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Vyndamax is a brand of tafamidis. 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, 3,194 of 5,492 Medicare Part D and Medicare Advantage drug plans (58.2%) list Vyndamax on their formulary, across 159 of 286 formularies. The most common placement is tier 5 (3,126 plans, 97.9% of those covering it). 3,098 of the covering plans require prior authorization (97%), 0 step therapy and 2,787 a quantity limit.
35 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $0, 35 of them $0; 3,159 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: 3,084 of 5,496 plans covered it (56.1%); 2027: 3,194 of 5,492 (58.2%).
Of 4,367 plans offered in both years, 30 added it to the formulary and 89 dropped it.
Among plans covering it both years, 15 moved it to a higher tier and 6 to a lower one; 4 added prior authorization and 0 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 61 |
| Tier 4 | 7 |
| Tier 5 | 3,126 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 117 of 323 | 36.2% | 100% |
| Medicare Advantage with drugs (MA-PD) | 1,822 of 3,200 | 56.9% | 96.3% |
| Special needs plans (SNP) | 1,255 of 1,969 | 63.7% | 97.7% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 0 of 846 | No tier listed | 0 |
| UnitedHealthcare | 830 of 830 | Tier 5 | 830 |
| Devoted Health | 728 of 728 | Tier 5 | 728 |
| Aetna Medicare | 611 of 631 | Tier 5 | 611 |
| Wellcare | 0 of 268 | No tier listed | 0 |
| HealthSpring | 226 of 226 | Tier 5 | 226 |
| Kaiser Permanente | 112 of 112 | Tier 5 | 16 |
| 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 | 40 of 40 | Tier 5 | 40 |
| CarePlus Health Plans, Inc. | 0 of 37 | No tier listed | 0 |
| Zing Health | 36 of 36 | Tier 5 | 36 |
| Capital Blue Cross | 0 of 35 | No tier listed | 0 |
| Prominence Health Plan | 29 of 29 | Tier 5 | 29 |
| Medica | 0 of 27 | No tier listed | 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 | 84 of 114 | 73.7% |
| Alaska | 3 of 9 | 33.3% |
| American Samoa | 1 of 1 | 100% |
| Arizona | 91 of 147 | 61.9% |
| Arkansas | 57 of 85 | 67.1% |
| California | 162 of 397 | 40.8% |
| Colorado | 74 of 106 | 69.8% |
| Connecticut | 35 of 54 | 64.8% |
| Delaware | 25 of 43 | 58.1% |
| District of Columbia | 11 of 12 | 91.7% |
| Florida | 269 of 545 | 49.4% |
| Georgia | 89 of 149 | 59.7% |
| Guam | 1 of 1 | 100% |
| Hawaii | 40 of 50 | 80% |
| Idaho | 20 of 45 | 44.4% |
| Illinois | 91 of 132 | 68.9% |
| Indiana | 77 of 138 | 55.8% |
| Iowa | 43 of 64 | 67.2% |
| Kansas | 49 of 84 | 58.3% |
| Kentucky | 55 of 121 | 45.5% |
| Louisiana | 72 of 125 | 57.6% |
| Maine | 26 of 52 | 50% |
| Maryland | 37 of 49 | 75.5% |
| Massachusetts | 57 of 89 | 64% |
| Michigan | 100 of 182 | 54.9% |
| Minnesota | 28 of 63 | 44.4% |
| Mississippi | 63 of 104 | 60.6% |
| Missouri | 119 of 170 | 70% |
| Montana | 5 of 27 | 18.5% |
| Nebraska | 31 of 51 | 60.8% |
| Nevada | 55 of 100 | 55% |
| New Hampshire | 14 of 25 | 56% |
| New Jersey | 44 of 73 | 60.3% |
| New Mexico | 48 of 68 | 70.6% |
| New York | 153 of 215 | 71.2% |
| North Carolina | 108 of 176 | 61.4% |
| North Dakota | 14 of 26 | 53.8% |
| Northern Mariana Islands | 1 of 1 | 100% |
| Ohio | 101 of 171 | 59.1% |
| Oklahoma | 50 of 81 | 61.7% |
| Oregon | 58 of 92 | 63% |
| Pennsylvania | 135 of 323 | 41.8% |
| Puerto Rico | 27 of 64 | 42.2% |
| Rhode Island | 19 of 29 | 65.5% |
| South Carolina | 55 of 89 | 61.8% |
| South Dakota | 16 of 30 | 53.3% |
| Tennessee | 118 of 156 | 75.6% |
| Texas | 241 of 407 | 59.2% |
| U.S. Virgin Islands | 1 of 1 | 100% |
| Utah | 30 of 53 | 56.6% |
| Vermont | 5 of 14 | 35.7% |
| Virginia | 78 of 144 | 54.2% |
| Washington | 76 of 114 | 66.7% |
| West Virginia | 29 of 69 | 42% |
| Wisconsin | 51 of 96 | 53.1% |
| Wyoming | 3 of 13 | 23.1% |
Medicare Part D paid for 126,856 30-day fills of Vyndamax in 2024 for about 13,925 enrollees, at an average total cost of $22,315.01 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Vyndamax and the rest of a client's list on every plan in their county.
Estimate Vyndamax 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.