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Movantik Part D coverage 2027

Movantik is a brand of naloxegol. 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.

Coverage at a glance

In 2027, 5,307 of 5,492 Medicare Part D and Medicare Advantage drug plans (96.6%) list Movantik on their formulary, across 264 of 286 formularies. The most common placement is tier 3 (4,483 plans, 84.5% of those covering it). 188 of the covering plans require prior authorization (3.5%), 0 step therapy and 5,157 a quantity limit.

What a 30-day fill costs

545 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $42, 74 of them $0; 4,762 charge coinsurance instead — median 22% 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.

What changed since 2026

2026: 5,263 of 5,496 plans covered it (95.8%); 2027: 5,307 of 5,492 (96.6%).

Of 4,367 plans offered in both years, 35 added it to the formulary and 3 dropped it.

Among plans covering it both years, 50 moved it to a higher tier and 234 to a lower one; 22 added prior authorization and 5 removed it.

Tier placement

TierPlans
Tier 1108
Tier 2276
Tier 34,483
Tier 4440

By plan type

Plan typePlans coveringSharePrior auth
Stand-alone Part D (PDP)323 of 323100%0.6%
Medicare Advantage with drugs (MA-PD)3,051 of 3,20095.3%2.7%
Special needs plans (SNP)1,933 of 1,96998.2%5.4%

By carrier

CarrierPlans coveringUsual tierPrior auth
Humana846 of 846Tier 30
UnitedHealthcare830 of 830Tier 30
Devoted Health728 of 728Tier 30
Aetna Medicare631 of 631Tier 30
Wellcare268 of 268Tier 20
HealthSpring226 of 226Tier 40
Kaiser Permanente112 of 112Tier 40
SCAN Health Plan83 of 83Tier 30
Highmark Blue Cross Blue Shield or Highmark Blue Shield80 of 80Tier 30
Alignment Health Plan77 of 77Tier 30
Anthem Blue Cross and Blue Shield74 of 74Tier 30
Wellpoint63 of 63Tier 30
Priority Health Medicare0 of 40No tier listed0
CarePlus Health Plans, Inc.37 of 37Tier 30
Zing Health36 of 36Tier 30
Capital Blue Cross35 of 35Tier 40
Prominence Health Plan29 of 29Tier 30
Medica0 of 27No tier listed0
Anthem HealthKeepers26 of 26Tier 30
Blue Cross Blue Shield of Michigan26 of 26Tier 426

By state

StatePlans coveringShare
Alabama114 of 114100%
Alaska9 of 9100%
American Samoa1 of 1100%
Arizona144 of 14798%
Arkansas83 of 8597.6%
California397 of 397100%
Colorado106 of 106100%
Connecticut54 of 54100%
Delaware43 of 43100%
District of Columbia12 of 12100%
Florida545 of 545100%
Georgia149 of 149100%
Guam1 of 1100%
Hawaii50 of 50100%
Idaho45 of 45100%
Illinois123 of 13293.2%
Indiana136 of 13898.6%
Iowa64 of 64100%
Kansas84 of 84100%
Kentucky119 of 12198.3%
Louisiana113 of 12590.4%
Maine52 of 52100%
Maryland49 of 49100%
Massachusetts83 of 8993.3%
Michigan140 of 18276.9%
Minnesota49 of 6377.8%
Mississippi104 of 104100%
Missouri162 of 17095.3%
Montana27 of 27100%
Nebraska49 of 5196.1%
Nevada100 of 100100%
New Hampshire25 of 25100%
New Jersey73 of 73100%
New Mexico68 of 68100%
New York213 of 21599.1%
North Carolina172 of 17697.7%
North Dakota20 of 2676.9%
Northern Mariana Islands1 of 1100%
Ohio147 of 17186%
Oklahoma81 of 81100%
Oregon92 of 92100%
Pennsylvania293 of 32390.7%
Puerto Rico47 of 6473.4%
Rhode Island29 of 29100%
South Carolina89 of 89100%
South Dakota22 of 3073.3%
Tennessee156 of 156100%
Texas407 of 407100%
U.S. Virgin Islands1 of 1100%
Utah53 of 53100%
Vermont14 of 14100%
Virginia144 of 144100%
Washington112 of 11498.2%
West Virginia65 of 6994.2%
Wisconsin91 of 9694.8%
Wyoming13 of 13100%

Medicare usage

Medicare Part D paid for 407,938 30-day fills of Movantik in 2024 for about 80,660 enrollees, at an average total cost of $369.14 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).

Agent Tools

Price Movantik and the rest of a client's list on every plan in their county.

Estimate Movantik 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.