Medicare drug coverage
Rinvoq in District of Columbia: 2027 Part D coverage
21 of 21 Part D plans offered in District of Columbia (100%) list Rinvoq on their 2027 formulary, the plan's list of covered drugs (up 4 points from 2026). 86% of those require prior authorization, step therapy, or a quantity limit. Plan counts include both Medicare Advantage plans with drug coverage (12 MA-PD) and stand-alone drug plans (9 PDP).
License: a US government work, in the public domain (Public Domain Mark 1.0).
For pharmacies and agencies: check a whole drug list against 2027 formularies.
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Every 2027 plan in District of Columbia
Each Part D plan offered in District of Columbia, with Rinvoq'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 |
|---|---|---|---|---|---|---|
| UHC Nursing Home Plan EX-F004 (PPO I-SNP) | H0710-032-000 | MA-PD (PPO I-SNP) | Tier 5 | Tier 5 | PA, QL | No change |
| Kaiser Permanente Medicare Advantage High DC (HMO-POS) | H2172-001-000 | MA-PD (HMO-POS) | Tier 5 | Tier 5 | None | No change |
| Kaiser Permanente Medicare Advantage Standard DC (HMO-POS) | H2172-020-000 | MA-PD (HMO-POS) | Tier 5 | Tier 5 | None | No change |
| Kaiser Permanente Medicare Advantage Value DC (HMO-POS) | H2172-027-000 | MA-PD (HMO-POS) | Tier 5 | Tier 5 | None | No change |
| UHC Dual Choice DC-Y2 (PPO D-SNP) | H2406-053-000 | MA-PD (PPO D-SNP) | Tier 5 | Tier 5 | PA, QL | No change |
| AARP Medicare Advantage from UHC DC-0002 (PPO) | H2406-082-000 | MA-PD (PPO) | Tier 5 | Tier 5 | PA, QL | No change |
| UHC Dual Choice DC-Q001 (PPO D-SNP) | H2406-099-000 | MA-PD (PPO D-SNP) | Tier 5 | Tier 5 | PA, QL | No change |
| Aetna Medicare Enhanced Plus (HMO-POS) | H3931-095-000 | MA-PD (HMO-POS) | Tier 5 | Tier 5 | PA, QL | No change |
| HumanaChoice H5216-383 (PPO) | H5216-383-000 | MA-PD (PPO) | Tier 5 | Tier 5 | PA, QL | No change |
| Aetna Medicare Premier (PPO) | H5521-015-000 | MA-PD (PPO) | Tier 5 | Tier 5 | PA, QL | No change |
| CareFirst BlueCross BlueShield Advantage Signature (PPO) | H7379-004-002 | MA-PD (PPO) | New plan ID | Tier 5 | PA, QL | New plan ID in 2027 |
| UHC Dual Choice DC-YL1 (HMO D-SNP) | H7464-010-000 | MA-PD (HMO D-SNP) | Tier 5 | Tier 5 | PA, QL | No change |
| Wellcare Classic (PDP) | S4802-079-000 | PDP | Tier 5 | Tier 5 | PA, QL | No change |
| Wellcare Value Script (PDP) | S4802-140-000 | PDP | Tier 5 | Tier 5 | PA, QL | No change |
| SilverScript Choice (PDP) | S5601-010-000 | PDP | Tier 5 | Tier 5 | PA, QL | No change |
| HealthSpring Assurance Rx (PDP) | S5715-026-000 | PDP | New plan ID | Tier 5 | PA, QL | New plan ID in 2027 |
| Humana Basic Rx Plan (PDP) | S5884-103-000 | PDP | Tier 5 | Tier 5 | PA, QL | No change |
| Humana Premier Rx Plan (PDP) | S5884-151-000 | PDP | Tier 5 | Tier 5 | PA, QL | No change |
| Humana Value Rx Plan (PDP) | S5884-184-000 | PDP | Tier 5 | Tier 5 | PA, QL | No change |
| AARP Medicare Rx Saver from UHC (PDP) | S5921-350-000 | PDP | Not listed | Tier 5 | PA, QL | Newly listed |
| AARP Medicare Rx Preferred from UHC (PDP) | S5921-387-000 | PDP | Tier 5 | Tier 5 | PA, QL | No change |
Data only, not plan advice. Confirm on Medicare.gov Plan Finder or 1-800-MEDICARE.
