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Lyumjev is a brand of insulin lispro. 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, 1,722 of 5,492 Medicare Part D and Medicare Advantage drug plans (31.4%) list Lyumjev on their formulary, across 116 of 286 formularies. The most common placement is tier 3 (1,643 plans, 95.4% of those covering it). 7 of the covering plans require prior authorization (0.4%), 0 step therapy and 269 a quantity limit. Generic insulin lispro is on 3,863 of 5,492 plans (70.3%).
239 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $42, 36 of them $0; 1,483 charge coinsurance instead — median 22% of the drug's cost. Covered insulin is capped at $35 for a month's supply.
2026: 1,773 of 5,496 plans covered it (32.3%); 2027: 1,722 of 5,492 (31.4%).
Of 4,367 plans offered in both years, 75 added it to the formulary and 47 dropped it.
Among plans covering it both years, 15 moved it to a higher tier and 9 to a lower one; 0 added prior authorization and 0 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 70 |
| Tier 2 | 1 |
| Tier 3 | 1,643 |
| Tier 4 | 7 |
| Tier 6 | 1 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 52 of 323 | 16.1% | 0% |
| Medicare Advantage with drugs (MA-PD) | 999 of 3,200 | 31.2% | 0.6% |
| Special needs plans (SNP) | 671 of 1,969 | 34.1% | 0.1% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 0 of 846 | No tier listed | 0 |
| UnitedHealthcare | 796 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 | 0 of 80 | No tier listed | 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 | 8 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 | 40 of 114 | 35.1% |
| Alaska | 1 of 9 | 11.1% |
| American Samoa | 1 of 1 | 100% |
| Arizona | 51 of 147 | 34.7% |
| Arkansas | 24 of 85 | 28.2% |
| California | 159 of 397 | 40.1% |
| Colorado | 32 of 106 | 30.2% |
| Connecticut | 8 of 54 | 14.8% |
| Delaware | 13 of 43 | 30.2% |
| District of Columbia | 5 of 12 | 41.7% |
| Florida | 149 of 545 | 27.3% |
| Georgia | 46 of 149 | 30.9% |
| Guam | 1 of 1 | 100% |
| Hawaii | 8 of 50 | 16% |
| Idaho | 19 of 45 | 42.2% |
| Illinois | 39 of 132 | 29.5% |
| Indiana | 29 of 138 | 21% |
| Iowa | 24 of 64 | 37.5% |
| Kansas | 22 of 84 | 26.2% |
| Kentucky | 26 of 121 | 21.5% |
| Louisiana | 26 of 125 | 20.8% |
| Maine | 11 of 52 | 21.2% |
| Maryland | 10 of 49 | 20.4% |
| Massachusetts | 12 of 89 | 13.5% |
| Michigan | 60 of 182 | 33% |
| Minnesota | 36 of 63 | 57.1% |
| Mississippi | 34 of 104 | 32.7% |
| Missouri | 48 of 170 | 28.2% |
| Montana | 3 of 27 | 11.1% |
| Nebraska | 18 of 51 | 35.3% |
| Nevada | 31 of 100 | 31% |
| New Hampshire | 6 of 25 | 24% |
| New Jersey | 26 of 73 | 35.6% |
| New Mexico | 33 of 68 | 48.5% |
| New York | 46 of 215 | 21.4% |
| North Carolina | 78 of 176 | 44.3% |
| North Dakota | 15 of 26 | 57.7% |
| Northern Mariana Islands | 1 of 1 | 100% |
| Ohio | 63 of 171 | 36.8% |
| Oklahoma | 28 of 81 | 34.6% |
| Oregon | 22 of 92 | 23.9% |
| Pennsylvania | 83 of 323 | 25.7% |
| Puerto Rico | 21 of 64 | 32.8% |
| Rhode Island | 15 of 29 | 51.7% |
| South Carolina | 32 of 89 | 36% |
| South Dakota | 15 of 30 | 50% |
| Tennessee | 42 of 156 | 26.9% |
| Texas | 141 of 407 | 34.6% |
| U.S. Virgin Islands | 1 of 1 | 100% |
| Utah | 17 of 53 | 32.1% |
| Vermont | 1 of 14 | 7.1% |
| Virginia | 41 of 144 | 28.5% |
| Washington | 37 of 114 | 32.5% |
| West Virginia | 23 of 69 | 33.3% |
| Wisconsin | 51 of 96 | 53.1% |
| Wyoming | 3 of 13 | 23.1% |
Medicare Part D paid for 132,553 30-day fills of Lyumjev in 2024 for about 22,647 enrollees, at an average total cost of $409.25 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
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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.