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Lyumjev is a brand of insulin lispro. What agents check before quoting it: how many 2026 Part D plans cover it, on which tier, with what restrictions and copays, by plan type, carrier and state.
In 2026, 1,773 of 5,496 Medicare Part D and Medicare Advantage drug plans (32.3%) list Lyumjev on their formulary, across 125 of 328 formularies. The most common placement is tier 3 (1,672 plans, 94.3% of those covering it). 8 of the covering plans require prior authorization (0.5%), 0 step therapy and 301 a quantity limit. Generic insulin lispro is on 4,002 of 5,496 plans (72.8%).
471 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $45, 42 of them $0; 1,302 charge coinsurance instead — median 21% of the drug's cost. Covered insulin is capped at $35 for a month's supply.
2025: 2,928 of 5,631 plans covered it (52%); 2026: 1,773 of 5,496 (32.3%).
Of 4,368 plans offered in both years, 118 added it to the formulary and 849 dropped it.
Among plans covering it both years, 16 moved it to a higher tier and 1 to a lower one; 0 added prior authorization and 0 removed it.
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 09/16/2026). CMS formulary data.