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Repatha is a brand of evolocumab. 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, 5,140 of 5,492 Medicare Part D and Medicare Advantage drug plans (93.6%) list Repatha on their formulary, across 275 of 286 formularies. The most common placement is tier 3 (4,857 plans, 94.5% of those covering it). 4,011 of the covering plans require prior authorization (78%), 171 step therapy and 4,324 a quantity limit.
582 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $42, 94 of them $0; 4,558 charge coinsurance instead — median 21% 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: 5,073 of 5,496 plans covered it (92.3%); 2027: 5,140 of 5,492 (93.6%).
Of 4,367 plans offered in both years, 0 added it to the formulary and 2 dropped it.
Among plans covering it both years, 45 moved it to a higher tier and 7 to a lower one; 13 added prior authorization and 6 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 123 |
| Tier 2 | 45 |
| Tier 3 | 4,857 |
| Tier 4 | 115 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 252 of 323 | 78% | 84.5% |
| Medicare Advantage with drugs (MA-PD) | 3,019 of 3,200 | 94.3% | 80.4% |
| Special needs plans (SNP) | 1,869 of 1,969 | 94.9% | 73.4% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 846 of 846 | Tier 3 | 846 |
| UnitedHealthcare | 830 of 830 | Tier 3 | 34 |
| 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 | 226 of 226 | Tier 3 | 226 |
| Kaiser Permanente | 112 of 112 | Tier 4 | 16 |
| 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 3 | 77 |
| Anthem Blue Cross and Blue Shield | 74 of 74 | Tier 3 | 74 |
| Wellpoint | 63 of 63 | Tier 3 | 63 |
| Priority Health Medicare | 40 of 40 | Tier 3 | 40 |
| CarePlus Health Plans, Inc. | 37 of 37 | Tier 3 | 37 |
| Zing Health | 36 of 36 | Tier 3 | 36 |
| Capital Blue Cross | 8 of 35 | Tier 3 | 8 |
| Prominence Health Plan | 29 of 29 | Tier 3 | 29 |
| Medica | 27 of 27 | Tier 3 | 27 |
| Anthem HealthKeepers | 26 of 26 | Tier 3 | 26 |
| Blue Cross Blue Shield of Michigan | 0 of 26 | No tier listed | 0 |
| State | Plans covering | Share |
|---|---|---|
| Alabama | 112 of 114 | 98.2% |
| Alaska | 7 of 9 | 77.8% |
| American Samoa | 1 of 1 | 100% |
| Arizona | 140 of 147 | 95.2% |
| Arkansas | 79 of 85 | 92.9% |
| California | 381 of 397 | 96% |
| Colorado | 104 of 106 | 98.1% |
| Connecticut | 48 of 54 | 88.9% |
| Delaware | 38 of 43 | 88.4% |
| District of Columbia | 12 of 12 | 100% |
| Florida | 514 of 545 | 94.3% |
| Georgia | 134 of 149 | 89.9% |
| Guam | 1 of 1 | 100% |
| Hawaii | 48 of 50 | 96% |
| Idaho | 43 of 45 | 95.6% |
| Illinois | 123 of 132 | 93.2% |
| Indiana | 133 of 138 | 96.4% |
| Iowa | 57 of 64 | 89.1% |
| Kansas | 79 of 84 | 94% |
| Kentucky | 112 of 121 | 92.6% |
| Louisiana | 113 of 125 | 90.4% |
| Maine | 46 of 52 | 88.5% |
| Maryland | 47 of 49 | 95.9% |
| Massachusetts | 87 of 89 | 97.8% |
| Michigan | 133 of 182 | 73.1% |
| Minnesota | 56 of 63 | 88.9% |
| Mississippi | 89 of 104 | 85.6% |
| Missouri | 163 of 170 | 95.9% |
| Montana | 24 of 27 | 88.9% |
| Nebraska | 45 of 51 | 88.2% |
| Nevada | 96 of 100 | 96% |
| New Hampshire | 23 of 25 | 92% |
| New Jersey | 68 of 73 | 93.2% |
| New Mexico | 66 of 68 | 97.1% |
| New York | 202 of 215 | 94% |
| North Carolina | 168 of 176 | 95.5% |
| North Dakota | 23 of 26 | 88.5% |
| Northern Mariana Islands | 1 of 1 | 100% |
| Ohio | 165 of 171 | 96.5% |
| Oklahoma | 79 of 81 | 97.5% |
| Oregon | 83 of 92 | 90.2% |
| Pennsylvania | 291 of 323 | 90.1% |
| Puerto Rico | 64 of 64 | 100% |
| Rhode Island | 27 of 29 | 93.1% |
| South Carolina | 81 of 89 | 91% |
| South Dakota | 27 of 30 | 90% |
| Tennessee | 154 of 156 | 98.7% |
| Texas | 380 of 407 | 93.4% |
| U.S. Virgin Islands | 1 of 1 | 100% |
| Utah | 51 of 53 | 96.2% |
| Vermont | 12 of 14 | 85.7% |
| Virginia | 142 of 144 | 98.6% |
| Washington | 108 of 114 | 94.7% |
| West Virginia | 67 of 69 | 97.1% |
| Wisconsin | 91 of 96 | 94.8% |
| Wyoming | 8 of 13 | 61.5% |
Medicare Part D paid for 3,424,796 30-day fills of Repatha in 2024 for about 440,471 enrollees, at an average total cost of $555.90 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Repatha and the rest of a client's list on every plan in their county.
Estimate Repatha 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.