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Clenpiq is a brand of citric acid / magnesium oxide / picosulfurate. 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, 2,059 of 5,492 Medicare Part D and Medicare Advantage drug plans (37.5%) list Clenpiq on their formulary, across 62 of 286 formularies. The most common placement is tier 3 (1,060 plans, 51.5% of those covering it). 0 of the covering plans require prior authorization (0%), 0 step therapy and 848 a quantity limit.
96 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $45, 27 of them $0; 1,963 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: 2,140 of 5,496 plans covered it (38.9%); 2027: 2,059 of 5,492 (37.5%).
Of 4,367 plans offered in both years, 50 added it to the formulary and 5 dropped it.
Among plans covering it both years, 0 moved it to a higher tier and 0 to a lower one; 0 added prior authorization and 0 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 23 |
| Tier 3 | 1,060 |
| Tier 4 | 976 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 135 of 323 | 41.8% | 0% |
| Medicare Advantage with drugs (MA-PD) | 1,225 of 3,200 | 38.3% | 0% |
| Special needs plans (SNP) | 699 of 1,969 | 35.5% | 0% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 0 of 846 | No tier listed | 0 |
| UnitedHealthcare | 830 of 830 | Tier 3 | 0 |
| Devoted Health | 0 of 728 | No tier listed | 0 |
| Aetna Medicare | 631 of 631 | Tier 4 | 0 |
| Wellcare | 0 of 268 | No tier listed | 0 |
| HealthSpring | 226 of 226 | Tier 4 | 0 |
| Kaiser Permanente | 0 of 112 | No tier listed | 0 |
| SCAN Health Plan | 0 of 83 | No tier listed | 0 |
| Highmark Blue Cross Blue Shield or Highmark Blue Shield | 0 of 80 | No tier listed | 0 |
| Alignment Health Plan | 0 of 77 | No tier listed | 0 |
| Anthem Blue Cross and Blue Shield | 0 of 74 | No tier listed | 0 |
| Wellpoint | 0 of 63 | No tier listed | 0 |
| Priority Health Medicare | 0 of 40 | No tier listed | 0 |
| CarePlus Health Plans, Inc. | 0 of 37 | No tier listed | 0 |
| Zing Health | 0 of 36 | No tier listed | 0 |
| Capital Blue Cross | 0 of 35 | No tier listed | 0 |
| Prominence Health Plan | 29 of 29 | Tier 3 | 0 |
| Medica | 0 of 27 | No tier listed | 0 |
| Anthem HealthKeepers | 0 of 26 | No tier listed | 0 |
| Blue Cross Blue Shield of Michigan | 0 of 26 | No tier listed | 0 |
| State | Plans covering | Share |
|---|---|---|
| Alabama | 45 of 114 | 39.5% |
| Alaska | 4 of 9 | 44.4% |
| American Samoa | 1 of 1 | 100% |
| Arizona | 43 of 147 | 29.3% |
| Arkansas | 36 of 85 | 42.4% |
| California | 72 of 397 | 18.1% |
| Colorado | 44 of 106 | 41.5% |
| Connecticut | 21 of 54 | 38.9% |
| Delaware | 21 of 43 | 48.8% |
| District of Columbia | 7 of 12 | 58.3% |
| Florida | 181 of 545 | 33.2% |
| Georgia | 66 of 149 | 44.3% |
| Guam | 1 of 1 | 100% |
| Hawaii | 10 of 50 | 20% |
| Idaho | 17 of 45 | 37.8% |
| Illinois | 51 of 132 | 38.6% |
| Indiana | 40 of 138 | 29% |
| Iowa | 32 of 64 | 50% |
| Kansas | 39 of 84 | 46.4% |
| Kentucky | 38 of 121 | 31.4% |
| Louisiana | 37 of 125 | 29.6% |
| Maine | 18 of 52 | 34.6% |
| Maryland | 11 of 49 | 22.4% |
| Massachusetts | 66 of 89 | 74.2% |
| Michigan | 29 of 182 | 15.9% |
| Minnesota | 25 of 63 | 39.7% |
| Mississippi | 44 of 104 | 42.3% |
| Missouri | 78 of 170 | 45.9% |
| Montana | 5 of 27 | 18.5% |
| Nebraska | 21 of 51 | 41.2% |
| Nevada | 50 of 100 | 50% |
| New Hampshire | 8 of 25 | 32% |
| New Jersey | 41 of 73 | 56.2% |
| New Mexico | 34 of 68 | 50% |
| New York | 87 of 215 | 40.5% |
| North Carolina | 81 of 176 | 46% |
| North Dakota | 14 of 26 | 53.8% |
| Northern Mariana Islands | 1 of 1 | 100% |
| Ohio | 60 of 171 | 35.1% |
| Oklahoma | 32 of 81 | 39.5% |
| Oregon | 14 of 92 | 15.2% |
| Pennsylvania | 142 of 323 | 44% |
| Puerto Rico | 3 of 64 | 4.7% |
| Rhode Island | 15 of 29 | 51.7% |
| South Carolina | 45 of 89 | 50.6% |
| South Dakota | 16 of 30 | 53.3% |
| Tennessee | 68 of 156 | 43.6% |
| Texas | 173 of 407 | 42.5% |
| U.S. Virgin Islands | 1 of 1 | 100% |
| Utah | 25 of 53 | 47.2% |
| Vermont | 3 of 14 | 21.4% |
| Virginia | 56 of 144 | 38.9% |
| Washington | 33 of 114 | 28.9% |
| West Virginia | 25 of 69 | 36.2% |
| Wisconsin | 52 of 96 | 54.2% |
| Wyoming | 3 of 13 | 23.1% |
Medicare Part D paid for 155,530 30-day fills of Clenpiq in 2024 for about 149,330 enrollees, at an average total cost of $169.07 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Clenpiq and the rest of a client's list on every plan in their county.
Estimate Clenpiq 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.