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Miebo is a brand of perfluorohexyloctane. 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, 4,814 of 5,492 Medicare Part D and Medicare Advantage drug plans (87.7%) list Miebo on their formulary, across 221 of 286 formularies. The most common placement is tier 3 (2,516 plans, 52.3% of those covering it). 96 of the covering plans require prior authorization (2%), 0 step therapy and 3,638 a quantity limit.
421 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $42, 57 of them $0; 4,393 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: 4,524 of 5,496 plans covered it (82.3%); 2027: 4,814 of 5,492 (87.7%).
Of 4,367 plans offered in both years, 228 added it to the formulary and 87 dropped it.
Among plans covering it both years, 47 moved it to a higher tier and 84 to a lower one; 12 added prior authorization and 6 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 111 |
| Tier 2 | 71 |
| Tier 3 | 2,516 |
| Tier 4 | 2,116 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 276 of 323 | 85.4% | 0.7% |
| Medicare Advantage with drugs (MA-PD) | 2,767 of 3,200 | 86.5% | 2.4% |
| Special needs plans (SNP) | 1,771 of 1,969 | 89.9% | 1.6% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 846 of 846 | Tier 4 | 0 |
| UnitedHealthcare | 830 of 830 | Tier 4 | 0 |
| Devoted Health | 728 of 728 | Tier 3 | 0 |
| Aetna Medicare | 631 of 631 | Tier 3 | 0 |
| Wellcare | 68 of 268 | Tier 2 | 0 |
| HealthSpring | 191 of 226 | Tier 3 | 0 |
| Kaiser Permanente | 112 of 112 | Tier 4 | 0 |
| SCAN Health Plan | 83 of 83 | Tier 3 | 0 |
| Highmark Blue Cross Blue Shield or Highmark Blue Shield | 80 of 80 | Tier 4 | 0 |
| Alignment Health Plan | 77 of 77 | Tier 3 | 0 |
| Anthem Blue Cross and Blue Shield | 74 of 74 | Tier 3 | 0 |
| Wellpoint | 58 of 63 | Tier 3 | 0 |
| Priority Health Medicare | 0 of 40 | No tier listed | 0 |
| CarePlus Health Plans, Inc. | 37 of 37 | Tier 4 | 0 |
| Zing Health | 36 of 36 | Tier 3 | 0 |
| Capital Blue Cross | 8 of 35 | Tier 3 | 8 |
| Prominence Health Plan | 0 of 29 | No tier listed | 0 |
| Medica | 1 of 27 | Tier 3 | 0 |
| Anthem HealthKeepers | 22 of 26 | Tier 3 | 0 |
| Blue Cross Blue Shield of Michigan | 26 of 26 | Tier 4 | 0 |
| State | Plans covering | Share |
|---|---|---|
| Alabama | 110 of 114 | 96.5% |
| Alaska | 8 of 9 | 88.9% |
| American Samoa | 1 of 1 | 100% |
| Arizona | 141 of 147 | 95.9% |
| Arkansas | 80 of 85 | 94.1% |
| California | 348 of 397 | 87.7% |
| Colorado | 101 of 106 | 95.3% |
| Connecticut | 49 of 54 | 90.7% |
| Delaware | 39 of 43 | 90.7% |
| District of Columbia | 12 of 12 | 100% |
| Florida | 414 of 545 | 76% |
| Georgia | 135 of 149 | 90.6% |
| Guam | 1 of 1 | 100% |
| Hawaii | 49 of 50 | 98% |
| Idaho | 33 of 45 | 73.3% |
| Illinois | 124 of 132 | 93.9% |
| Indiana | 134 of 138 | 97.1% |
| Iowa | 54 of 64 | 84.4% |
| Kansas | 78 of 84 | 92.9% |
| Kentucky | 113 of 121 | 93.4% |
| Louisiana | 114 of 125 | 91.2% |
| Maine | 47 of 52 | 90.4% |
| Maryland | 48 of 49 | 98% |
| Massachusetts | 77 of 89 | 86.5% |
| Michigan | 135 of 182 | 74.2% |
| Minnesota | 30 of 63 | 47.6% |
| Mississippi | 90 of 104 | 86.5% |
| Missouri | 164 of 170 | 96.5% |
| Montana | 23 of 27 | 85.2% |
| Nebraska | 41 of 51 | 80.4% |
| Nevada | 84 of 100 | 84% |
| New Hampshire | 24 of 25 | 96% |
| New Jersey | 68 of 73 | 93.2% |
| New Mexico | 64 of 68 | 94.1% |
| New York | 186 of 215 | 86.5% |
| North Carolina | 155 of 176 | 88.1% |
| North Dakota | 18 of 26 | 69.2% |
| Northern Mariana Islands | 1 of 1 | 100% |
| Ohio | 163 of 171 | 95.3% |
| Oklahoma | 80 of 81 | 98.8% |
| Oregon | 83 of 92 | 90.2% |
| Pennsylvania | 279 of 323 | 86.4% |
| Puerto Rico | 26 of 64 | 40.6% |
| Rhode Island | 23 of 29 | 79.3% |
| South Carolina | 82 of 89 | 92.1% |
| South Dakota | 20 of 30 | 66.7% |
| Tennessee | 149 of 156 | 95.5% |
| Texas | 368 of 407 | 90.4% |
| U.S. Virgin Islands | 1 of 1 | 100% |
| Utah | 49 of 53 | 92.5% |
| Vermont | 13 of 14 | 92.9% |
| Virginia | 137 of 144 | 95.1% |
| Washington | 107 of 114 | 93.9% |
| West Virginia | 67 of 69 | 97.1% |
| Wisconsin | 75 of 96 | 78.1% |
| Wyoming | 11 of 13 | 84.6% |
Medicare Part D paid for 161,355 30-day fills of Miebo in 2024 for about 48,571 enrollees, at an average total cost of $720.42 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Miebo and the rest of a client's list on every plan in their county.
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.