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Vemlidy is a brand of tenofovir alafenamide. 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, 2,710 of 5,492 Medicare Part D and Medicare Advantage drug plans (49.3%) list Vemlidy on their formulary, across 121 of 286 formularies. The most common placement is tier 5 (2,654 plans, 97.9% of those covering it). 175 of the covering plans require prior authorization (6.5%), 0 step therapy and 2,066 a quantity limit. Generic tenofovir disoproxil is on 5,492 of 5,492 plans (100%).
29 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $0, 29 of them $0; 2,681 charge coinsurance instead — median 26% 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: 3,153 of 5,496 plans covered it (57.4%); 2027: 2,710 of 5,492 (49.3%).
Of 4,367 plans offered in both years, 16 added it to the formulary and 273 dropped it.
Among plans covering it both years, 15 moved it to a higher tier and 24 to a lower one; 10 added prior authorization and 5 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 33 |
| Tier 2 | 1 |
| Tier 3 | 13 |
| Tier 4 | 9 |
| Tier 5 | 2,654 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 113 of 323 | 35% | 0% |
| Medicare Advantage with drugs (MA-PD) | 1,688 of 3,200 | 52.8% | 6.9% |
| Special needs plans (SNP) | 909 of 1,969 | 46.2% | 6.4% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 744 of 846 | Tier 5 | 0 |
| UnitedHealthcare | 830 of 830 | Tier 5 | 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 | 226 of 226 | Tier 5 | 0 |
| Kaiser Permanente | 112 of 112 | Tier 5 | 0 |
| SCAN Health Plan | 83 of 83 | Tier 5 | 0 |
| Highmark Blue Cross Blue Shield or Highmark Blue Shield | 80 of 80 | Tier 5 | 0 |
| Alignment Health Plan | 77 of 77 | Tier 5 | 77 |
| 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 5 | 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 5 | 0 |
| Medica | 27 of 27 | Tier 5 | 0 |
| Anthem HealthKeepers | 0 of 26 | No tier listed | 0 |
| Blue Cross Blue Shield of Michigan | 0 of 26 | No tier listed | 0 |
| State | Plans covering | Share |
|---|---|---|
| Alabama | 50 of 114 | 43.9% |
| Alaska | 3 of 9 | 33.3% |
| American Samoa | 1 of 1 | 100% |
| Arizona | 71 of 147 | 48.3% |
| Arkansas | 46 of 85 | 54.1% |
| California | 278 of 397 | 70% |
| Colorado | 63 of 106 | 59.4% |
| Connecticut | 14 of 54 | 25.9% |
| Delaware | 22 of 43 | 51.2% |
| District of Columbia | 9 of 12 | 75% |
| Florida | 205 of 545 | 37.6% |
| Georgia | 80 of 149 | 53.7% |
| Guam | 1 of 1 | 100% |
| Hawaii | 20 of 50 | 40% |
| Idaho | 25 of 45 | 55.6% |
| Illinois | 63 of 132 | 47.7% |
| Indiana | 56 of 138 | 40.6% |
| Iowa | 20 of 64 | 31.3% |
| Kansas | 32 of 84 | 38.1% |
| Kentucky | 68 of 121 | 56.2% |
| Louisiana | 69 of 125 | 55.2% |
| Maine | 25 of 52 | 48.1% |
| Maryland | 24 of 49 | 49% |
| Massachusetts | 50 of 89 | 56.2% |
| Michigan | 33 of 182 | 18.1% |
| Minnesota | 31 of 63 | 49.2% |
| Mississippi | 56 of 104 | 53.8% |
| Missouri | 77 of 170 | 45.3% |
| Montana | 19 of 27 | 70.4% |
| Nebraska | 17 of 51 | 33.3% |
| Nevada | 71 of 100 | 71% |
| New Hampshire | 14 of 25 | 56% |
| New Jersey | 28 of 73 | 38.4% |
| New Mexico | 44 of 68 | 64.7% |
| New York | 96 of 215 | 44.7% |
| North Carolina | 82 of 176 | 46.6% |
| North Dakota | 13 of 26 | 50% |
| Northern Mariana Islands | 1 of 1 | 100% |
| Ohio | 87 of 171 | 50.9% |
| Oklahoma | 51 of 81 | 63% |
| Oregon | 39 of 92 | 42.4% |
| Pennsylvania | 195 of 323 | 60.4% |
| Puerto Rico | 47 of 64 | 73.4% |
| Rhode Island | 12 of 29 | 41.4% |
| South Carolina | 42 of 89 | 47.2% |
| South Dakota | 13 of 30 | 43.3% |
| Tennessee | 59 of 156 | 37.8% |
| Texas | 206 of 407 | 50.6% |
| U.S. Virgin Islands | 1 of 1 | 100% |
| Utah | 31 of 53 | 58.5% |
| Vermont | 7 of 14 | 50% |
| Virginia | 90 of 144 | 62.5% |
| Washington | 62 of 114 | 54.4% |
| West Virginia | 39 of 69 | 56.5% |
| Wisconsin | 53 of 96 | 55.2% |
| Wyoming | 5 of 13 | 38.5% |
Medicare Part D paid for 140,043 30-day fills of Vemlidy in 2024 for about 14,939 enrollees, at an average total cost of $1,419.76 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Vemlidy and the rest of a client's list on every plan in their county.
Estimate Vemlidy 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.