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Acetaminophen / Tramadol is a generic drug. What agents check before quoting it: how many 2027 Part D plans cover it, on which tier, with what restrictions and copays, by plan type, carrier and state.
In 2027, 3,644 of 5,492 Medicare Part D and Medicare Advantage drug plans (66.4%) list Acetaminophen / Tramadol on their formulary, across 269 of 286 formularies. The most common placement is tier 2 (2,919 plans, 80.1% of those covering it). 15 of the covering plans require prior authorization (0.4%), 0 step therapy and 3,381 a quantity limit.
3,141 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $0, 1,716 of them $0; 503 charge coinsurance instead — median 25% of the drug's cost. Once a member's out-of-pocket drug spending reaches $2,400 in 2027, covered drugs cost $0 for the rest of the year.
2026: 3,704 of 5,496 plans covered it (67.4%); 2027: 3,644 of 5,492 (66.4%).
Of 4,367 plans offered in both years, 2 added it to the formulary and 68 dropped it.
Among plans covering it both years, 40 moved it to a higher tier and 305 to a lower one; 0 added prior authorization and 0 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 495 |
| Tier 2 | 2,919 |
| Tier 3 | 161 |
| Tier 4 | 69 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 112 of 323 | 34.7% | 0% |
| Medicare Advantage with drugs (MA-PD) | 2,169 of 3,200 | 67.8% | 0.7% |
| Special needs plans (SNP) | 1,363 of 1,969 | 69.2% | 0% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 0 of 846 | No tier listed | 0 |
| UnitedHealthcare | 0 of 830 | No tier listed | 0 |
| Devoted Health | 728 of 728 | Tier 2 | 0 |
| Aetna Medicare | 631 of 631 | Tier 2 | 0 |
| Wellcare | 234 of 268 | Tier 1 | 0 |
| HealthSpring | 226 of 226 | Tier 2 | 0 |
| Kaiser Permanente | 112 of 112 | Tier 2 | 0 |
| SCAN Health Plan | 83 of 83 | Tier 2 | 0 |
| Highmark Blue Cross Blue Shield or Highmark Blue Shield | 12 of 80 | Tier 2 | 12 |
| Alignment Health Plan | 77 of 77 | Tier 2 | 0 |
| Anthem Blue Cross and Blue Shield | 74 of 74 | Tier 2 | 0 |
| Wellpoint | 63 of 63 | Tier 2 | 0 |
| Priority Health Medicare | 40 of 40 | Tier 3 | 0 |
| CarePlus Health Plans, Inc. | 0 of 37 | No tier listed | 0 |
| Zing Health | 36 of 36 | Tier 2 | 0 |
| Capital Blue Cross | 35 of 35 | Tier 3 | 0 |
| Prominence Health Plan | 29 of 29 | Tier 2 | 0 |
| Medica | 27 of 27 | Tier 2 | 0 |
| Anthem HealthKeepers | 26 of 26 | Tier 2 | 0 |
| Blue Cross Blue Shield of Michigan | 26 of 26 | Tier 2 | 0 |
| State | Plans covering | Share |
|---|---|---|
| Alabama | 78 of 114 | 68.4% |
| Alaska | 3 of 9 | 33.3% |
| American Samoa | 0 of 1 | 0% |
| Arizona | 104 of 147 | 70.7% |
| Arkansas | 50 of 85 | 58.8% |
| California | 323 of 397 | 81.4% |
| Colorado | 64 of 106 | 60.4% |
| Connecticut | 36 of 54 | 66.7% |
| Delaware | 23 of 43 | 53.5% |
| District of Columbia | 6 of 12 | 50% |
| Florida | 374 of 545 | 68.6% |
| Georgia | 93 of 149 | 62.4% |
| Guam | 0 of 1 | 0% |
| Hawaii | 33 of 50 | 66% |
| Idaho | 17 of 45 | 37.8% |
| Illinois | 82 of 132 | 62.1% |
| Indiana | 84 of 138 | 60.9% |
| Iowa | 41 of 64 | 64.1% |
| Kansas | 49 of 84 | 58.3% |
| Kentucky | 57 of 121 | 47.1% |
| Louisiana | 65 of 125 | 52% |
| Maine | 24 of 52 | 46.2% |
| Maryland | 35 of 49 | 71.4% |
| Massachusetts | 69 of 89 | 77.5% |
| Michigan | 151 of 182 | 83% |
| Minnesota | 50 of 63 | 79.4% |
| Mississippi | 60 of 104 | 57.7% |
| Missouri | 106 of 170 | 62.4% |
| Montana | 5 of 27 | 18.5% |
| Nebraska | 33 of 51 | 64.7% |
| Nevada | 60 of 100 | 60% |
| New Hampshire | 8 of 25 | 32% |
| New Jersey | 48 of 73 | 65.8% |
| New Mexico | 20 of 68 | 29.4% |
| New York | 164 of 215 | 76.3% |
| North Carolina | 117 of 176 | 66.5% |
| North Dakota | 16 of 26 | 61.5% |
| Northern Mariana Islands | 0 of 1 | 0% |
| Ohio | 120 of 171 | 70.2% |
| Oklahoma | 37 of 81 | 45.7% |
| Oregon | 68 of 92 | 73.9% |
| Pennsylvania | 215 of 323 | 66.6% |
| Puerto Rico | 63 of 64 | 98.4% |
| Rhode Island | 13 of 29 | 44.8% |
| South Carolina | 54 of 89 | 60.7% |
| South Dakota | 22 of 30 | 73.3% |
| Tennessee | 111 of 156 | 71.2% |
| Texas | 265 of 407 | 65.1% |
| U.S. Virgin Islands | 0 of 1 | 0% |
| Utah | 22 of 53 | 41.5% |
| Vermont | 3 of 14 | 21.4% |
| Virginia | 62 of 144 | 43.1% |
| Washington | 69 of 114 | 60.5% |
| West Virginia | 35 of 69 | 50.7% |
| Wisconsin | 53 of 96 | 55.2% |
| Wyoming | 5 of 13 | 38.5% |
Medicare Part D paid for 291,022 30-day fills of Acetaminophen / Tramadol in 2024 for about 114,136 enrollees, at an average total cost of $12.64 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Acetaminophen / Tramadol and the rest of a client's list on every plan in their county.
Estimate Acetaminophen / Tramadol costs by plan
Free tools for licensed insurance agents. Data from CMS public files; verify with plan documents before advising a client.
Counts are over every Medicare Advantage drug plan and stand-alone Part D plan in the CMS monthly formulary files, excluding employer plans. A plan counts as covering a drug when any strength or form of it is on the plan’s formulary; the tier, prior authorization, step therapy and quantity limit shown are the most favorable version on that formulary. Copays are for a 30-day supply at a preferred retail pharmacy after the deductible. This is a reference for licensed agents, not a plan recommendation; verify with the plan’s formulary before advising a client. Source: CMS Part D formulary files (release 10/08/2026). CMS formulary data.