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Xeljanz Part D coverage 2027

Xeljanz is a brand of tofacitinib. 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.

Coverage at a glance

In 2027, 31 of 5,492 Medicare Part D and Medicare Advantage drug plans (0.6%) list Xeljanz on their formulary, across 5 of 286 formularies. The most common placement is tier 5 (30 plans, 96.8% of those covering it). 31 of the covering plans require prior authorization (100%), 0 step therapy and 30 a quantity limit.

What a 30-day fill costs

1 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $0, 1 of them $0; 30 charge coinsurance instead — median 28% 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.

What changed since 2026

2026: 1,612 of 5,496 plans covered it (29.3%); 2027: 31 of 5,492 (0.6%).

Of 4,367 plans offered in both years, 2 added it to the formulary and 1,192 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 placement

TierPlans
Tier 11
Tier 530

By plan type

Plan typePlans coveringSharePrior auth
Stand-alone Part D (PDP)0 of 3230%—
Medicare Advantage with drugs (MA-PD)24 of 3,2000.8%100%
Special needs plans (SNP)7 of 1,9690.4%100%

By carrier

CarrierPlans coveringUsual tierPrior auth
Humana0 of 846No tier listed0
UnitedHealthcare0 of 830No tier listed0
Devoted Health0 of 728No tier listed0
Aetna Medicare0 of 631No tier listed0
Wellcare0 of 268No tier listed0
HealthSpring0 of 226No tier listed0
Kaiser Permanente0 of 112No tier listed0
SCAN Health Plan0 of 83No tier listed0
Highmark Blue Cross Blue Shield or Highmark Blue Shield0 of 80No tier listed0
Alignment Health Plan0 of 77No tier listed0
Anthem Blue Cross and Blue Shield0 of 74No tier listed0
Wellpoint0 of 63No tier listed0
Priority Health Medicare0 of 40No tier listed0
CarePlus Health Plans, Inc.0 of 37No tier listed0
Zing Health0 of 36No tier listed0
Capital Blue Cross0 of 35No tier listed0
Prominence Health Plan0 of 29No tier listed0
Medica0 of 27No tier listed0
Anthem HealthKeepers0 of 26No tier listed0
Blue Cross Blue Shield of Michigan0 of 26No tier listed0

By state

StatePlans coveringShare
Alabama0 of 1140%
Alaska0 of 90%
American Samoa0 of 10%
Arizona0 of 1470%
Arkansas0 of 850%
California3 of 3970.8%
Colorado0 of 1060%
Connecticut0 of 540%
Delaware0 of 430%
District of Columbia0 of 120%
Florida0 of 5450%
Georgia0 of 1490%
Guam0 of 10%
Hawaii0 of 500%
Idaho0 of 450%
Illinois0 of 1320%
Indiana0 of 1380%
Iowa0 of 640%
Kansas0 of 840%
Kentucky0 of 1210%
Louisiana0 of 1250%
Maine0 of 520%
Maryland0 of 490%
Massachusetts6 of 896.7%
Michigan0 of 1820%
Minnesota0 of 630%
Mississippi0 of 1040%
Missouri0 of 1700%
Montana0 of 270%
Nebraska0 of 510%
Nevada0 of 1000%
New Hampshire0 of 250%
New Jersey0 of 730%
New Mexico0 of 680%
New York21 of 2159.8%
North Carolina0 of 1760%
North Dakota0 of 260%
Northern Mariana Islands0 of 10%
Ohio0 of 1710%
Oklahoma0 of 810%
Oregon0 of 920%
Pennsylvania0 of 3230%
Puerto Rico0 of 640%
Rhode Island0 of 290%
South Carolina0 of 890%
South Dakota0 of 300%
Tennessee0 of 1560%
Texas0 of 4070%
U.S. Virgin Islands0 of 10%
Utah0 of 530%
Vermont0 of 140%
Virginia0 of 1440%
Washington0 of 1140%
West Virginia0 of 690%
Wisconsin1 of 961%
Wyoming0 of 130%

Medicare usage

Medicare Part D paid for 103,278 30-day fills of Xeljanz in 2024 for about 12,575 enrollees, at an average total cost of $5,689.57 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).

Agent Tools

Price Xeljanz and the rest of a client's list on every plan in their county.

Estimate Xeljanz 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.