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Procrit is a brand of epoetin alfa. 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, 3,732 of 5,492 Medicare Part D and Medicare Advantage drug plans (68%) list Procrit on their formulary, across 141 of 286 formularies. The most common placement is tier 3 (2,129 plans, 57% of those covering it). 3,597 of the covering plans require prior authorization (96.4%), 0 step therapy and 13 a quantity limit.
339 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $42, 70 of them $0; 3,393 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: 3,784 of 5,496 plans covered it (68.9%); 2027: 3,732 of 5,492 (68%).
Of 4,367 plans offered in both years, 18 added it to the formulary and 132 dropped it.
Among plans covering it both years, 27 moved it to a higher tier and 12 to a lower one; 0 added prior authorization and 1 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 53 |
| Tier 2 | 37 |
| Tier 3 | 2,129 |
| Tier 4 | 1,513 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 101 of 323 | 31.3% | 100% |
| Medicare Advantage with drugs (MA-PD) | 2,256 of 3,200 | 70.5% | 95.5% |
| Special needs plans (SNP) | 1,375 of 1,969 | 69.8% | 97.5% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 0 of 846 | No tier listed | 0 |
| UnitedHealthcare | 830 of 830 | Tier 4 | 830 |
| Devoted Health | 728 of 728 | Tier 3 | 728 |
| Aetna Medicare | 631 of 631 | Tier 3 | 631 |
| Wellcare | 0 of 268 | No tier listed | 0 |
| HealthSpring | 186 of 226 | Tier 4 | 186 |
| Kaiser Permanente | 112 of 112 | Tier 3 | 0 |
| SCAN Health Plan | 83 of 83 | Tier 3 | 83 |
| Highmark Blue Cross Blue Shield or Highmark Blue Shield | 80 of 80 | Tier 3 | 80 |
| Alignment Health Plan | 77 of 77 | Tier 4 | 77 |
| Anthem Blue Cross and Blue Shield | 74 of 74 | Tier 4 | 74 |
| Wellpoint | 63 of 63 | Tier 4 | 63 |
| Priority Health Medicare | 40 of 40 | Tier 3 | 40 |
| CarePlus Health Plans, Inc. | 0 of 37 | No tier listed | 0 |
| Zing Health | 36 of 36 | Tier 3 | 36 |
| Capital Blue Cross | 27 of 35 | Tier 4 | 27 |
| Prominence Health Plan | 0 of 29 | No tier listed | 0 |
| Medica | 27 of 27 | Tier 3 | 27 |
| Anthem HealthKeepers | 26 of 26 | Tier 4 | 26 |
| Blue Cross Blue Shield of Michigan | 26 of 26 | Tier 3 | 26 |
| State | Plans covering | Share |
|---|---|---|
| Alabama | 84 of 114 | 73.7% |
| Alaska | 3 of 9 | 33.3% |
| American Samoa | 1 of 1 | 100% |
| Arizona | 109 of 147 | 74.1% |
| Arkansas | 55 of 85 | 64.7% |
| California | 276 of 397 | 69.5% |
| Colorado | 74 of 106 | 69.8% |
| Connecticut | 40 of 54 | 74.1% |
| Delaware | 30 of 43 | 69.8% |
| District of Columbia | 11 of 12 | 91.7% |
| Florida | 301 of 545 | 55.2% |
| Georgia | 93 of 149 | 62.4% |
| Guam | 1 of 1 | 100% |
| Hawaii | 39 of 50 | 78% |
| Idaho | 27 of 45 | 60% |
| Illinois | 90 of 132 | 68.2% |
| Indiana | 97 of 138 | 70.3% |
| Iowa | 39 of 64 | 60.9% |
| Kansas | 51 of 84 | 60.7% |
| Kentucky | 66 of 121 | 54.5% |
| Louisiana | 73 of 125 | 58.4% |
| Maine | 30 of 52 | 57.7% |
| Maryland | 37 of 49 | 75.5% |
| Massachusetts | 67 of 89 | 75.3% |
| Michigan | 138 of 182 | 75.8% |
| Minnesota | 40 of 63 | 63.5% |
| Mississippi | 63 of 104 | 60.6% |
| Missouri | 121 of 170 | 71.2% |
| Montana | 6 of 27 | 22.2% |
| Nebraska | 32 of 51 | 62.7% |
| Nevada | 57 of 100 | 57% |
| New Hampshire | 13 of 25 | 52% |
| New Jersey | 51 of 73 | 69.9% |
| New Mexico | 44 of 68 | 64.7% |
| New York | 164 of 215 | 76.3% |
| North Carolina | 128 of 176 | 72.7% |
| North Dakota | 19 of 26 | 73.1% |
| Northern Mariana Islands | 1 of 1 | 100% |
| Ohio | 130 of 171 | 76% |
| Oklahoma | 42 of 81 | 51.9% |
| Oregon | 47 of 92 | 51.1% |
| Pennsylvania | 276 of 323 | 85.4% |
| Puerto Rico | 18 of 64 | 28.1% |
| Rhode Island | 18 of 29 | 62.1% |
| South Carolina | 54 of 89 | 60.7% |
| South Dakota | 23 of 30 | 76.7% |
| Tennessee | 125 of 156 | 80.1% |
| Texas | 265 of 407 | 65.1% |
| U.S. Virgin Islands | 1 of 1 | 100% |
| Utah | 29 of 53 | 54.7% |
| Vermont | 4 of 14 | 28.6% |
| Virginia | 95 of 144 | 66% |
| Washington | 79 of 114 | 69.3% |
| West Virginia | 40 of 69 | 58% |
| Wisconsin | 49 of 96 | 51% |
| Wyoming | 4 of 13 | 30.8% |
Medicare Part D paid for 113,221 30-day fills of Procrit in 2024 for about 24,680 enrollees, at an average total cost of $1,380.30 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Procrit and the rest of a client's list on every plan in their county.
Estimate Procrit 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.