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Humalog Mix is a brand of insulin lispro / insulin lispro protamine, human. 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, 2,031 of 5,492 Medicare Part D and Medicare Advantage drug plans (37%) list Humalog Mix on their formulary, across 146 of 286 formularies. The most common placement is tier 3 (1,918 plans, 94.4% of those covering it). 7 of the covering plans require prior authorization (0.3%), 0 step therapy and 338 a quantity limit. Generic insulin lispro is on 3,863 of 5,492 plans (70.3%).
290 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $42, 52 of them $0; 1,741 charge coinsurance instead — median 22% of the drug's cost. Covered insulin is capped at $35 for a month's supply.
2026: 2,124 of 5,496 plans covered it (38.6%); 2027: 2,031 of 5,492 (37%).
Of 4,367 plans offered in both years, 39 added it to the formulary and 49 dropped it.
Among plans covering it both years, 19 moved it to a higher tier and 25 to a lower one; 0 added prior authorization and 0 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 80 |
| Tier 2 | 1 |
| Tier 3 | 1,918 |
| Tier 4 | 31 |
| Tier 6 | 1 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 89 of 323 | 27.6% | 0% |
| Medicare Advantage with drugs (MA-PD) | 1,239 of 3,200 | 38.7% | 0.5% |
| Special needs plans (SNP) | 703 of 1,969 | 35.7% | 0.1% |
| 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 | 0 of 631 | No tier listed | 0 |
| Wellcare | 0 of 268 | No tier listed | 0 |
| HealthSpring | 186 of 226 | Tier 3 | 0 |
| Kaiser Permanente | 0 of 112 | No tier listed | 0 |
| SCAN Health Plan | 83 of 83 | Tier 3 | 0 |
| Highmark Blue Cross Blue Shield or Highmark Blue Shield | 80 of 80 | Tier 3 | 0 |
| Alignment Health Plan | 77 of 77 | Tier 3 | 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 | 35 of 35 | Tier 3 | 0 |
| Prominence Health Plan | 0 of 29 | No tier listed | 0 |
| Medica | 27 of 27 | Tier 3 | 0 |
| Anthem HealthKeepers | 0 of 26 | No tier listed | 0 |
| Blue Cross Blue Shield of Michigan | 26 of 26 | Tier 3 | 0 |
| State | Plans covering | Share |
|---|---|---|
| Alabama | 41 of 114 | 36% |
| Alaska | 2 of 9 | 22.2% |
| American Samoa | 1 of 1 | 100% |
| Arizona | 52 of 147 | 35.4% |
| Arkansas | 25 of 85 | 29.4% |
| California | 183 of 397 | 46.1% |
| Colorado | 37 of 106 | 34.9% |
| Connecticut | 9 of 54 | 16.7% |
| Delaware | 17 of 43 | 39.5% |
| District of Columbia | 5 of 12 | 41.7% |
| Florida | 155 of 545 | 28.4% |
| Georgia | 47 of 149 | 31.5% |
| Guam | 1 of 1 | 100% |
| Hawaii | 9 of 50 | 18% |
| Idaho | 20 of 45 | 44.4% |
| Illinois | 40 of 132 | 30.3% |
| Indiana | 30 of 138 | 21.7% |
| Iowa | 26 of 64 | 40.6% |
| Kansas | 23 of 84 | 27.4% |
| Kentucky | 27 of 121 | 22.3% |
| Louisiana | 27 of 125 | 21.6% |
| Maine | 12 of 52 | 23.1% |
| Maryland | 11 of 49 | 22.4% |
| Massachusetts | 59 of 89 | 66.3% |
| Michigan | 61 of 182 | 33.5% |
| Minnesota | 42 of 63 | 66.7% |
| Mississippi | 35 of 104 | 33.7% |
| Missouri | 49 of 170 | 28.8% |
| Montana | 5 of 27 | 18.5% |
| Nebraska | 20 of 51 | 39.2% |
| Nevada | 35 of 100 | 35% |
| New Hampshire | 7 of 25 | 28% |
| New Jersey | 29 of 73 | 39.7% |
| New Mexico | 37 of 68 | 54.4% |
| New York | 79 of 215 | 36.7% |
| North Carolina | 79 of 176 | 44.9% |
| North Dakota | 17 of 26 | 65.4% |
| Northern Mariana Islands | 1 of 1 | 100% |
| Ohio | 67 of 171 | 39.2% |
| Oklahoma | 29 of 81 | 35.8% |
| Oregon | 23 of 92 | 25% |
| Pennsylvania | 192 of 323 | 59.4% |
| Puerto Rico | 45 of 64 | 70.3% |
| Rhode Island | 16 of 29 | 55.2% |
| South Carolina | 33 of 89 | 37.1% |
| South Dakota | 17 of 30 | 56.7% |
| Tennessee | 43 of 156 | 27.6% |
| Texas | 142 of 407 | 34.9% |
| U.S. Virgin Islands | 1 of 1 | 100% |
| Utah | 21 of 53 | 39.6% |
| Vermont | 2 of 14 | 14.3% |
| Virginia | 44 of 144 | 30.6% |
| Washington | 38 of 114 | 33.3% |
| West Virginia | 32 of 69 | 46.4% |
| Wisconsin | 53 of 96 | 55.2% |
| Wyoming | 5 of 13 | 38.5% |
Medicare Part D paid for 277,942 30-day fills of Humalog Mix in 2024 for about 39,232 enrollees, at an average total cost of $187.67 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Humalog Mix and the rest of a client's list on every plan in their county.
Estimate Humalog Mix 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.