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Febuxostat is a generic drug. 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, 4,694 of 5,492 Medicare Part D and Medicare Advantage drug plans (85.5%) list Febuxostat on their formulary, across 201 of 286 formularies. The most common placement is tier 3 (2,530 plans, 53.9% of those covering it). 30 of the covering plans require prior authorization (0.6%), 2,500 step therapy and 1,451 a quantity limit.
862 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $0, 439 of them $0; 3,832 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: 4,449 of 5,496 plans covered it (80.9%); 2027: 4,694 of 5,492 (85.5%).
Of 4,367 plans offered in both years, 401 added it to the formulary and 53 dropped it.
Among plans covering it both years, 74 moved it to a higher tier and 216 to a lower one; 0 added prior authorization and 222 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 324 |
| Tier 2 | 397 |
| Tier 3 | 2,530 |
| Tier 4 | 1,443 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 218 of 323 | 67.5% | 0% |
| Medicare Advantage with drugs (MA-PD) | 2,708 of 3,200 | 84.6% | 0.9% |
| Special needs plans (SNP) | 1,768 of 1,969 | 89.8% | 0.3% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 846 of 846 | Tier 3 | 0 |
| UnitedHealthcare | 796 of 830 | Tier 3 | 0 |
| Devoted Health | 446 of 728 | Tier 4 | 0 |
| Aetna Medicare | 611 of 631 | Tier 4 | 0 |
| Wellcare | 234 of 268 | Tier 1 | 0 |
| HealthSpring | 226 of 226 | Tier 3 | 0 |
| Kaiser Permanente | 112 of 112 | Tier 2 | 0 |
| SCAN Health Plan | 83 of 83 | Tier 3 | 0 |
| Highmark Blue Cross Blue Shield or Highmark Blue Shield | 0 of 80 | No tier listed | 0 |
| Alignment Health Plan | 77 of 77 | Tier 3 | 0 |
| Anthem Blue Cross and Blue Shield | 74 of 74 | Tier 3 | 0 |
| Wellpoint | 63 of 63 | Tier 3 | 0 |
| Priority Health Medicare | 40 of 40 | Tier 4 | 0 |
| CarePlus Health Plans, Inc. | 37 of 37 | Tier 3 | 0 |
| Zing Health | 6 of 36 | Tier 4 | 0 |
| Capital Blue Cross | 0 of 35 | No tier listed | 0 |
| Prominence Health Plan | 29 of 29 | Tier 4 | 0 |
| Medica | 27 of 27 | Tier 3 | 0 |
| Anthem HealthKeepers | 26 of 26 | Tier 3 | 0 |
| Blue Cross Blue Shield of Michigan | 26 of 26 | Tier 3 | 0 |
| State | Plans covering | Share |
|---|---|---|
| Alabama | 98 of 114 | 86% |
| Alaska | 6 of 9 | 66.7% |
| American Samoa | 1 of 1 | 100% |
| Arizona | 129 of 147 | 87.8% |
| Arkansas | 71 of 85 | 83.5% |
| California | 383 of 397 | 96.5% |
| Colorado | 95 of 106 | 89.6% |
| Connecticut | 44 of 54 | 81.5% |
| Delaware | 34 of 43 | 79.1% |
| District of Columbia | 11 of 12 | 91.7% |
| Florida | 457 of 545 | 83.9% |
| Georgia | 139 of 149 | 93.3% |
| Guam | 1 of 1 | 100% |
| Hawaii | 35 of 50 | 70% |
| Idaho | 31 of 45 | 68.9% |
| Illinois | 107 of 132 | 81.1% |
| Indiana | 113 of 138 | 81.9% |
| Iowa | 58 of 64 | 90.6% |
| Kansas | 69 of 84 | 82.1% |
| Kentucky | 113 of 121 | 93.4% |
| Louisiana | 114 of 125 | 91.2% |
| Maine | 48 of 52 | 92.3% |
| Maryland | 35 of 49 | 71.4% |
| Massachusetts | 53 of 89 | 59.6% |
| Michigan | 166 of 182 | 91.2% |
| Minnesota | 49 of 63 | 77.8% |
| Mississippi | 91 of 104 | 87.5% |
| Missouri | 150 of 170 | 88.2% |
| Montana | 22 of 27 | 81.5% |
| Nebraska | 42 of 51 | 82.4% |
| Nevada | 97 of 100 | 97% |
| New Hampshire | 20 of 25 | 80% |
| New Jersey | 63 of 73 | 86.3% |
| New Mexico | 56 of 68 | 82.4% |
| New York | 164 of 215 | 76.3% |
| North Carolina | 152 of 176 | 86.4% |
| North Dakota | 23 of 26 | 88.5% |
| Northern Mariana Islands | 1 of 1 | 100% |
| Ohio | 152 of 171 | 88.9% |
| Oklahoma | 67 of 81 | 82.7% |
| Oregon | 73 of 92 | 79.3% |
| Pennsylvania | 190 of 323 | 58.8% |
| Puerto Rico | 64 of 64 | 100% |
| Rhode Island | 18 of 29 | 62.1% |
| South Carolina | 84 of 89 | 94.4% |
| South Dakota | 27 of 30 | 90% |
| Tennessee | 133 of 156 | 85.3% |
| Texas | 378 of 407 | 92.9% |
| U.S. Virgin Islands | 1 of 1 | 100% |
| Utah | 48 of 53 | 90.6% |
| Vermont | 10 of 14 | 71.4% |
| Virginia | 131 of 144 | 91% |
| Washington | 103 of 114 | 90.4% |
| West Virginia | 59 of 69 | 85.5% |
| Wisconsin | 94 of 96 | 97.9% |
| Wyoming | 10 of 13 | 76.9% |
Medicare Part D paid for 671,772 30-day fills of Febuxostat in 2024 for about 82,165 enrollees, at an average total cost of $54.63 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Febuxostat and the rest of a client's list on every plan in their county.
Estimate Febuxostat 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.