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Glyburide / Metformin 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, 1,094 of 5,492 Medicare Part D and Medicare Advantage drug plans (19.9%) list Glyburide / Metformin on their formulary, across 156 of 286 formularies. The most common placement is tier 1 (595 plans, 54.4% of those covering it). 95 of the covering plans require prior authorization (8.7%), 0 step therapy and 523 a quantity limit.
957 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $0, 756 of them $0; 137 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: 1,215 of 5,496 plans covered it (22.1%); 2027: 1,094 of 5,492 (19.9%).
Of 4,367 plans offered in both years, 40 added it to the formulary and 47 dropped it.
Among plans covering it both years, 20 moved it to a higher tier and 153 to a lower one; 8 added prior authorization and 10 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 595 |
| Tier 2 | 202 |
| Tier 3 | 25 |
| Tier 4 | 2 |
| Tier 5 | 3 |
| Tier 6 | 267 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 11 of 323 | 3.4% | 0% |
| Medicare Advantage with drugs (MA-PD) | 652 of 3,200 | 20.4% | 6.6% |
| Special needs plans (SNP) | 431 of 1,969 | 21.9% | 12.1% |
| 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 | 0 of 728 | No tier listed | 0 |
| Aetna Medicare | 0 of 631 | No tier listed | 0 |
| Wellcare | 0 of 268 | No tier listed | 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 2 | 0 |
| Alignment Health Plan | 77 of 77 | Tier 6 | 0 |
| Anthem Blue Cross and Blue Shield | 74 of 74 | Tier 1 | 0 |
| Wellpoint | 63 of 63 | Tier 1 | 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 | 8 of 35 | Tier 2 | 0 |
| Prominence Health Plan | 29 of 29 | Tier 6 | 0 |
| Medica | 0 of 27 | No tier listed | 0 |
| Anthem HealthKeepers | 26 of 26 | Tier 1 | 0 |
| Blue Cross Blue Shield of Michigan | 26 of 26 | Tier 1 | 0 |
| State | Plans covering | Share |
|---|---|---|
| Alabama | 7 of 114 | 6.1% |
| Alaska | 0 of 9 | 0% |
| American Samoa | 0 of 1 | 0% |
| Arizona | 35 of 147 | 23.8% |
| Arkansas | 5 of 85 | 5.9% |
| California | 158 of 397 | 39.8% |
| Colorado | 13 of 106 | 12.3% |
| Connecticut | 6 of 54 | 11.1% |
| Delaware | 5 of 43 | 11.6% |
| District of Columbia | 0 of 12 | 0% |
| Florida | 105 of 545 | 19.3% |
| Georgia | 12 of 149 | 8.1% |
| Guam | 0 of 1 | 0% |
| Hawaii | 1 of 50 | 2% |
| Idaho | 4 of 45 | 8.9% |
| Illinois | 2 of 132 | 1.5% |
| Indiana | 32 of 138 | 23.2% |
| Iowa | 13 of 64 | 20.3% |
| Kansas | 9 of 84 | 10.7% |
| Kentucky | 17 of 121 | 14% |
| Louisiana | 6 of 125 | 4.8% |
| Maine | 5 of 52 | 9.6% |
| Maryland | 2 of 49 | 4.1% |
| Massachusetts | 41 of 89 | 46.1% |
| Michigan | 49 of 182 | 26.9% |
| Minnesota | 16 of 63 | 25.4% |
| Mississippi | 5 of 104 | 4.8% |
| Missouri | 15 of 170 | 8.8% |
| Montana | 0 of 27 | 0% |
| Nebraska | 5 of 51 | 9.8% |
| Nevada | 33 of 100 | 33% |
| New Hampshire | 0 of 25 | 0% |
| New Jersey | 18 of 73 | 24.7% |
| New Mexico | 0 of 68 | 0% |
| New York | 64 of 215 | 29.8% |
| North Carolina | 36 of 176 | 20.5% |
| North Dakota | 4 of 26 | 15.4% |
| Northern Mariana Islands | 0 of 1 | 0% |
| Ohio | 27 of 171 | 15.8% |
| Oklahoma | 12 of 81 | 14.8% |
| Oregon | 23 of 92 | 25% |
| Pennsylvania | 109 of 323 | 33.7% |
| Puerto Rico | 20 of 64 | 31.3% |
| Rhode Island | 5 of 29 | 17.2% |
| South Carolina | 12 of 89 | 13.5% |
| South Dakota | 4 of 30 | 13.3% |
| Tennessee | 15 of 156 | 9.6% |
| Texas | 91 of 407 | 22.4% |
| U.S. Virgin Islands | 0 of 1 | 0% |
| Utah | 6 of 53 | 11.3% |
| Vermont | 0 of 14 | 0% |
| Virginia | 17 of 144 | 11.8% |
| Washington | 12 of 114 | 10.5% |
| West Virginia | 20 of 69 | 29% |
| Wisconsin | 19 of 96 | 19.8% |
| Wyoming | 2 of 13 | 15.4% |
Medicare Part D paid for 119,496 30-day fills of Glyburide / Metformin in 2024 for about 15,587 enrollees, at an average total cost of $9.06 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Glyburide / Metformin and the rest of a client's list on every plan in their county.
Estimate Glyburide / Metformin 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.