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Trospium is a generic drug. 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, 4,144 of 5,492 Medicare Part D and Medicare Advantage drug plans (75.5%) list Trospium on their formulary, across 242 of 286 formularies. The most common placement is tier 2 (1,603 plans, 38.7% of those covering it). 10 of the covering plans require prior authorization (0.2%), 0 step therapy and 2,573 a quantity limit.
1,610 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $5, 679 of them $0; 2,534 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: 4,828 of 5,496 plans covered it (87.8%); 2027: 4,144 of 5,492 (75.5%).
Of 4,367 plans offered in both years, 21 added it to the formulary and 700 dropped it.
Among plans covering it both years, 144 moved it to a higher tier and 159 to a lower one; 0 added prior authorization and 0 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 112 |
| Tier 2 | 1,603 |
| Tier 3 | 1,329 |
| Tier 4 | 1,100 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 201 of 323 | 62.2% | 0% |
| Medicare Advantage with drugs (MA-PD) | 2,478 of 3,200 | 77.4% | 0.1% |
| Special needs plans (SNP) | 1,465 of 1,969 | 74.4% | 0.5% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 846 of 846 | Tier 4 | 0 |
| UnitedHealthcare | 0 of 830 | No tier listed | 0 |
| Devoted Health | 728 of 728 | Tier 3 | 0 |
| Aetna Medicare | 631 of 631 | Tier 2 | 0 |
| Wellcare | 268 of 268 | Tier 3 | 0 |
| HealthSpring | 0 of 226 | No tier listed | 0 |
| Kaiser Permanente | 112 of 112 | Tier 2 | 0 |
| SCAN Health Plan | 83 of 83 | Tier 2 | 0 |
| Highmark Blue Cross Blue Shield or Highmark Blue Shield | 80 of 80 | Tier 2 | 0 |
| Alignment Health Plan | 77 of 77 | Tier 3 | 0 |
| Anthem Blue Cross and Blue Shield | 69 of 74 | Tier 4 | 0 |
| Wellpoint | 50 of 63 | Tier 4 | 0 |
| Priority Health Medicare | 40 of 40 | Tier 2 | 0 |
| CarePlus Health Plans, Inc. | 37 of 37 | Tier 4 | 0 |
| Zing Health | 36 of 36 | Tier 2 | 0 |
| Capital Blue Cross | 35 of 35 | Tier 2 | 0 |
| Prominence Health Plan | 29 of 29 | Tier 4 | 0 |
| Medica | 27 of 27 | Tier 2 | 0 |
| Anthem HealthKeepers | 25 of 26 | Tier 4 | 0 |
| Blue Cross Blue Shield of Michigan | 0 of 26 | No tier listed | 0 |
| State | Plans covering | Share |
|---|---|---|
| Alabama | 78 of 114 | 68.4% |
| Alaska | 6 of 9 | 66.7% |
| American Samoa | 0 of 1 | 0% |
| Arizona | 108 of 147 | 73.5% |
| Arkansas | 64 of 85 | 75.3% |
| California | 339 of 397 | 85.4% |
| Colorado | 76 of 106 | 71.7% |
| Connecticut | 44 of 54 | 81.5% |
| Delaware | 28 of 43 | 65.1% |
| District of Columbia | 7 of 12 | 58.3% |
| Florida | 388 of 545 | 71.2% |
| Georgia | 109 of 149 | 73.2% |
| Guam | 0 of 1 | 0% |
| Hawaii | 41 of 50 | 82% |
| Idaho | 17 of 45 | 37.8% |
| Illinois | 102 of 132 | 77.3% |
| Indiana | 111 of 138 | 80.4% |
| Iowa | 49 of 64 | 76.6% |
| Kansas | 67 of 84 | 79.8% |
| Kentucky | 96 of 121 | 79.3% |
| Louisiana | 101 of 125 | 80.8% |
| Maine | 39 of 52 | 75% |
| Maryland | 39 of 49 | 79.6% |
| Massachusetts | 71 of 89 | 79.8% |
| Michigan | 127 of 182 | 69.8% |
| Minnesota | 38 of 63 | 60.3% |
| Mississippi | 73 of 104 | 70.2% |
| Missouri | 132 of 170 | 77.6% |
| Montana | 19 of 27 | 70.4% |
| Nebraska | 37 of 51 | 72.5% |
| Nevada | 72 of 100 | 72% |
| New Hampshire | 17 of 25 | 68% |
| New Jersey | 53 of 73 | 72.6% |
| New Mexico | 35 of 68 | 51.5% |
| New York | 176 of 215 | 81.9% |
| North Carolina | 129 of 176 | 73.3% |
| North Dakota | 18 of 26 | 69.2% |
| Northern Mariana Islands | 0 of 1 | 0% |
| Ohio | 133 of 171 | 77.8% |
| Oklahoma | 56 of 81 | 69.1% |
| Oregon | 80 of 92 | 87% |
| Pennsylvania | 275 of 323 | 85.1% |
| Puerto Rico | 52 of 64 | 81.3% |
| Rhode Island | 12 of 29 | 41.4% |
| South Carolina | 67 of 89 | 75.3% |
| South Dakota | 24 of 30 | 80% |
| Tennessee | 116 of 156 | 74.4% |
| Texas | 299 of 407 | 73.5% |
| U.S. Virgin Islands | 0 of 1 | 0% |
| Utah | 37 of 53 | 69.8% |
| Vermont | 11 of 14 | 78.6% |
| Virginia | 102 of 144 | 70.8% |
| Washington | 87 of 114 | 76.3% |
| West Virginia | 56 of 69 | 81.2% |
| Wisconsin | 70 of 96 | 72.9% |
| Wyoming | 7 of 13 | 53.8% |
Medicare Part D paid for 1,065,734 30-day fills of Trospium in 2024 for about 183,113 enrollees, at an average total cost of $43.34 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Trospium and the rest of a client's list on every plan in their county.
Estimate Trospium 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.