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Rhopressa is a brand of netarsudil. 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, 4,956 of 5,492 Medicare Part D and Medicare Advantage drug plans (90.2%) list Rhopressa on their formulary, across 247 of 286 formularies. The most common placement is tier 3 (2,883 plans, 58.2% of those covering it). 8 of the covering plans require prior authorization (0.2%), 1,835 step therapy and 1,511 a quantity limit.
475 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $42, 85 of them $0; 4,481 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: 5,024 of 5,496 plans covered it (91.4%); 2027: 4,956 of 5,492 (90.2%).
Of 4,367 plans offered in both years, 1 added it to the formulary and 30 dropped it.
Among plans covering it both years, 42 moved it to a higher tier and 182 to a lower one; 1 added prior authorization and 0 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 122 |
| Tier 2 | 208 |
| Tier 3 | 2,883 |
| Tier 4 | 1,743 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 71 of 323 | 22% | 0% |
| Medicare Advantage with drugs (MA-PD) | 2,973 of 3,200 | 92.9% | 0.2% |
| Special needs plans (SNP) | 1,912 of 1,969 | 97.1% | 0.1% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 744 of 846 | Tier 3 | 0 |
| UnitedHealthcare | 796 of 830 | Tier 3 | 0 |
| Devoted Health | 728 of 728 | Tier 4 | 0 |
| Aetna Medicare | 631 of 631 | Tier 4 | 0 |
| Wellcare | 200 of 268 | Tier 2 | 0 |
| HealthSpring | 186 of 226 | Tier 3 | 0 |
| Kaiser Permanente | 0 of 112 | No tier listed | 0 |
| SCAN Health Plan | 83 of 83 | Tier 3 | 0 |
| Highmark Blue Cross Blue Shield or Highmark Blue Shield | 80 of 80 | Tier 4 | 0 |
| Alignment Health Plan | 77 of 77 | Tier 3 | 0 |
| Anthem Blue Cross and Blue Shield | 74 of 74 | Tier 3 | 0 |
| Wellpoint | 63 of 63 | Tier 3 | 0 |
| Priority Health Medicare | 40 of 40 | Tier 3 | 0 |
| CarePlus Health Plans, Inc. | 37 of 37 | Tier 3 | 0 |
| Zing Health | 36 of 36 | Tier 4 | 0 |
| Capital Blue Cross | 8 of 35 | Tier 3 | 0 |
| Prominence Health Plan | 29 of 29 | Tier 3 | 0 |
| Medica | 1 of 27 | Tier 3 | 0 |
| Anthem HealthKeepers | 26 of 26 | Tier 3 | 0 |
| Blue Cross Blue Shield of Michigan | 26 of 26 | Tier 3 | 0 |
| State | Plans covering | Share |
|---|---|---|
| Alabama | 104 of 114 | 91.2% |
| Alaska | 2 of 9 | 22.2% |
| American Samoa | 1 of 1 | 100% |
| Arizona | 140 of 147 | 95.2% |
| Arkansas | 78 of 85 | 91.8% |
| California | 342 of 397 | 86.1% |
| Colorado | 88 of 106 | 83% |
| Connecticut | 47 of 54 | 87% |
| Delaware | 36 of 43 | 83.7% |
| District of Columbia | 9 of 12 | 75% |
| Florida | 497 of 545 | 91.2% |
| Georgia | 134 of 149 | 89.9% |
| Guam | 1 of 1 | 100% |
| Hawaii | 37 of 50 | 74% |
| Idaho | 35 of 45 | 77.8% |
| Illinois | 124 of 132 | 93.9% |
| Indiana | 131 of 138 | 94.9% |
| Iowa | 56 of 64 | 87.5% |
| Kansas | 75 of 84 | 89.3% |
| Kentucky | 114 of 121 | 94.2% |
| Louisiana | 118 of 125 | 94.4% |
| Maine | 45 of 52 | 86.5% |
| Maryland | 32 of 49 | 65.3% |
| Massachusetts | 82 of 89 | 92.1% |
| Michigan | 175 of 182 | 96.2% |
| Minnesota | 33 of 63 | 52.4% |
| Mississippi | 97 of 104 | 93.3% |
| Missouri | 163 of 170 | 95.9% |
| Montana | 19 of 27 | 70.4% |
| Nebraska | 38 of 51 | 74.5% |
| Nevada | 90 of 100 | 90% |
| New Hampshire | 18 of 25 | 72% |
| New Jersey | 64 of 73 | 87.7% |
| New Mexico | 60 of 68 | 88.2% |
| New York | 196 of 215 | 91.2% |
| North Carolina | 169 of 176 | 96% |
| North Dakota | 12 of 26 | 46.2% |
| Northern Mariana Islands | 1 of 1 | 100% |
| Ohio | 148 of 171 | 86.5% |
| Oklahoma | 73 of 81 | 90.1% |
| Oregon | 81 of 92 | 88% |
| Pennsylvania | 289 of 323 | 89.5% |
| Puerto Rico | 38 of 64 | 59.4% |
| Rhode Island | 17 of 29 | 58.6% |
| South Carolina | 82 of 89 | 92.1% |
| South Dakota | 14 of 30 | 46.7% |
| Tennessee | 147 of 156 | 94.2% |
| Texas | 399 of 407 | 98% |
| U.S. Virgin Islands | 1 of 1 | 100% |
| Utah | 46 of 53 | 86.8% |
| Vermont | 7 of 14 | 50% |
| Virginia | 129 of 144 | 89.6% |
| Washington | 89 of 114 | 78.1% |
| West Virginia | 62 of 69 | 89.9% |
| Wisconsin | 85 of 96 | 88.5% |
| Wyoming | 5 of 13 | 38.5% |
Medicare Part D paid for 536,998 30-day fills of Rhopressa in 2024 for about 89,279 enrollees, at an average total cost of $313.04 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Rhopressa and the rest of a client's list on every plan in their county.
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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.