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Combigan is a brand of brimonidine / timolol. 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, 1,534 of 5,492 Medicare Part D and Medicare Advantage drug plans (27.9%) list Combigan on their formulary, across 84 of 286 formularies. The most common placement is tier 3 (817 plans, 53.3% of those covering it). 0 of the covering plans require prior authorization (0%), 0 step therapy and 12 a quantity limit. Generic brimonidine / timolol is on 5,159 of 5,492 plans (93.9%).
513 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $0, 321 of them $0; 1,021 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: 3,625 of 5,496 plans covered it (66%); 2027: 1,534 of 5,492 (27.9%).
Of 4,367 plans offered in both years, 36 added it to the formulary and 1,928 dropped it.
Among plans covering it both years, 14 moved it to a higher tier and 532 to a lower one; 0 added prior authorization and 0 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 31 |
| Tier 2 | 682 |
| Tier 3 | 817 |
| Tier 4 | 4 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 74 of 323 | 22.9% | 0% |
| Medicare Advantage with drugs (MA-PD) | 836 of 3,200 | 26.1% | 0% |
| Special needs plans (SNP) | 624 of 1,969 | 31.7% | 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 | 0 of 631 | No tier listed | 0 |
| Wellcare | 268 of 268 | Tier 2 | 0 |
| HealthSpring | 0 of 226 | No tier listed | 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 | 80 of 80 | Tier 3 | 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 | 40 of 40 | Tier 3 | 0 |
| CarePlus Health Plans, Inc. | 0 of 37 | No tier listed | 0 |
| Zing Health | 36 of 36 | Tier 3 | 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 | 42 of 114 | 36.8% |
| Alaska | 2 of 9 | 22.2% |
| American Samoa | 0 of 1 | 0% |
| Arizona | 54 of 147 | 36.7% |
| Arkansas | 24 of 85 | 28.2% |
| California | 26 of 397 | 6.5% |
| Colorado | 27 of 106 | 25.5% |
| Connecticut | 20 of 54 | 37% |
| Delaware | 17 of 43 | 39.5% |
| District of Columbia | 1 of 12 | 8.3% |
| Florida | 153 of 545 | 28.1% |
| Georgia | 36 of 149 | 24.2% |
| Guam | 0 of 1 | 0% |
| Hawaii | 27 of 50 | 54% |
| Idaho | 5 of 45 | 11.1% |
| Illinois | 42 of 132 | 31.8% |
| Indiana | 40 of 138 | 29% |
| Iowa | 25 of 64 | 39.1% |
| Kansas | 16 of 84 | 19% |
| Kentucky | 22 of 121 | 18.2% |
| Louisiana | 36 of 125 | 28.8% |
| Maine | 14 of 52 | 26.9% |
| Maryland | 19 of 49 | 38.8% |
| Massachusetts | 16 of 89 | 18% |
| Michigan | 77 of 182 | 42.3% |
| Minnesota | 11 of 63 | 17.5% |
| Mississippi | 35 of 104 | 33.7% |
| Missouri | 41 of 170 | 24.1% |
| Montana | 2 of 27 | 7.4% |
| Nebraska | 19 of 51 | 37.3% |
| Nevada | 17 of 100 | 17% |
| New Hampshire | 8 of 25 | 32% |
| New Jersey | 18 of 73 | 24.7% |
| New Mexico | 14 of 68 | 20.6% |
| New York | 74 of 215 | 34.4% |
| North Carolina | 62 of 176 | 35.2% |
| North Dakota | 6 of 26 | 23.1% |
| Northern Mariana Islands | 0 of 1 | 0% |
| Ohio | 42 of 171 | 24.6% |
| Oklahoma | 14 of 81 | 17.3% |
| Oregon | 36 of 92 | 39.1% |
| Pennsylvania | 119 of 323 | 36.8% |
| Puerto Rico | 24 of 64 | 37.5% |
| Rhode Island | 6 of 29 | 20.7% |
| South Carolina | 27 of 89 | 30.3% |
| South Dakota | 6 of 30 | 20% |
| Tennessee | 70 of 156 | 44.9% |
| Texas | 104 of 407 | 25.6% |
| U.S. Virgin Islands | 0 of 1 | 0% |
| Utah | 13 of 53 | 24.5% |
| Vermont | 4 of 14 | 28.6% |
| Virginia | 19 of 144 | 13.2% |
| Washington | 31 of 114 | 27.2% |
| West Virginia | 11 of 69 | 15.9% |
| Wisconsin | 23 of 96 | 24% |
| Wyoming | 2 of 13 | 15.4% |
Medicare Part D paid for 752,912 30-day fills of Combigan in 2024 for about 114,363 enrollees, at an average total cost of $215.69 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Combigan and the rest of a client's list on every plan in their county.
Estimate Combigan 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.