 | None | New plan ID in 2027 |
| Aetna Medicare Signature (HMO) | H1206-012-000 | MA-PD (HMO) | New plan ID | Tier 5 | None | New plan ID in 2027 |
| Aetna Medicare Signature (HMO) | H1206-013-000 | MA-PD (HMO) | New plan ID | Tier 5 | None | New plan ID in 2027 |
| Wellcare Simple (HMO-POS) | H1416-009-000 | MA-PD (HMO-POS) | Tier 5 | Tier 5 | None | No change |
| Wellcare Simple Value (HMO-POS) | H1416-084-000 | MA-PD (HMO-POS) | New plan ID | Tier 5 | None | New plan ID in 2027 |
| Wellcare Simple Exclusive Value (HMO-POS) | H1416-085-000 | MA-PD (HMO-POS) | New plan ID | Tier 5 | None | New plan ID in 2027 |
| Humana Gold Plus H1468-007 (HMO) | H1468-007-000 | MA-PD (HMO) | Tier 5 | Tier 5 | QL | No change |
| Humana Total Complete (HMO) | H1468-013-000 | MA-PD (HMO) | Tier 5 | Tier 5 | QL | No change |
| Humana Community HMO Diabetes and Heart (HMO C-SNP) | H1468-017-000 | MA-PD (HMO C-SNP) | Tier 5 | Tier 5 | QL | No change |
| Humana Essentials Plus Giveback (HMO) | H1468-021-000 | MA-PD (HMO) | Tier 5 | Tier 5 | QL | No change |
| UHC Complete Care Support ST-1A (PPO C-SNP) | H2001-037-000 | MA-PD (PPO C-SNP) | Tier 5 | Tier 5 | QL | No change |
| UHC Complete Care Support IL-1A (PPO C-SNP) | H2001-038-000 | MA-PD (PPO C-SNP) | Tier 5 | Tier 5 | QL | No change |
| AARP Medicare Advantage from UHC ST-0001 (PPO) | H2406-043-000 | MA-PD (PPO) | Tier 5 | Tier 5 | QL | No change |
| Essence Advantage (HMO) | H2610-005-000 | MA-PD (HMO) | Tier 5 | Tier 5 | None | No change |
| Essence Advantage Plus (HMO) | H2610-006-000 | MA-PD (HMO) | Tier 5 | Tier 5 | None | No change |
| Essence Advantage Select (HMO) | H2610-016-000 | MA-PD (HMO) | Tier 5 | Tier 5 | None | No change |
| Essence Advantage Select (HMO) | H2610-027-000 | MA-PD (HMO) | Tier 5 | Tier 5 | None | No change |
| Aetna Medicare Chronic Care (HMO C-SNP) | H2663-100-000 | MA-PD (HMO C-SNP) | Tier 5 | Tier 5 | None | No change |
Data only, not plan advice. Confirm on Medicare.gov Plan Finder or 1-800-MEDICARE.
Illinois compared with the nation
47% of the 133 Part D plans offered in Illinois leave Prezcobix off the 2027 formulary or restrict it, against 55% nationally (8 points lower). Illinois ranks 42 of 51 states from most to least restrictive. A plan offered in several states counts in each.
2027 compared with 2026
| Measure | 2026 | 2027 | Change |
|---|---|---|---|
| Part D plans in the file | 150 | 133 | -17 |
| Plans that list it | 150 (100%) | 133 (100%) | no change |
| Prior authorization (of plans that list it) | 0 (0%) | 0 (0%) | no change |
| Step therapy (of plans that list it) | 0 (0%) | 0 (0%) | no change |
| Quantity limit (of plans that list it) | 75 (50%) | 62 (47%) | -3 points |
| Any of the three (of plans that list it) | 75 (50%) | 62 (47%) | -3 points |
| Not listed or restricted (of all plans) | 75 (50%) | 62 (47%) | -3 points |
Formulary tier
| Tier | 2026 plans | 2027 plans |
|---|---|---|
| Tier 1 | 2 (1%) | 2 (2%) |
| Tier 5 | 148 (99%) | 131 (98%) |
Plan by plan, 2026 to 2027
| Plan by plan | Plans |
|---|---|
| Same plan ID in both years | 115 |
| Listed it in 2026, not in 2027 | 0 (0%) |
| Listed it in 2027, not in 2026 | 0 (0%) |
| Moved it to a higher tier | 0 (0%) |
| Moved it to a lower tier | 0 (0%) |
| Added prior authorization | 0 (0%) |
| Added step therapy | 0 (0%) |
| Added a quantity limit | 1 (1%) |
| Added at least one of the three | 1 (1%) |
| Removed at least one of the three | 0 (0%) |
| Plan IDs new in 2027 | 18 |
| 2026 plan IDs not in the 2027 file | 34 |
The CMS summary has no count of tier moves down, so "Moved it to a lower tier" is counted from the plan rows on this page: plans with the same plan ID in both years that list Prezcobix both years.
