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Qulipta is a brand of atogepant. 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, 3,394 of 5,492 Medicare Part D and Medicare Advantage drug plans (61.8%) list Qulipta on their formulary, across 183 of 286 formularies. The most common placement is tier 3 (2,130 plans, 62.8% of those covering it). 3,289 of the covering plans require prior authorization (96.9%), 0 step therapy and 3,281 a quantity limit.
184 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $44.50, 34 of them $0; 3,210 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: 4,016 of 5,496 plans covered it (73.1%); 2027: 3,394 of 5,492 (61.8%).
Of 4,367 plans offered in both years, 87 added it to the formulary and 778 dropped it.
Among plans covering it both years, 45 moved it to a higher tier and 16 to a lower one; 12 added prior authorization and 0 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 95 |
| Tier 2 | 8 |
| Tier 3 | 2,130 |
| Tier 4 | 951 |
| Tier 5 | 210 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 128 of 323 | 39.6% | 100% |
| Medicare Advantage with drugs (MA-PD) | 2,019 of 3,200 | 63.1% | 96.4% |
| Special needs plans (SNP) | 1,247 of 1,969 | 63.3% | 97.4% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 846 of 846 | Tier 4 | 846 |
| UnitedHealthcare | 0 of 830 | No tier listed | 0 |
| 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 | 0 of 226 | No tier listed | 0 |
| Kaiser Permanente | 112 of 112 | Tier 5 | 16 |
| SCAN Health Plan | 0 of 83 | No tier listed | 0 |
| Highmark Blue Cross Blue Shield or Highmark Blue Shield | 80 of 80 | Tier 3 | 80 |
| Alignment Health Plan | 0 of 77 | No tier listed | 0 |
| Anthem Blue Cross and Blue Shield | 74 of 74 | Tier 3 | 74 |
| Wellpoint | 58 of 63 | Tier 3 | 58 |
| Priority Health Medicare | 0 of 40 | No tier listed | 0 |
| CarePlus Health Plans, Inc. | 37 of 37 | Tier 4 | 37 |
| Zing Health | 36 of 36 | Tier 3 | 36 |
| Capital Blue Cross | 0 of 35 | No tier listed | 0 |
| Prominence Health Plan | 29 of 29 | Tier 3 | 29 |
| Medica | 1 of 27 | Tier 3 | 1 |
| Anthem HealthKeepers | 22 of 26 | Tier 3 | 22 |
| Blue Cross Blue Shield of Michigan | 26 of 26 | Tier 5 | 26 |
| State | Plans covering | Share |
|---|---|---|
| Alabama | 73 of 114 | 64% |
| Alaska | 4 of 9 | 44.4% |
| American Samoa | 0 of 1 | 0% |
| Arizona | 90 of 147 | 61.2% |
| Arkansas | 55 of 85 | 64.7% |
| California | 202 of 397 | 50.9% |
| Colorado | 70 of 106 | 66% |
| Connecticut | 38 of 54 | 70.4% |
| Delaware | 23 of 43 | 53.5% |
| District of Columbia | 7 of 12 | 58.3% |
| Florida | 315 of 545 | 57.8% |
| Georgia | 91 of 149 | 61.1% |
| Guam | 0 of 1 | 0% |
| Hawaii | 38 of 50 | 76% |
| Idaho | 15 of 45 | 33.3% |
| Illinois | 91 of 132 | 68.9% |
| Indiana | 106 of 138 | 76.8% |
| Iowa | 39 of 64 | 60.9% |
| Kansas | 57 of 84 | 67.9% |
| Kentucky | 87 of 121 | 71.9% |
| Louisiana | 88 of 125 | 70.4% |
| Maine | 33 of 52 | 63.5% |
| Maryland | 37 of 49 | 75.5% |
| Massachusetts | 63 of 89 | 70.8% |
| Michigan | 106 of 182 | 58.2% |
| Minnesota | 18 of 63 | 28.6% |
| Mississippi | 54 of 104 | 51.9% |
| Missouri | 125 of 170 | 73.5% |
| Montana | 17 of 27 | 63% |
| Nebraska | 26 of 51 | 51% |
| Nevada | 60 of 100 | 60% |
| New Hampshire | 15 of 25 | 60% |
| New Jersey | 40 of 73 | 54.8% |
| New Mexico | 27 of 68 | 39.7% |
| New York | 134 of 215 | 62.3% |
| North Carolina | 100 of 176 | 56.8% |
| North Dakota | 6 of 26 | 23.1% |
| Northern Mariana Islands | 0 of 1 | 0% |
| Ohio | 114 of 171 | 66.7% |
| Oklahoma | 54 of 81 | 66.7% |
| Oregon | 61 of 92 | 66.3% |
| Pennsylvania | 230 of 323 | 71.2% |
| Puerto Rico | 24 of 64 | 37.5% |
| Rhode Island | 10 of 29 | 34.5% |
| South Carolina | 50 of 89 | 56.2% |
| South Dakota | 10 of 30 | 33.3% |
| Tennessee | 109 of 156 | 69.9% |
| Texas | 251 of 407 | 61.7% |
| U.S. Virgin Islands | 0 of 1 | 0% |
| Utah | 30 of 53 | 56.6% |
| Vermont | 9 of 14 | 64.3% |
| Virginia | 97 of 144 | 67.4% |
| Washington | 73 of 114 | 64% |
| West Virginia | 54 of 69 | 78.3% |
| Wisconsin | 57 of 96 | 59.4% |
| Wyoming | 7 of 13 | 53.8% |
Medicare Part D paid for 243,834 30-day fills of Qulipta in 2024 for about 45,031 enrollees, at an average total cost of $1,047 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Qulipta and the rest of a client's list on every plan in their county.
Estimate Qulipta 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.