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Lumigan is a brand of bimatoprost. 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, 3,870 of 5,492 Medicare Part D and Medicare Advantage drug plans (70.5%) list Lumigan on their formulary, across 116 of 286 formularies. The most common placement is tier 3 (2,997 plans, 77.4% of those covering it). 782 of the covering plans require prior authorization (20.2%), 1 step therapy and 1,081 a quantity limit. Generic bimatoprost is on 5,160 of 5,492 plans (94%).
186 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $30, 43 of them $0; 3,684 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: 5,043 of 5,496 plans covered it (91.8%); 2027: 3,870 of 5,492 (70.5%).
Of 4,367 plans offered in both years, 5 added it to the formulary and 929 dropped it.
Among plans covering it both years, 721 moved it to a higher tier and 1 to a lower one; 695 added prior authorization and 0 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 39 |
| Tier 2 | 37 |
| Tier 3 | 2,997 |
| Tier 4 | 797 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 65 of 323 | 20.1% | 0% |
| Medicare Advantage with drugs (MA-PD) | 2,345 of 3,200 | 73.3% | 23.1% |
| Special needs plans (SNP) | 1,460 of 1,969 | 74.1% | 16.4% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 744 of 846 | Tier 4 | 744 |
| UnitedHealthcare | 796 of 830 | Tier 3 | 0 |
| Devoted Health | 728 of 728 | Tier 3 | 0 |
| Aetna Medicare | 631 of 631 | Tier 3 | 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 3 | 0 |
| Alignment Health Plan | 0 of 77 | No tier listed | 0 |
| Anthem Blue Cross and Blue Shield | 74 of 74 | Tier 3 | 0 |
| Wellpoint | 63 of 63 | Tier 3 | 0 |
| Priority Health Medicare | 0 of 40 | No tier listed | 0 |
| CarePlus Health Plans, Inc. | 37 of 37 | Tier 4 | 37 |
| Zing Health | 36 of 36 | Tier 3 | 0 |
| Capital Blue Cross | 0 of 35 | No tier listed | 0 |
| Prominence Health Plan | 0 of 29 | No tier listed | 0 |
| Medica | 0 of 27 | No tier listed | 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 | 82 of 114 | 71.9% |
| Alaska | 2 of 9 | 22.2% |
| American Samoa | 1 of 1 | 100% |
| Arizona | 104 of 147 | 70.7% |
| Arkansas | 61 of 85 | 71.8% |
| California | 156 of 397 | 39.3% |
| Colorado | 71 of 106 | 67% |
| Connecticut | 42 of 54 | 77.8% |
| Delaware | 30 of 43 | 69.8% |
| District of Columbia | 9 of 12 | 75% |
| Florida | 408 of 545 | 74.9% |
| Georgia | 97 of 149 | 65.1% |
| Guam | 1 of 1 | 100% |
| Hawaii | 37 of 50 | 74% |
| Idaho | 34 of 45 | 75.6% |
| Illinois | 99 of 132 | 75% |
| Indiana | 121 of 138 | 87.7% |
| Iowa | 48 of 64 | 75% |
| Kansas | 66 of 84 | 78.6% |
| Kentucky | 99 of 121 | 81.8% |
| Louisiana | 93 of 125 | 74.4% |
| Maine | 41 of 52 | 78.8% |
| Maryland | 27 of 49 | 55.1% |
| Massachusetts | 81 of 89 | 91% |
| Michigan | 109 of 182 | 59.9% |
| Minnesota | 24 of 63 | 38.1% |
| Mississippi | 72 of 104 | 69.2% |
| Missouri | 138 of 170 | 81.2% |
| Montana | 19 of 27 | 70.4% |
| Nebraska | 34 of 51 | 66.7% |
| Nevada | 57 of 100 | 57% |
| New Hampshire | 18 of 25 | 72% |
| New Jersey | 53 of 73 | 72.6% |
| New Mexico | 56 of 68 | 82.4% |
| New York | 174 of 215 | 80.9% |
| North Carolina | 129 of 176 | 73.3% |
| North Dakota | 12 of 26 | 46.2% |
| Northern Mariana Islands | 1 of 1 | 100% |
| Ohio | 118 of 171 | 69% |
| Oklahoma | 58 of 81 | 71.6% |
| Oregon | 49 of 92 | 53.3% |
| Pennsylvania | 223 of 323 | 69% |
| Puerto Rico | 25 of 64 | 39.1% |
| Rhode Island | 16 of 29 | 55.2% |
| South Carolina | 63 of 89 | 70.8% |
| South Dakota | 14 of 30 | 46.7% |
| Tennessee | 127 of 156 | 81.4% |
| Texas | 286 of 407 | 70.3% |
| U.S. Virgin Islands | 1 of 1 | 100% |
| Utah | 40 of 53 | 75.5% |
| Vermont | 6 of 14 | 42.9% |
| Virginia | 124 of 144 | 86.1% |
| Washington | 74 of 114 | 64.9% |
| West Virginia | 49 of 69 | 71% |
| Wisconsin | 68 of 96 | 70.8% |
| Wyoming | 5 of 13 | 38.5% |
Medicare Part D paid for 2,461,829 30-day fills of Lumigan in 2024 for about 336,756 enrollees, at an average total cost of $262.72 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Lumigan and the rest of a client's list on every plan in their county.
Estimate Lumigan 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.