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Xigduo is a brand of dapagliflozin / 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, 2,357 of 5,492 Medicare Part D and Medicare Advantage drug plans (42.9%) list Xigduo on their formulary, across 100 of 286 formularies. The most common placement is tier 3 (2,047 plans, 86.8% of those covering it). 0 of the covering plans require prior authorization (0%), 0 step therapy and 2,345 a quantity limit.
156 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $32.50, 49 of them $0; 2,201 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: 5,143 of 5,496 plans covered it (93.6%); 2027: 2,357 of 5,492 (42.9%).
Of 4,367 plans offered in both years, 0 added it to the formulary and 2,094 dropped it.
Among plans covering it both years, 9 moved it to a higher tier and 239 to a lower one; 0 added prior authorization and 0 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 34 |
| Tier 2 | 268 |
| Tier 3 | 2,047 |
| Tier 6 | 8 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 177 of 323 | 54.8% | 0% |
| Medicare Advantage with drugs (MA-PD) | 1,399 of 3,200 | 43.7% | 0% |
| Special needs plans (SNP) | 781 of 1,969 | 39.7% | 0% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 0 of 846 | No tier listed | 0 |
| UnitedHealthcare | 830 of 830 | Tier 3 | 0 |
| Devoted Health | 0 of 728 | No tier listed | 0 |
| Aetna Medicare | 631 of 631 | Tier 3 | 0 |
| Wellcare | 268 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 | 0 of 83 | No tier listed | 0 |
| Highmark Blue Cross Blue Shield or Highmark Blue Shield | 80 of 80 | Tier 3 | 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 | 0 of 40 | No tier listed | 0 |
| CarePlus Health Plans, Inc. | 0 of 37 | No tier listed | 0 |
| Zing Health | 0 of 36 | No tier listed | 0 |
| Capital Blue Cross | 8 of 35 | Tier 3 | 0 |
| Prominence Health Plan | 29 of 29 | Tier 3 | 0 |
| Medica | 0 of 27 | No tier listed | 0 |
| Anthem HealthKeepers | 0 of 26 | No tier listed | 0 |
| Blue Cross Blue Shield of Michigan | 26 of 26 | Tier 3 | 0 |
| State | Plans covering | Share |
|---|---|---|
| Alabama | 34 of 114 | 29.8% |
| Alaska | 5 of 9 | 55.6% |
| American Samoa | 1 of 1 | 100% |
| Arizona | 44 of 147 | 29.9% |
| Arkansas | 36 of 85 | 42.4% |
| California | 122 of 397 | 30.7% |
| Colorado | 38 of 106 | 35.8% |
| Connecticut | 26 of 54 | 48.1% |
| Delaware | 25 of 43 | 58.1% |
| District of Columbia | 7 of 12 | 58.3% |
| Florida | 233 of 545 | 42.8% |
| Georgia | 59 of 149 | 39.6% |
| Guam | 1 of 1 | 100% |
| Hawaii | 11 of 50 | 22% |
| Idaho | 21 of 45 | 46.7% |
| Illinois | 54 of 132 | 40.9% |
| Indiana | 44 of 138 | 31.9% |
| Iowa | 38 of 64 | 59.4% |
| Kansas | 49 of 84 | 58.3% |
| Kentucky | 43 of 121 | 35.5% |
| Louisiana | 48 of 125 | 38.4% |
| Maine | 23 of 52 | 44.2% |
| Maryland | 9 of 49 | 18.4% |
| Massachusetts | 67 of 89 | 75.3% |
| Michigan | 77 of 182 | 42.3% |
| Minnesota | 37 of 63 | 58.7% |
| Mississippi | 51 of 104 | 49% |
| Missouri | 79 of 170 | 46.5% |
| Montana | 7 of 27 | 25.9% |
| Nebraska | 29 of 51 | 56.9% |
| Nevada | 51 of 100 | 51% |
| New Hampshire | 9 of 25 | 36% |
| New Jersey | 45 of 73 | 61.6% |
| New Mexico | 39 of 68 | 57.4% |
| New York | 123 of 215 | 57.2% |
| North Carolina | 76 of 176 | 43.2% |
| North Dakota | 16 of 26 | 61.5% |
| Northern Mariana Islands | 1 of 1 | 100% |
| Ohio | 58 of 171 | 33.9% |
| Oklahoma | 29 of 81 | 35.8% |
| Oregon | 28 of 92 | 30.4% |
| Pennsylvania | 174 of 323 | 53.9% |
| Puerto Rico | 18 of 64 | 28.1% |
| Rhode Island | 21 of 29 | 72.4% |
| South Carolina | 42 of 89 | 47.2% |
| South Dakota | 18 of 30 | 60% |
| Tennessee | 37 of 156 | 23.7% |
| Texas | 175 of 407 | 43% |
| U.S. Virgin Islands | 1 of 1 | 100% |
| Utah | 28 of 53 | 52.8% |
| Vermont | 4 of 14 | 28.6% |
| Virginia | 54 of 144 | 37.5% |
| Washington | 42 of 114 | 36.8% |
| West Virginia | 34 of 69 | 49.3% |
| Wisconsin | 49 of 96 | 51% |
| Wyoming | 7 of 13 | 53.8% |
Medicare Part D paid for 389,635 30-day fills of Xigduo in 2024 for about 46,597 enrollees, at an average total cost of $520.57 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Xigduo and the rest of a client's list on every plan in their county.
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.