Home › Agent Hub › Agent Tools › Part D coverage by drug › Alphagan

Agent Tools

Alphagan Part D coverage 2027

Alphagan is a brand of brimonidine. 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, 457 of 5,492 Medicare Part D and Medicare Advantage drug plans (8.3%) list Alphagan on their formulary, across 16 of 286 formularies. The most common placement is tier 2 (268 plans, 58.6% of those covering it). 0 of the covering plans require prior authorization (0%), 0 step therapy and 19 a quantity limit. Generic brimonidine is on 5,492 of 5,492 plans (100%).

What a 30-day fill costs

43 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $44, 11 of them $0; 414 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.

What changed since 2026

2026: 1,403 of 5,496 plans covered it (25.5%); 2027: 457 of 5,492 (8.3%).

Of 4,367 plans offered in both years, 2 added it to the formulary and 731 dropped it.

Among plans covering it both years, 0 moved it to a higher tier and 230 to a lower one; 0 added prior authorization and 0 removed it.

Tier placement

TierPlans
Tier 2268
Tier 3189

By plan type

Plan typePlans coveringSharePrior auth
Stand-alone Part D (PDP)68 of 32321.1%0%
Medicare Advantage with drugs (MA-PD)260 of 3,2008.1%0%
Special needs plans (SNP)129 of 1,9696.6%0%

By carrier

CarrierPlans coveringUsual tierPrior auth
Humana0 of 846No tier listed0
UnitedHealthcare0 of 830No tier listed0
Devoted Health0 of 728No tier listed0
Aetna Medicare0 of 631No tier listed0
Wellcare268 of 268Tier 20
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 Shield80 of 80Tier 30
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 Health0 of 36No tier listed0
Capital Blue Cross0 of 35No tier listed0
Prominence Health Plan29 of 29Tier 30
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
Alabama2 of 1141.8%
Alaska2 of 922.2%
American Samoa0 of 10%
Arizona7 of 1474.8%
Arkansas9 of 8510.6%
California16 of 3974%
Colorado6 of 1065.7%
Connecticut6 of 5411.1%
Delaware8 of 4318.6%
District of Columbia0 of 120%
Florida30 of 5455.5%
Georgia15 of 14910.1%
Guam0 of 10%
Hawaii2 of 504%
Idaho2 of 454.4%
Illinois9 of 1326.8%
Indiana5 of 1383.6%
Iowa6 of 649.4%
Kansas5 of 846%
Kentucky9 of 1217.4%
Louisiana12 of 1259.6%
Maine6 of 5211.5%
Maryland2 of 494.1%
Massachusetts8 of 899%
Michigan8 of 1824.4%
Minnesota2 of 633.2%
Mississippi19 of 10418.3%
Missouri7 of 1704.1%
Montana2 of 277.4%
Nebraska5 of 519.8%
Nevada17 of 10017%
New Hampshire2 of 258%
New Jersey5 of 736.8%
New Mexico5 of 687.4%
New York41 of 21519.1%
North Carolina8 of 1764.5%
North Dakota2 of 267.7%
Northern Mariana Islands0 of 10%
Ohio6 of 1713.5%
Oklahoma2 of 812.5%
Oregon9 of 929.8%
Pennsylvania74 of 32322.9%
Puerto Rico24 of 6437.5%
Rhode Island2 of 296.9%
South Carolina8 of 899%
South Dakota2 of 306.7%
Tennessee2 of 1561.3%
Texas40 of 4079.8%
U.S. Virgin Islands0 of 10%
Utah5 of 539.4%
Vermont2 of 1414.3%
Virginia2 of 1441.4%
Washington6 of 1145.3%
West Virginia10 of 6914.5%
Wisconsin5 of 965.2%
Wyoming2 of 1315.4%

Medicare usage

Medicare Part D paid for 408,749 30-day fills of Alphagan in 2024 for about 69,303 enrollees, at an average total cost of $226.80 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).

Related

Agent Tools

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

Estimate Alphagan 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.