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Admelog Part D coverage 2027

Admelog is a brand of insulin lispro. 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.

Coverage at a glance

In 2027, 640 of 5,492 Medicare Part D and Medicare Advantage drug plans (11.7%) list Admelog on their formulary, across 46 of 286 formularies. The most common placement is tier 3 (615 plans, 96.1% of those covering it). 7 of the covering plans require prior authorization (1.1%), 0 step therapy and 0 a quantity limit. Generic insulin lispro is on 3,863 of 5,492 plans (70.3%).

What a 30-day fill costs

27 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $40, 11 of them $0; 613 charge coinsurance instead — median 20% of the drug's cost. Covered insulin is capped at $35 for a month's supply.

What changed since 2026

2026: 682 of 5,496 plans covered it (12.4%); 2027: 640 of 5,492 (11.7%).

Of 4,367 plans offered in both years, 6 added it to the formulary and 87 dropped it.

Among plans covering it both years, 4 moved it to a higher tier and 1 to a lower one; 0 added prior authorization and 0 removed it.

Tier placement

TierPlans
Tier 118
Tier 3615
Tier 47

By plan type

Plan typePlans coveringSharePrior auth
Stand-alone Part D (PDP)4 of 3231.2%0%
Medicare Advantage with drugs (MA-PD)296 of 3,2009.3%2%
Special needs plans (SNP)340 of 1,96917.3%0.3%

By carrier

CarrierPlans coveringUsual tierPrior auth
Humana0 of 846No tier listed0
UnitedHealthcare0 of 830No tier listed0
Devoted Health446 of 728Tier 30
Aetna Medicare0 of 631No tier listed0
Wellcare0 of 268No tier listed0
HealthSpring0 of 226No tier listed0
Kaiser Permanente0 of 112No tier listed0
SCAN Health Plan0 of 83No tier listed0
Highmark Blue Cross Blue Shield or Highmark Blue Shield0 of 80No tier listed0
Alignment Health Plan0 of 77No tier listed0
Anthem Blue Cross and Blue Shield0 of 74No tier listed0
Wellpoint0 of 63No tier listed0
Priority Health Medicare0 of 40No tier listed0
CarePlus Health Plans, Inc.0 of 37No tier listed0
Zing Health36 of 36Tier 30
Capital Blue Cross0 of 35No tier listed0
Prominence Health Plan0 of 29No tier listed0
Medica0 of 27No tier listed0
Anthem HealthKeepers0 of 26No tier listed0
Blue Cross Blue Shield of Michigan0 of 26No tier listed0

By state

StatePlans coveringShare
Alabama34 of 11429.8%
Alaska0 of 90%
American Samoa0 of 10%
Arizona29 of 14719.7%
Arkansas11 of 8512.9%
California10 of 3972.5%
Colorado13 of 10612.3%
Connecticut8 of 5414.8%
Delaware2 of 434.7%
District of Columbia0 of 120%
Florida82 of 54515%
Georgia9 of 1496%
Guam0 of 10%
Hawaii17 of 5034%
Idaho2 of 454.4%
Illinois20 of 13215.2%
Indiana19 of 13813.8%
Iowa8 of 6412.5%
Kansas5 of 846%
Kentucky7 of 1215.8%
Louisiana14 of 12511.2%
Maine8 of 5215.4%
Maryland15 of 4930.6%
Massachusetts19 of 8921.3%
Michigan21 of 18211.5%
Minnesota1 of 631.6%
Mississippi12 of 10411.5%
Missouri17 of 17010%
Montana0 of 270%
Nebraska7 of 5113.7%
Nevada0 of 1000%
New Hampshire3 of 2512%
New Jersey4 of 735.5%
New Mexico6 of 688.8%
New York37 of 21517.2%
North Carolina20 of 17611.4%
North Dakota0 of 260%
Northern Mariana Islands0 of 10%
Ohio26 of 17115.2%
Oklahoma6 of 817.4%
Oregon11 of 9212%
Pennsylvania20 of 3236.2%
Puerto Rico0 of 640%
Rhode Island4 of 2913.8%
South Carolina7 of 897.9%
South Dakota0 of 300%
Tennessee37 of 15623.7%
Texas42 of 40710.3%
U.S. Virgin Islands0 of 10%
Utah5 of 539.4%
Vermont2 of 1414.3%
Virginia8 of 1445.6%
Washington16 of 11414%
West Virginia0 of 690%
Wisconsin11 of 9611.5%
Wyoming0 of 130%

Medicare usage

Medicare Part D paid for 232,402 30-day fills of Admelog in 2024 for about 50,850 enrollees, at an average total cost of $140.74 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).

Related

Agent Tools

Price Admelog and the rest of a client's list on every plan in their county.

Estimate Admelog 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.