Medicare drug coverage
Xiidra in Oklahoma: 2027 Part D coverage
56 of 81 Part D plans offered in Oklahoma (69%) list Xiidra on their 2027 formulary, the plan's list of covered drugs (up 3 points from 2026). 79% of those require prior authorization, step therapy, or a quantity limit. Plan counts include both Medicare Advantage plans with drug coverage (72 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.
Upload your patient list or your book of clients and Rivvi checks each drug against the CMS 2027 formulary files, plan by plan, so you see tier changes and new limits before the next refill or open enrollment. Free to start. HIPAA BAA included.
Every 2027 plan in Oklahoma
Each Part D plan offered in Oklahoma, with Xiidra'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 OK-F001 (PPO I-SNP) | H0710-052-000 | MA-PD (PPO I-SNP) | Tier 4 | Tier 4 | QL | No change |
| UHC Dual Complete OK-S001 (PPO D-SNP) | H2001-056-000 | MA-PD (PPO D-SNP) | Tier 4 | Tier 4 | QL | No change |
| Aetna Medicare Signature Care (HMO) | H2663-034-000 | MA-PD (HMO) | Tier 3 | Tier 3 | QL | No change |
| Aetna Medicare Signature Care (HMO) | H2663-116-000 | MA-PD (HMO) | New plan ID | Tier 3 | QL | New plan ID in 2027 |
| Aetna Medicare Dual Extra Care (HMO D-SNP) | H2663-117-000 | MA-PD (HMO D-SNP) | New plan ID | Tier 3 | QL | New plan ID in 2027 |
| DEVOTED CHOICE 001 OK (PPO) | H2845-001-000 | MA-PD (PPO) | Tier 3 | Tier 3 | None | No change |
| DEVOTED CHOICE GIVEBACK 002 OK (PPO) | H2845-002-000 | MA-PD (PPO) | Tier 3 | Tier 3 | None | No change |
| DEVOTED DUAL CHOICE FULL 003 OK (PPO D-SNP) | H2845-003-000 | MA-PD (PPO D-SNP) | Tier 3 | Tier 3 | None | No change |
| DEVOTED CHOICE 005 OK (PPO) | H2845-005-000 | MA-PD (PPO) | Tier 3 | Tier 3 | None | No change |
| DEVOTED CHOICE GIVEBACK 006 OK (PPO) | H2845-006-000 | MA-PD (PPO) | Tier 3 | Tier 3 | None | No change |
| DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-SNP) | H2845-008-000 | MA-PD (PPO C-SNP) | Tier 3 | Tier 3 | None | No change |
| DEVOTED C-SNP CHOICE ENHANCED 009 OK (PPO C-SNP) | H2845-009-000 | MA-PD (PPO C-SNP) | Tier 3 | Tier 3 | None | No change |
| DEVOTED C-SNP CHOICE ENHANCED 010 OK (PPO C-SNP) | H2845-010-000 | MA-PD (PPO C-SNP) | Tier 3 | Tier 3 | None | No change |
| DEVOTED C-SNP CHOICE GIVEBACK EXTRAS 011 OK (PPO C-SNP) | H2845-011-000 | MA-PD (PPO C-SNP) | New plan ID | Tier 3 | None | New plan ID in 2027 |
| DEVOTED C-SNP CHOICE GIVEBACK EXTRAS 012 OK (PPO C-SNP) | H2845-012-000 | MA-PD (PPO C-SNP) | New plan ID | Tier 3 | None | New plan ID in 2027 |
| DEVOTED CHOICE GIVEBACK EXTRAS 013 OK (PPO) | H2845-013-000 | MA-PD (PPO) | New plan ID | Tier 3 | None | New plan ID in 2027 |
| DEVOTED CHOICE GIVEBACK EXTRAS 014 OK (PPO) | H2845-014-000 | MA-PD (PPO) | New plan ID | Tier 3 | None | New plan ID in 2027 |
| Native Advantage (HMO) | H2851-001-000 | MA-PD (HMO) | New plan ID | Tier 3 | QL | New plan ID in 2027 |
| Aetna Medicare Value Plus (PPO) | H3288-017-000 | MA-PD (PPO) | Tier 3 | Tier 3 | QL | No change |
| Aetna Medicare Value Plus (PPO) | H3288-019-000 | MA-PD (PPO) | Tier 3 | Tier 3 | QL | No change |
| Aetna Medicare Signature (PPO) | H3288-020-000 | MA-PD (PPO) | Tier 3 | Tier 3 | QL | No change |
| Aetna Medicare Dual Care (PPO D-SNP) | H3288-053-000 | MA-PD (PPO D-SNP) | Tier 3 | Tier 3 | QL | No change |
| Generations Classic Rewards (HMO) | H3706-001-000 | MA-PD (HMO) | Tier 3 | Tier 3 | QL | No change |
| Generations Classic Plus (HMO) | H3706-023-000 | MA-PD (HMO) | Tier 3 | Tier 3 | QL | No change |
| Generations Chronic Care (HMO C-SNP) | H3706-024-000 | MA-PD (HMO C-SNP) | Tier 3 | Tier 3 | QL | No change |
Data only, not plan advice. Confirm on Medicare.gov Plan Finder or 1-800-MEDICARE.
