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Symbicort is a brand of budesonide / formoterol. 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, 1,898 of 5,492 Medicare Part D and Medicare Advantage drug plans (34.6%) list Symbicort on their formulary, across 24 of 286 formularies. The most common placement is tier 3 (1,887 plans, 99.4% of those covering it). 0 of the covering plans require prior authorization (0%), 0 step therapy and 1,898 a quantity limit. Generic budesonide / formoterol is on 5,492 of 5,492 plans (100%).
82 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $0, 43 of them $0; 1,816 charge coinsurance instead — median 20% 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: 1,914 of 5,496 plans covered it (34.8%); 2027: 1,898 of 5,492 (34.6%).
Of 4,367 plans offered in both years, 0 added it to the formulary and 3 dropped it.
Among plans covering it both years, 0 moved it to a higher tier and 0 to a lower one; 0 added prior authorization and 0 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 11 |
| Tier 3 | 1,887 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 177 of 323 | 54.8% | 0% |
| Medicare Advantage with drugs (MA-PD) | 1,080 of 3,200 | 33.8% | 0% |
| Special needs plans (SNP) | 641 of 1,969 | 32.6% | 0% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 846 of 846 | Tier 3 | 0 |
| UnitedHealthcare | 830 of 830 | Tier 3 | 0 |
| Devoted Health | 0 of 728 | No tier listed | 0 |
| Aetna Medicare | 0 of 631 | No tier listed | 0 |
| Wellcare | 0 of 268 | No tier listed | 0 |
| HealthSpring | 0 of 226 | No tier listed | 0 |
| Kaiser Permanente | 0 of 112 | No tier listed | 0 |
| SCAN Health Plan | 0 of 83 | No tier listed | 0 |
| Highmark Blue Cross Blue Shield or Highmark Blue Shield | 0 of 80 | No tier listed | 0 |
| Alignment Health Plan | 0 of 77 | No tier listed | 0 |
| Anthem Blue Cross and Blue Shield | 0 of 74 | No tier listed | 0 |
| Wellpoint | 0 of 63 | No tier listed | 0 |
| Priority Health Medicare | 0 of 40 | No tier listed | 0 |
| CarePlus Health Plans, Inc. | 37 of 37 | Tier 3 | 0 |
| Zing Health | 0 of 36 | No tier listed | 0 |
| Capital Blue Cross | 0 of 35 | No tier listed | 0 |
| Prominence Health Plan | 29 of 29 | Tier 3 | 0 |
| Medica | 0 of 27 | No tier listed | 0 |
| Anthem HealthKeepers | 0 of 26 | No tier listed | 0 |
| Blue Cross Blue Shield of Michigan | 26 of 26 | Tier 3 | 0 |
| State | Plans covering | Share |
|---|---|---|
| Alabama | 35 of 114 | 30.7% |
| Alaska | 5 of 9 | 55.6% |
| American Samoa | 1 of 1 | 100% |
| Arizona | 42 of 147 | 28.6% |
| Arkansas | 33 of 85 | 38.8% |
| California | 72 of 397 | 18.1% |
| Colorado | 41 of 106 | 38.7% |
| Connecticut | 16 of 54 | 29.6% |
| Delaware | 16 of 43 | 37.2% |
| District of Columbia | 6 of 12 | 50% |
| Florida | 176 of 545 | 32.3% |
| Georgia | 55 of 149 | 36.9% |
| Guam | 1 of 1 | 100% |
| Hawaii | 16 of 50 | 32% |
| Idaho | 27 of 45 | 60% |
| Illinois | 49 of 132 | 37.1% |
| Indiana | 53 of 138 | 38.4% |
| Iowa | 22 of 64 | 34.4% |
| Kansas | 34 of 84 | 40.5% |
| Kentucky | 63 of 121 | 52.1% |
| Louisiana | 59 of 125 | 47.2% |
| Maine | 27 of 52 | 51.9% |
| Maryland | 13 of 49 | 26.5% |
| Massachusetts | 36 of 89 | 40.4% |
| Michigan | 71 of 182 | 39% |
| Minnesota | 12 of 63 | 19% |
| Mississippi | 43 of 104 | 41.3% |
| Missouri | 63 of 170 | 37.1% |
| Montana | 21 of 27 | 77.8% |
| Nebraska | 17 of 51 | 33.3% |
| Nevada | 49 of 100 | 49% |
| New Hampshire | 16 of 25 | 64% |
| New Jersey | 26 of 73 | 35.6% |
| New Mexico | 44 of 68 | 64.7% |
| New York | 60 of 215 | 27.9% |
| North Carolina | 58 of 176 | 33% |
| North Dakota | 9 of 26 | 34.6% |
| Northern Mariana Islands | 1 of 1 | 100% |
| Ohio | 50 of 171 | 29.2% |
| Oklahoma | 43 of 81 | 53.1% |
| Oregon | 23 of 92 | 25% |
| Pennsylvania | 62 of 323 | 19.2% |
| Puerto Rico | 42 of 64 | 65.6% |
| Rhode Island | 14 of 29 | 48.3% |
| South Carolina | 34 of 89 | 38.2% |
| South Dakota | 7 of 30 | 23.3% |
| Tennessee | 44 of 156 | 28.2% |
| Texas | 154 of 407 | 37.8% |
| U.S. Virgin Islands | 1 of 1 | 100% |
| Utah | 30 of 53 | 56.6% |
| Vermont | 9 of 14 | 64.3% |
| Virginia | 81 of 144 | 56.3% |
| Washington | 44 of 114 | 38.6% |
| West Virginia | 28 of 69 | 40.6% |
| Wisconsin | 42 of 96 | 43.8% |
| Wyoming | 9 of 13 | 69.2% |
Medicare Part D paid for 2,758,506 30-day fills of Symbicort in 2024 for about 587,798 enrollees, at an average total cost of $216.07 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Symbicort and the rest of a client's list on every plan in their county.
Estimate Symbicort 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.