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SSD Part D coverage 2027

SSD is a brand of silver sulfadiazine. 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.

Coverage at a glance

In 2027, 5,463 of 5,492 Medicare Part D and Medicare Advantage drug plans (99.5%) list SSD on their formulary, across 284 of 286 formularies. The most common placement is tier 2 (2,955 plans, 54.1% of those covering it). 0 of the covering plans require prior authorization (0%), 0 step therapy and 0 a quantity limit. Generic silver sulfadiazine is on 5,492 of 5,492 plans (100%).

What a 30-day fill costs

3,245 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $0, 1,755 of them $0; 2,218 charge coinsurance instead — median 22% 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.

What changed since 2026

2026: 5,443 of 5,496 plans covered it (99%); 2027: 5,463 of 5,492 (99.5%).

Of 4,367 plans offered in both years, 16 added it to the formulary and 0 dropped it.

Among plans covering it both years, 37 moved it to a higher tier and 377 to a lower one; 0 added prior authorization and 0 removed it.

Tier placement

TierPlans
Tier 1481
Tier 22,955
Tier 31,781
Tier 4246

By plan type

Plan typePlans coveringSharePrior auth
Stand-alone Part D (PDP)303 of 32393.8%0%
Medicare Advantage with drugs (MA-PD)3,200 of 3,200100%0%
Special needs plans (SNP)1,960 of 1,96999.5%0%

By carrier

CarrierPlans coveringUsual tierPrior auth
Humana846 of 846Tier 20
UnitedHealthcare830 of 830Tier 30
Devoted Health728 of 728Tier 20
Aetna Medicare611 of 631Tier 30
Wellcare268 of 268Tier 10
HealthSpring226 of 226Tier 30
Kaiser Permanente112 of 112Tier 20
SCAN Health Plan83 of 83Tier 20
Highmark Blue Cross Blue Shield or Highmark Blue Shield80 of 80Tier 40
Alignment Health Plan77 of 77Tier 20
Anthem Blue Cross and Blue Shield74 of 74Tier 20
Wellpoint63 of 63Tier 20
Priority Health Medicare40 of 40Tier 20
CarePlus Health Plans, Inc.37 of 37Tier 20
Zing Health36 of 36Tier 20
Capital Blue Cross35 of 35Tier 20
Prominence Health Plan29 of 29Tier 40
Medica27 of 27Tier 20
Anthem HealthKeepers26 of 26Tier 20
Blue Cross Blue Shield of Michigan26 of 26Tier 30

By state

StatePlans coveringShare
Alabama113 of 11499.1%
Alaska8 of 988.9%
American Samoa1 of 1100%
Arizona146 of 14799.3%
Arkansas84 of 8598.8%
California397 of 397100%
Colorado106 of 106100%
Connecticut54 of 54100%
Delaware42 of 4397.7%
District of Columbia12 of 12100%
Florida544 of 54599.8%
Georgia148 of 14999.3%
Guam1 of 1100%
Hawaii50 of 50100%
Idaho45 of 45100%
Illinois131 of 13299.2%
Indiana138 of 138100%
Iowa64 of 64100%
Kansas83 of 8498.8%
Kentucky121 of 121100%
Louisiana125 of 125100%
Maine52 of 52100%
Maryland48 of 4998%
Massachusetts89 of 89100%
Michigan181 of 18299.5%
Minnesota63 of 63100%
Mississippi103 of 10499%
Missouri169 of 17099.4%
Montana27 of 27100%
Nebraska51 of 51100%
Nevada99 of 10099%
New Hampshire25 of 25100%
New Jersey72 of 7398.6%
New Mexico67 of 6898.5%
New York214 of 21599.5%
North Carolina175 of 17699.4%
North Dakota26 of 26100%
Northern Mariana Islands1 of 1100%
Ohio170 of 17199.4%
Oklahoma81 of 81100%
Oregon92 of 92100%
Pennsylvania323 of 323100%
Puerto Rico55 of 6485.9%
Rhode Island29 of 29100%
South Carolina89 of 89100%
South Dakota30 of 30100%
Tennessee155 of 15699.4%
Texas406 of 40799.8%
U.S. Virgin Islands1 of 1100%
Utah53 of 53100%
Vermont14 of 14100%
Virginia143 of 14499.3%
Washington114 of 114100%
West Virginia69 of 69100%
Wisconsin96 of 96100%
Wyoming13 of 13100%

Medicare usage

Medicare Part D paid for 309,872 30-day fills of SSD in 2024 for about 184,835 enrollees, at an average total cost of $16.68 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).

Related

Agent Tools

Price SSD and the rest of a client's list on every plan in their county.

Estimate SSD 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.