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Synjardy is a brand of empagliflozin / metformin. 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, 2,809 of 5,492 Medicare Part D and Medicare Advantage drug plans (51.1%) list Synjardy on their formulary, across 179 of 286 formularies. The most common placement is tier 3 (2,491 plans, 88.7% of those covering it). 40 of the covering plans require prior authorization (1.4%), 0 step therapy and 2,646 a quantity limit.
455 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $42, 72 of them $0; 2,354 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.
2026: 3,609 of 5,496 plans covered it (65.7%); 2027: 2,809 of 5,492 (51.1%).
Of 4,367 plans offered in both years, 330 added it to the formulary and 930 dropped it.
Among plans covering it both years, 21 moved it to a higher tier and 188 to a lower one; 34 added prior authorization and 0 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 59 |
| Tier 2 | 245 |
| Tier 3 | 2,491 |
| Tier 4 | 6 |
| Tier 6 | 8 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 53 of 323 | 16.4% | 0% |
| Medicare Advantage with drugs (MA-PD) | 1,603 of 3,200 | 50.1% | 2.2% |
| Special needs plans (SNP) | 1,153 of 1,969 | 58.6% | 0.4% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 0 of 846 | No tier listed | 0 |
| UnitedHealthcare | 796 of 830 | Tier 3 | 0 |
| Devoted Health | 414 of 728 | Tier 3 | 0 |
| Aetna Medicare | 0 of 631 | No tier listed | 0 |
| Wellcare | 200 of 268 | Tier 2 | 0 |
| HealthSpring | 0 of 226 | No tier listed | 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 3 | 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 | 40 |
| CarePlus Health Plans, Inc. | 0 of 37 | No tier listed | 0 |
| Zing Health | 0 of 36 | No tier listed | 0 |
| Capital Blue Cross | 35 of 35 | Tier 3 | 0 |
| Prominence Health Plan | 29 of 29 | Tier 3 | 0 |
| Medica | 27 of 27 | Tier 3 | 0 |
| Anthem HealthKeepers | 26 of 26 | Tier 3 | 0 |
| Blue Cross Blue Shield of Michigan | 0 of 26 | No tier listed | 0 |
| State | Plans covering | Share |
|---|---|---|
| Alabama | 46 of 114 | 40.4% |
| Alaska | 1 of 9 | 11.1% |
| American Samoa | 1 of 1 | 100% |
| Arizona | 93 of 147 | 63.3% |
| Arkansas | 28 of 85 | 32.9% |
| California | 276 of 397 | 69.5% |
| Colorado | 43 of 106 | 40.6% |
| Connecticut | 24 of 54 | 44.4% |
| Delaware | 20 of 43 | 46.5% |
| District of Columbia | 5 of 12 | 41.7% |
| Florida | 284 of 545 | 52.1% |
| Georgia | 50 of 149 | 33.6% |
| Guam | 1 of 1 | 100% |
| Hawaii | 19 of 50 | 38% |
| Idaho | 26 of 45 | 57.8% |
| Illinois | 51 of 132 | 38.6% |
| Indiana | 67 of 138 | 48.6% |
| Iowa | 28 of 64 | 43.8% |
| Kansas | 30 of 84 | 35.7% |
| Kentucky | 49 of 121 | 40.5% |
| Louisiana | 61 of 125 | 48.8% |
| Maine | 20 of 52 | 38.5% |
| Maryland | 5 of 49 | 10.2% |
| Massachusetts | 56 of 89 | 62.9% |
| Michigan | 71 of 182 | 39% |
| Minnesota | 48 of 63 | 76.2% |
| Mississippi | 41 of 104 | 39.4% |
| Missouri | 69 of 170 | 40.6% |
| Montana | 6 of 27 | 22.2% |
| Nebraska | 26 of 51 | 51% |
| Nevada | 58 of 100 | 58% |
| New Hampshire | 9 of 25 | 36% |
| New Jersey | 36 of 73 | 49.3% |
| New Mexico | 37 of 68 | 54.4% |
| New York | 121 of 215 | 56.3% |
| North Carolina | 86 of 176 | 48.9% |
| North Dakota | 16 of 26 | 61.5% |
| Northern Mariana Islands | 1 of 1 | 100% |
| Ohio | 84 of 171 | 49.1% |
| Oklahoma | 31 of 81 | 38.3% |
| Oregon | 49 of 92 | 53.3% |
| Pennsylvania | 192 of 323 | 59.4% |
| Puerto Rico | 62 of 64 | 96.9% |
| Rhode Island | 15 of 29 | 51.7% |
| South Carolina | 30 of 89 | 33.7% |
| South Dakota | 16 of 30 | 53.3% |
| Tennessee | 86 of 156 | 55.1% |
| Texas | 211 of 407 | 51.8% |
| U.S. Virgin Islands | 1 of 1 | 100% |
| Utah | 23 of 53 | 43.4% |
| Vermont | 1 of 14 | 7.1% |
| Virginia | 58 of 144 | 40.3% |
| Washington | 52 of 114 | 45.6% |
| West Virginia | 26 of 69 | 37.7% |
| Wisconsin | 57 of 96 | 59.4% |
| Wyoming | 2 of 13 | 15.4% |
Medicare Part D paid for 924,545 30-day fills of Synjardy in 2024 for about 113,157 enrollees, at an average total cost of $539.26 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Synjardy and the rest of a client's list on every plan in their county.
Estimate Synjardy 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.