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Xiidra is a brand of lifitegrast. 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, 4,013 of 5,492 Medicare Part D and Medicare Advantage drug plans (73.1%) list Xiidra on their formulary, across 237 of 286 formularies. The most common placement is tier 3 (2,796 plans, 69.7% of those covering it). 75 of the covering plans require prior authorization (1.9%), 0 step therapy and 3,023 a quantity limit.
433 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $42, 68 of them $0; 3,580 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: 3,978 of 5,496 plans covered it (72.4%); 2027: 4,013 of 5,492 (73.1%).
Of 4,367 plans offered in both years, 24 added it to the formulary and 55 dropped it.
Among plans covering it both years, 62 moved it to a higher tier and 78 to a lower one; 13 added prior authorization and 18 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 113 |
| Tier 2 | 76 |
| Tier 3 | 2,796 |
| Tier 4 | 1,028 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 142 of 323 | 44% | 1.4% |
| Medicare Advantage with drugs (MA-PD) | 2,303 of 3,200 | 72% | 2% |
| Special needs plans (SNP) | 1,568 of 1,969 | 79.6% | 1.7% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 0 of 846 | No tier listed | 0 |
| UnitedHealthcare | 796 of 830 | Tier 4 | 0 |
| Devoted Health | 728 of 728 | Tier 3 | 0 |
| Aetna Medicare | 631 of 631 | Tier 3 | 0 |
| Wellcare | 68 of 268 | Tier 2 | 0 |
| HealthSpring | 191 of 226 | Tier 3 | 0 |
| Kaiser Permanente | 0 of 112 | No tier listed | 0 |
| SCAN Health Plan | 83 of 83 | Tier 3 | 0 |
| Highmark Blue Cross Blue Shield or Highmark Blue Shield | 80 of 80 | Tier 3 | 0 |
| Alignment Health Plan | 77 of 77 | Tier 3 | 0 |
| Anthem Blue Cross and Blue Shield | 74 of 74 | Tier 3 | 0 |
| Wellpoint | 58 of 63 | Tier 3 | 0 |
| Priority Health Medicare | 40 of 40 | Tier 3 | 0 |
| CarePlus Health Plans, Inc. | 0 of 37 | No tier listed | 0 |
| Zing Health | 36 of 36 | Tier 3 | 0 |
| Capital Blue Cross | 8 of 35 | Tier 3 | 8 |
| Prominence Health Plan | 29 of 29 | Tier 3 | 0 |
| Medica | 0 of 27 | No tier listed | 0 |
| Anthem HealthKeepers | 22 of 26 | Tier 3 | 0 |
| Blue Cross Blue Shield of Michigan | 26 of 26 | Tier 4 | 0 |
| State | Plans covering | Share |
|---|---|---|
| Alabama | 90 of 114 | 78.9% |
| Alaska | 4 of 9 | 44.4% |
| American Samoa | 1 of 1 | 100% |
| Arizona | 116 of 147 | 78.9% |
| Arkansas | 58 of 85 | 68.2% |
| California | 303 of 397 | 76.3% |
| Colorado | 74 of 106 | 69.8% |
| Connecticut | 41 of 54 | 75.9% |
| Delaware | 31 of 43 | 72.1% |
| District of Columbia | 8 of 12 | 66.7% |
| Florida | 367 of 545 | 67.3% |
| Georgia | 91 of 149 | 61.1% |
| Guam | 1 of 1 | 100% |
| Hawaii | 34 of 50 | 68% |
| Idaho | 21 of 45 | 46.7% |
| Illinois | 95 of 132 | 72% |
| Indiana | 103 of 138 | 74.6% |
| Iowa | 48 of 64 | 75% |
| Kansas | 58 of 84 | 69% |
| Kentucky | 70 of 121 | 57.9% |
| Louisiana | 77 of 125 | 61.6% |
| Maine | 31 of 52 | 59.6% |
| Maryland | 30 of 49 | 61.2% |
| Massachusetts | 80 of 89 | 89.9% |
| Michigan | 145 of 182 | 79.7% |
| Minnesota | 34 of 63 | 54% |
| Mississippi | 65 of 104 | 62.5% |
| Missouri | 129 of 170 | 75.9% |
| Montana | 5 of 27 | 18.5% |
| Nebraska | 32 of 51 | 62.7% |
| Nevada | 74 of 100 | 74% |
| New Hampshire | 14 of 25 | 56% |
| New Jersey | 55 of 73 | 75.3% |
| New Mexico | 52 of 68 | 76.5% |
| New York | 154 of 215 | 71.6% |
| North Carolina | 137 of 176 | 77.8% |
| North Dakota | 14 of 26 | 53.8% |
| Northern Mariana Islands | 1 of 1 | 100% |
| Ohio | 143 of 171 | 83.6% |
| Oklahoma | 56 of 81 | 69.1% |
| Oregon | 65 of 92 | 70.7% |
| Pennsylvania | 264 of 323 | 81.7% |
| Puerto Rico | 46 of 64 | 71.9% |
| Rhode Island | 19 of 29 | 65.5% |
| South Carolina | 58 of 89 | 65.2% |
| South Dakota | 16 of 30 | 53.3% |
| Tennessee | 127 of 156 | 81.4% |
| Texas | 311 of 407 | 76.4% |
| U.S. Virgin Islands | 1 of 1 | 100% |
| Utah | 36 of 53 | 67.9% |
| Vermont | 5 of 14 | 35.7% |
| Virginia | 88 of 144 | 61.1% |
| Washington | 73 of 114 | 64% |
| West Virginia | 49 of 69 | 71% |
| Wisconsin | 69 of 96 | 71.9% |
| Wyoming | 5 of 13 | 38.5% |
Medicare Part D paid for 759,021 30-day fills of Xiidra in 2024 for about 166,278 enrollees, at an average total cost of $664.58 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Xiidra 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.