Medicare drug coverage

Taltz: 2027 Medicare Part D coverage

138 of 5,495 Part D plans (3%) list Taltz on their 2027 formulary, the plan's list of covered drugs (the same share as 2026). 30% 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.

2027 compared with 2026

Taltz is number 86 by total Medicare Part D spending in 2024 ($564 million). Plans that list it most often put it on tier 5 (a tier is the cost level a plan puts a drug on; a lower tier usually costs less). Counts use 5 RxNorm products for this name.

Taltz Part D coverage, 2026 and 2027
Measure20262027Change
Part D plans in the file5,5185,495-23
Plans that list it183 (3%)138 (3%)no change
Prior authorization (of plans that list it)83 (45%)41 (30%)-15 points
Step therapy (of plans that list it)0 (0%)0 (0%)no change
Quantity limit (of plans that list it)47 (26%)9 (7%)-19 points
Any of the three (of plans that list it)83 (45%)41 (30%)-15 points
Not listed or restricted (of all plans)5,418 (98%)5,398 (98%)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

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Formulary tier

Taltz formulary tier, 2026 and 2027
Tier2026 plans2027 plans
Tier 15 (3%)2 (1%)
Tier 22 (1%)1 (1%)
Tier 5176 (96%)135 (98%)

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 Taltz, and 32 stopped listing it.

Taltz: plans in both 2026 and 2027
Plan by planPlans
Same plan ID in both years4,380
Listed it in 2026, not in 202732 (1%)
Listed it in 2027, not in 20261 (0%)
Moved it to a higher tier0 (0%)
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 Taltz off the formulary or list it with prior authorization, step therapy, or a quantity limit. 41 states tie for the highest share, 100%; Maryland ranks last at 80%. 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 Taltz, 2027
RankState2027 plansNot listed or restrictedPrior auth or step therapyChange from 2026
1Pennsylvania324100%4%no change
Tied 2Nevada100100%3%no change
Tied 2New Jersey74100%3%no change
4Florida549100%2%no change
Tied 5Alaska9100%0%no change
Tied 5Alabama115100%0%no change
Tied 5Arkansas86100%0%no change
Tied 5Arizona148100%0%no change
Tied 5Connecticut54100%0%no change
Tied 5Delaware43100%0%no change
Tied 5Iowa64100%0%no change
Tied 5Idaho45100%0%no change
Tied 5Illinois133100%0%no change
Tied 5Indiana140100%0%no change
Tied 5Kansas84100%0%no change
Tied 5Kentucky123100%0%no change
Tied 5Louisiana126100%0%no change
Tied 5Massachusetts92100%0%no change
Tied 5Maine52100%0%no change
Tied 5Michigan183100%0%no change
Tied 5Minnesota63100%0%no change
Tied 5Missouri171100%0%no change
Tied 5Mississippi105100%0%no change
Tied 5Montana27100%0%no change
Tied 5North Carolina177100%0%no change
Tied 5North Dakota26100%0%no change
Tied 5Nebraska51100%0%no change
Tied 5New Hampshire25100%0%no change
Tied 5New Mexico68100%0%no change
Tied 5New York215100%0%no change
Tied 5Ohio173100%0%no change
Tied 5Oklahoma81100%0%no change
Tied 5Rhode Island29100%0%no change
Tied 5South Carolina91100%0%no change
Tied 5South Dakota30100%0%no change
Tied 5Tennessee157100%0%no change
Tied 5Texas412100%0%no change
Tied 5Utah53100%0%no change
Tied 5Vermont14100%0%no change
Tied 5West Virginia70100%0%no change
Tied 5Wyoming13100%0%no change
42Wisconsin9799%0%no change
43Washington11497%11%-1 point
Tied 44Virginia14596%0%no change
Tied 44Oregon9296%0%no change
46Georgia15195%0%no change
47Colorado10690%0%+3 points
48California39788%1%no change
49Hawaii5088%0%no change
50District of Columbia2186%0%-2 points
51Maryland4980%0%-4 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 Taltz off or restrict it.

Taltz coverage by parent organization, 2027
Parent organization2027 plans ↑List itRestrict it (of listing)Not listed or restrictedChange from 2026Plans that added a restriction
AIDS Healthcare Foundation10%none list it100%no change0
Alameda Alliance for Health10%none list it100%no change0
AllCare Health, Inc.10%none list it100%no change0
AlohaCare10%none list it100%no change0
BCBS MN, MT, NE, ND, WY, Wellmark IA and SD10%none list it100%no change0
CareOregon, Inc.10%none list it100%no change0
Contra Costa Health Services10%none list it100%no change0
DLP Marquette Health Plan, LLC10%none list it100%no change0
Health Plan of San Mateo1100%100%100%no change0
IMPERIAL COUNTY LOCAL HEALTH AUTHORITY10%none list it100%no change0
INLAND EMPIRE HEALTH PLAN10%none list it100%no change0
Itasca County10%none list it100%no change0
Kern Health Systems (KHS)10%none list it100%no change0
Local Initiative Health Authority for LA County10%none list it100%no change0
Muscogee Creek Nation10%none list it100%new in 20270
Orange County Health Authority1100%100%100%no change0
SAN FRANCISCO HEALTH AUTHORITY10%none list it100%no change0
SAN JOAQUIN COUNTY HEALTH COMMISSION10%none list it100%no change0
SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTH10%none list it100%no change0
SANTA CLARA COUNTY HEALTH AUTHORITY10%none list it100%no change0
SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MAN10%none list it100%no change0
Samaritan Health Services, Inc.10%none list it100%no change0
The Schroer Group, Inc.10%none list it100%no change0
Ventura County Medi-Cal Managed Care Commission10%none list it100%no change0
BayCare Health System, Inc.20%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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