Oklahoma compared with the nation
85% of the 81 Part D plans offered in Oklahoma leave Xiidra off the 2027 formulary or restrict it, against 82% nationally (3 points higher). Oklahoma is tied with 6 other states at 85% of plans restricting or leaving it off. A plan offered in several states counts in each.
2027 compared with 2026
| Measure | 2026 | 2027 | Change |
|---|---|---|---|
| Part D plans in the file | 82 | 81 | -1 |
| Plans that list it | 54 (66%) | 56 (69%) | +3 points |
| Prior authorization (of plans that list it) | 9 (17%) | 0 (0%) | -17 points |
| Step therapy (of plans that list it) | 0 (0%) | 0 (0%) | no change |
| Quantity limit (of plans that list it) | 46 (85%) | 44 (79%) | -6 points |
| Any of the three (of plans that list it) | 46 (85%) | 44 (79%) | -6 points |
| Not listed or restricted (of all plans) | 74 (90%) | 69 (85%) | -5 points |
Formulary tier
| Tier | 2026 plans | 2027 plans |
|---|---|---|
| Tier 1 | 2 (4%) | 1 (2%) |
| Tier 2 | 0 (0%) | 2 (4%) |
| Tier 3 | 37 (69%) | 34 (61%) |
| Tier 4 | 15 (28%) | 19 (34%) |
Plan by plan, 2026 to 2027
| Plan by plan | Plans |
|---|---|
| Same plan ID in both years | 68 |
| Listed it in 2026, not in 2027 | 1 (1%) |
| Listed it in 2027, not in 2026 | 0 (0%) |
| Moved it to a higher tier | 0 (0%) |
| Moved it to a lower tier | 2 (3%) |
| 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 | 1 (1%) |
| Plan IDs new in 2027 | 13 |
| 2026 plan IDs not in the 2027 file | 14 |
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 Xiidra both years.
Xiidra in other states
- Alabama65% restrict or leave off, -10 pointsAL
- Alaska100% restrict or leave off, no changeAK
- Arizona74% restrict or leave off, -5 pointsAZ
- Arkansas83% restrict or leave off, no changeAR
- California92% restrict or leave off, +17 pointsCA
- Colorado80% restrict or leave off, -8 pointsCO
- Connecticut74% restrict or leave off, -5 pointsCT
- Delaware88% restrict or leave off, -5 pointsDE
- District of Columbia95% restrict or leave off, -1 pointDC
- Florida80% restrict or leave off, -4 pointsFL
- Georgia89% restrict or leave off, -3 pointsGA
- Hawaii52% restrict or leave off, -8 pointsHI
- Idaho93% restrict or leave off, +11 pointsID
- Illinois76% restrict or leave off, -5 pointsIL
- Indiana77% restrict or leave off, -5 pointsIN
- Iowa83% restrict or leave off, -2 pointsIA
- Kansas87% restrict or leave off, -5 pointsKS
- Kentucky89% restrict or leave off, -3 pointsKY
- Louisiana82% restrict or leave off, -10 pointsLA
- Maine85% restrict or leave off, -2 pointsME
- Maryland65% restrict or leave off, -22 pointsMD
- Massachusetts54% restrict or leave off, no changeMA
- Michigan85% restrict or leave off, -6 pointsMI
- Minnesota98% restrict or leave off, -1 pointMN
- Mississippi85% restrict or leave off, +1 pointMS
- Missouri82% restrict or leave off, -8 pointsMO
- Montana100% restrict or leave off, +3 pointsMT
- Nebraska80% restrict or leave off, -5 pointsNE
- Nevada100% restrict or leave off, +5 pointsNV
- New Hampshire76% restrict or leave off, -24 pointsNH
- New Jersey92% restrict or leave off, no changeNJ
- New Mexico82% restrict or leave off, no changeNM
- New York77% restrict or leave off, -6 pointsNY
- North Carolina80% restrict or leave off, -9 pointsNC
- North Dakota100% restrict or leave off, no changeND
- Ohio77% restrict or leave off, -3 pointsOH
- Oregon71% restrict or leave off, -13 pointsOR
- Pennsylvania85% restrict or leave off, -3 pointsPA
- Rhode Island86% restrict or leave off, -1 pointRI
- South Carolina89% restrict or leave off, +1 pointSC
- South Dakota100% restrict or leave off, +7 pointsSD
- Tennessee71% restrict or leave off, -8 pointsTN
- Texas85% restrict or leave off, -4 pointsTX
- Utah85% restrict or leave off, -3 pointsUT
- Vermont86% restrict or leave off, +1 pointVT
- Virginia88% restrict or leave off, -4 pointsVA
- Washington78% restrict or leave off, -15 pointsWA
- West Virginia100% restrict or leave off, no changeWV
- Wisconsin96% 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