Listings with prior authorization, step therapy, or a quantity limit fell from 75 to 62, but none of the 115 plans offered in both years removed any of the three from Prezcobix. The fall comes from the plan list. 34 plan IDs offered here in 2026 are not in the 2027 file, and 34 of them listed it, 20 with a limit. 18 plan IDs are new in 2027, and 18 of them list it, 4 with a limit. 4 plan IDs offered here in 2026 are offered only in other states in 2027, and 4 of them listed it, 1 with a limit. 3 plan IDs offered here in 2027 were offered only in other states in 2026.
Same plan ID in both years (115) plus 2026 plan IDs not in the 2027 file (34) add up to 149, not the 150 plans offered in Illinois in 2026, because some plans are offered in different states in 2026 and 2027. 3 plan IDs counted in both years were offered only in other states in 2026, and 4 plan IDs offered here in 2026 are offered only in other states in 2027, so they count in neither row.
Prezcobix in other states
- Alabama54% restrict or leave off, -8 pointsAL
- Alaska67% restrict or leave off, no changeAK
- Arizona51% restrict or leave off, -5 pointsAZ
- Arkansas50% restrict or leave off, -2 pointsAR
- California51% restrict or leave off, +5 pointsCA
- Colorado57% restrict or leave off, -3 pointsCO
- Connecticut43% restrict or leave off, -4 pointsCT
- Delaware56% restrict or leave off, -4 pointsDE
- District of Columbia57% restrict or leave off, -7 pointsDC
- Florida61% restrict or leave off, -4 pointsFL
- Georgia60% restrict or leave off, +1 pointGA
- Hawaii36% restrict or leave off, -4 pointsHI
- Idaho89% restrict or leave off, +13 pointsID
- Indiana61% restrict or leave off, -2 pointsIN
- Iowa58% restrict or leave off, no changeIA
- Kansas54% restrict or leave off, -6 pointsKS
- Kentucky68% restrict or leave off, -2 pointsKY
- Louisiana53% restrict or leave off, -2 pointsLA
- Maine63% restrict or leave off, +4 pointsME
- Maryland39% restrict or leave off, -12 pointsMD
- Massachusetts43% restrict or leave off, -1 pointMA
- Michigan71% restrict or leave off, -4 pointsMI
- Minnesota51% restrict or leave off, -5 pointsMN
- Mississippi54% restrict or leave off, -4 pointsMS
- Missouri48% restrict or leave off, -9 pointsMO
- Montana93% restrict or leave off, +4 pointsMT
- Nebraska53% restrict or leave off, -2 pointsNE
- Nevada59% restrict or leave off, -1 pointNV
- New Hampshire68% restrict or leave off, no changeNH
- New Jersey64% restrict or leave off, +3 pointsNJ
- New Mexico78% restrict or leave off, no changeNM
- New York38% restrict or leave off, -6 pointsNY
- North Carolina60% restrict or leave off, -12 pointsNC
- North Dakota58% restrict or leave off, -3 pointsND
- Ohio45% restrict or leave off, +1 pointOH
- Oklahoma67% restrict or leave off, -4 pointsOK
- Oregon38% restrict or leave off, -8 pointsOR
- Pennsylvania45% restrict or leave off, no changePA
- Rhode Island69% restrict or leave off, +1 pointRI
- South Carolina65% restrict or leave off, +2 pointsSC
- South Dakota43% restrict or leave off, -4 pointsSD
- Tennessee62% restrict or leave off, -4 pointsTN
- Texas60% restrict or leave off, -4 pointsTX
- Utah70% restrict or leave off, -1 pointUT
- Vermont71% restrict or leave off, +9 pointsVT
- Virginia72% restrict or leave off, -3 pointsVA
- Washington51% restrict or leave off, -10 pointsWA
- West Virginia61% restrict or leave off, +4 pointsWV
- Wisconsin69% restrict or leave off, +1 pointWI
- Wyoming85% restrict or leave off, +1 pointWY
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 2026 Part D formulary file (basic drugs and plan information), as of September 30, 2026. Publisher page
Source: CMS CY2027 landscape file (states and parent organizations), as of September 30, 2026. Publisher page
Source: CMS CY2026 landscape file, as of September 25, 2025. Publisher page
Source: CMS Medicare Part D Spending by Drug, 2024 data, as of June 25, 2026. Publisher page
Source: US Census Bureau 2020 ZCTA to county relationship file (ZIP lookup), as of December 9, 2021. Publisher page