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Nuedexta is a brand of dextromethorphan / quinidine. 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, 4,219 of 5,492 Medicare Part D and Medicare Advantage drug plans (76.8%) list Nuedexta on their formulary, across 212 of 286 formularies. The most common placement is tier 5 (3,551 plans, 84.2% of those covering it). 4,219 of the covering plans require prior authorization (100%), 0 step therapy and 3,714 a quantity limit.
63 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $0, 36 of them $0; 4,156 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: 5,311 of 5,496 plans covered it (96.6%); 2027: 4,219 of 5,492 (76.8%).
Of 4,367 plans offered in both years, 7 added it to the formulary and 924 dropped it.
Among plans covering it both years, 50 moved it to a higher tier and 346 to a lower one; 3 added prior authorization and 0 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 105 |
| Tier 2 | 269 |
| Tier 3 | 196 |
| Tier 4 | 98 |
| Tier 5 | 3,551 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 146 of 323 | 45.2% | 100% |
| Medicare Advantage with drugs (MA-PD) | 2,575 of 3,200 | 80.5% | 100% |
| Special needs plans (SNP) | 1,498 of 1,969 | 76.1% | 100% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 744 of 846 | Tier 5 | 744 |
| UnitedHealthcare | 0 of 830 | No tier listed | 0 |
| Devoted Health | 728 of 728 | Tier 5 | 728 |
| Aetna Medicare | 631 of 631 | Tier 5 | 631 |
| Wellcare | 268 of 268 | Tier 2 | 268 |
| HealthSpring | 226 of 226 | Tier 5 | 226 |
| Kaiser Permanente | 112 of 112 | Tier 5 | 112 |
| SCAN Health Plan | 83 of 83 | Tier 5 | 83 |
| Highmark Blue Cross Blue Shield or Highmark Blue Shield | 80 of 80 | Tier 5 | 80 |
| Alignment Health Plan | 77 of 77 | Tier 5 | 77 |
| Anthem Blue Cross and Blue Shield | 74 of 74 | Tier 5 | 74 |
| Wellpoint | 63 of 63 | Tier 5 | 63 |
| Priority Health Medicare | 0 of 40 | No tier listed | 0 |
| CarePlus Health Plans, Inc. | 37 of 37 | Tier 5 | 37 |
| Zing Health | 36 of 36 | Tier 5 | 36 |
| Capital Blue Cross | 35 of 35 | Tier 3 | 35 |
| Prominence Health Plan | 0 of 29 | No tier listed | 0 |
| Medica | 0 of 27 | No tier listed | 0 |
| Anthem HealthKeepers | 26 of 26 | Tier 5 | 26 |
| Blue Cross Blue Shield of Michigan | 26 of 26 | Tier 5 | 26 |
| State | Plans covering | Share |
|---|---|---|
| Alabama | 95 of 114 | 83.3% |
| Alaska | 4 of 9 | 44.4% |
| American Samoa | 0 of 1 | 0% |
| Arizona | 113 of 147 | 76.9% |
| Arkansas | 68 of 85 | 80% |
| California | 284 of 397 | 71.5% |
| Colorado | 75 of 106 | 70.8% |
| Connecticut | 42 of 54 | 77.8% |
| Delaware | 31 of 43 | 72.1% |
| District of Columbia | 7 of 12 | 58.3% |
| Florida | 466 of 545 | 85.5% |
| Georgia | 126 of 149 | 84.6% |
| Guam | 0 of 1 | 0% |
| Hawaii | 39 of 50 | 78% |
| Idaho | 26 of 45 | 57.8% |
| Illinois | 99 of 132 | 75% |
| Indiana | 107 of 138 | 77.5% |
| Iowa | 48 of 64 | 75% |
| Kansas | 66 of 84 | 78.6% |
| Kentucky | 95 of 121 | 78.5% |
| Louisiana | 87 of 125 | 69.6% |
| Maine | 37 of 52 | 71.2% |
| Maryland | 40 of 49 | 81.6% |
| Massachusetts | 75 of 89 | 84.3% |
| Michigan | 121 of 182 | 66.5% |
| Minnesota | 35 of 63 | 55.6% |
| Mississippi | 82 of 104 | 78.8% |
| Missouri | 127 of 170 | 74.7% |
| Montana | 20 of 27 | 74.1% |
| Nebraska | 37 of 51 | 72.5% |
| Nevada | 58 of 100 | 58% |
| New Hampshire | 15 of 25 | 60% |
| New Jersey | 58 of 73 | 79.5% |
| New Mexico | 35 of 68 | 51.5% |
| New York | 170 of 215 | 79.1% |
| North Carolina | 138 of 176 | 78.4% |
| North Dakota | 11 of 26 | 42.3% |
| Northern Mariana Islands | 0 of 1 | 0% |
| Ohio | 115 of 171 | 67.3% |
| Oklahoma | 52 of 81 | 64.2% |
| Oregon | 67 of 92 | 72.8% |
| Pennsylvania | 297 of 323 | 92% |
| Puerto Rico | 63 of 64 | 98.4% |
| Rhode Island | 15 of 29 | 51.7% |
| South Carolina | 75 of 89 | 84.3% |
| South Dakota | 15 of 30 | 50% |
| Tennessee | 130 of 156 | 83.3% |
| Texas | 312 of 407 | 76.7% |
| U.S. Virgin Islands | 0 of 1 | 0% |
| Utah | 32 of 53 | 60.4% |
| Vermont | 9 of 14 | 64.3% |
| Virginia | 104 of 144 | 72.2% |
| Washington | 84 of 114 | 73.7% |
| West Virginia | 51 of 69 | 73.9% |
| Wisconsin | 66 of 96 | 68.8% |
| Wyoming | 8 of 13 | 61.5% |
Medicare Part D paid for 164,656 30-day fills of Nuedexta in 2024 for about 15,788 enrollees, at an average total cost of $973.43 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Nuedexta and the rest of a client's list on every plan in their county.
Estimate Nuedexta 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.