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Constulose Part D coverage 2027

Constulose is a brand of lactulose. 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, 5,371 of 5,492 Medicare Part D and Medicare Advantage drug plans (97.8%) list Constulose on their formulary, across 282 of 286 formularies. The most common placement is tier 2 (4,748 plans, 88.4% of those covering it). 0 of the covering plans require prior authorization (0%), 0 step therapy and 0 a quantity limit. Generic lactulose is on 5,492 of 5,492 plans (100%).

What a 30-day fill costs

4,819 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $0, 2,477 of them $0; 552 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: 5,358 of 5,496 plans covered it (97.5%); 2027: 5,371 of 5,492 (97.8%).

Of 4,367 plans offered in both years, 4 added it to the formulary and 1 dropped it.

Among plans covering it both years, 51 moved it to a higher tier and 261 to a lower one; 0 added prior authorization and 0 removed it.

Tier placement

TierPlans
Tier 1523
Tier 24,748
Tier 353
Tier 447

By plan type

Plan typePlans coveringSharePrior auth
Stand-alone Part D (PDP)323 of 323100%0%
Medicare Advantage with drugs (MA-PD)3,118 of 3,20097.4%0%
Special needs plans (SNP)1,930 of 1,96998%0%

By carrier

CarrierPlans coveringUsual tierPrior auth
Humana846 of 846Tier 20
UnitedHealthcare830 of 830Tier 20
Devoted Health728 of 728Tier 20
Aetna Medicare631 of 631Tier 20
Wellcare268 of 268Tier 10
HealthSpring226 of 226Tier 20
Kaiser Permanente0 of 112No tier listed0
SCAN Health Plan83 of 83Tier 20
Highmark Blue Cross Blue Shield or Highmark Blue Shield80 of 80Tier 20
Alignment Health Plan77 of 77Tier 20
Anthem Blue Cross and Blue Shield74 of 74Tier 20
Wellpoint63 of 63Tier 20
Priority Health Medicare40 of 40Tier 20
CarePlus Health Plans, Inc.37 of 37Tier 20
Zing Health36 of 36Tier 20
Capital Blue Cross35 of 35Tier 20
Prominence Health Plan29 of 29Tier 20
Medica27 of 27Tier 20
Anthem HealthKeepers26 of 26Tier 20
Blue Cross Blue Shield of Michigan26 of 26Tier 20

By state

StatePlans coveringShare
Alabama114 of 114100%
Alaska9 of 9100%
American Samoa1 of 1100%
Arizona147 of 147100%
Arkansas85 of 85100%
California349 of 39787.9%
Colorado95 of 10689.6%
Connecticut54 of 54100%
Delaware43 of 43100%
District of Columbia9 of 1275%
Florida545 of 545100%
Georgia141 of 14994.6%
Guam1 of 1100%
Hawaii44 of 5088%
Idaho45 of 45100%
Illinois132 of 132100%
Indiana138 of 138100%
Iowa64 of 64100%
Kansas84 of 84100%
Kentucky121 of 121100%
Louisiana125 of 125100%
Maine52 of 52100%
Maryland39 of 4979.6%
Massachusetts89 of 89100%
Michigan182 of 182100%
Minnesota63 of 63100%
Mississippi104 of 104100%
Missouri170 of 170100%
Montana27 of 27100%
Nebraska51 of 51100%
Nevada97 of 10097%
New Hampshire25 of 25100%
New Jersey73 of 73100%
New Mexico68 of 68100%
New York215 of 215100%
North Carolina176 of 176100%
North Dakota26 of 26100%
Northern Mariana Islands1 of 1100%
Ohio171 of 171100%
Oklahoma81 of 81100%
Oregon88 of 9295.7%
Pennsylvania323 of 323100%
Puerto Rico55 of 6485.9%
Rhode Island29 of 29100%
South Carolina89 of 89100%
South Dakota30 of 30100%
Tennessee156 of 156100%
Texas407 of 407100%
U.S. Virgin Islands1 of 1100%
Utah53 of 53100%
Vermont14 of 14100%
Virginia138 of 14495.8%
Washington98 of 11486%
West Virginia69 of 69100%
Wisconsin96 of 96100%
Wyoming13 of 13100%

Medicare usage

Medicare Part D paid for 254,323 30-day fills of Constulose in 2024 for about 103,675 enrollees, at an average total cost of $18.52 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).

Related

Agent Tools

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

Estimate Constulose 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.