By dosage form
The 2027 formularies list Rinvoq by dosage form. A plan can cover one form and leave off or restrict another, so each form is counted on its own.
| Dosage form | Plans that list it | Restricted (of listing) | Most common tier |
|---|---|---|---|
| Extended release oral tablet | 21 (100%) | 18 (86%) | Tier 5 |
| Oral solution | 21 (100%) | 18 (86%) | Tier 5 |
District of Columbia compared with the nation
86% of the 21 Part D plans offered in District of Columbia leave Rinvoq off the 2027 formulary or restrict it, against 98% nationally (12 points lower). District of Columbia ranks 50 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 | 25 | 21 | -4 |
| Plans that list it | 24 (96%) | 21 (100%) | +4 points |
| Prior authorization (of plans that list it) | 21 (88%) | 18 (86%) | -2 points |
| Step therapy (of plans that list it) | 0 (0%) | 0 (0%) | no change |
| Quantity limit (of plans that list it) | 21 (88%) | 18 (86%) | -2 points |
| Any of the three (of plans that list it) | 21 (88%) | 18 (86%) | -2 points |
| Not listed or restricted (of all plans) | 22 (88%) | 18 (86%) | -2 points |
Formulary tier
| Tier | 2026 plans | 2027 plans |
|---|---|---|
| Tier 5 | 24 (100%) | 21 (100%) |
Plan by plan, 2026 to 2027
| Plan by plan | Plans |
|---|---|
| Same plan ID in both years | 19 |
| Listed it in 2026, not in 2027 | 0 (0%) |
| Listed it in 2027, not in 2026 | 1 (5%) |
| 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 | 0 (0%) |
| Added at least one of the three | 0 (0%) |
| Removed at least one of the three | 0 (0%) |
| Plan IDs new in 2027 | 2 |
| 2026 plan IDs not in the 2027 file | 5 |
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 Rinvoq both years.
Listings with prior authorization, step therapy, or a quantity limit fell from 21 to 18, but none of the 19 plans offered in both years removed any of the three from Rinvoq. The fall comes from the plan list. 5 plan IDs offered here in 2026 are not in the 2027 file, and 5 of them listed it, all with a limit. 2 plan IDs are new in 2027, and 2 of them list it, all with a limit. 1 plan ID offered here in 2026 is offered only in other states in 2027, and it listed it with a limit.
Same plan ID in both years (19) plus 2026 plan IDs not in the 2027 file (5) add up to 24, not the 25 plans offered in District of Columbia in 2026, because some plans are offered in different states in 2026 and 2027. 1 plan ID offered here in 2026 is offered only in other states in 2027, so it counts in neither row.
Rinvoq in other states
- Alabama100% restrict or leave off, no changeAL
- Alaska100% restrict or leave off, no changeAK
- Arizona100% restrict or leave off, no changeAZ
- Arkansas100% restrict or leave off, no changeAR
- California88% restrict or leave off, no changeCA
- Colorado90% restrict or leave off, +3 pointsCO
- Connecticut100% restrict or leave off, no changeCT
- Delaware100% restrict or leave off, no changeDE
- Florida100% restrict or leave off, no changeFL
- Georgia95% restrict or leave off, no changeGA
- Hawaii88% restrict or leave off, no changeHI
- Idaho100% restrict or leave off, no changeID
- Illinois100% restrict or leave off, no changeIL
- Indiana100% restrict or leave off, no changeIN
- Iowa100% restrict or leave off, no changeIA
- Kansas100% restrict or leave off, no changeKS
- Kentucky100% restrict or leave off, no changeKY
- Louisiana100% restrict or leave off, no changeLA
- Maine100% restrict or leave off, no changeME
- Maryland80% restrict or leave off, -4 pointsMD
- Massachusetts100% restrict or leave off, no changeMA
- Michigan100% restrict or leave off, no changeMI
- Minnesota100% restrict or leave off, no changeMN
- Mississippi100% restrict or leave off, no changeMS
- Missouri100% restrict or leave off, no changeMO
- Montana100% restrict or leave off, no changeMT
- Nebraska100% restrict or leave off, no changeNE
- Nevada100% restrict or leave off, no changeNV
- New Hampshire100% restrict or leave off, no changeNH
- New Jersey100% restrict or leave off, no changeNJ
- New Mexico100% restrict or leave off, no changeNM
- New York100% restrict or leave off, no changeNY
- North Carolina100% restrict or leave off, no changeNC
- North Dakota100% restrict or leave off, no changeND
- Ohio100% restrict or leave off, no changeOH
- Oklahoma100% restrict or leave off, no changeOK
- Oregon96% restrict or leave off, no changeOR
- Pennsylvania100% restrict or leave off, no changePA
- Rhode Island100% restrict or leave off, no changeRI
- South Carolina100% restrict or leave off, no changeSC
- South Dakota100% restrict or leave off, no changeSD
- Tennessee100% restrict or leave off, no changeTN
- Texas100% restrict or leave off, no changeTX
- Utah100% restrict or leave off, no changeUT
- Vermont100% restrict or leave off, no changeVT
- Virginia96% restrict or leave off, no changeVA
- Washington97% restrict or leave off, -1 pointWA
- West Virginia100% restrict or leave off, no changeWV
- Wisconsin100% restrict or leave off, no changeWI
- Wyoming100% restrict or leave off, no changeWY
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