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Zenpep is a brand of amylase / lipase / protease. 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, 5,217 of 5,492 Medicare Part D and Medicare Advantage drug plans (95%) list Zenpep on their formulary, across 267 of 286 formularies. The most common placement is tier 4 (2,625 plans, 50.3% of those covering it). 1 of the covering plans require prior authorization (<0.1%), 0 step therapy and 0 a quantity limit.
475 covering plans charge a flat copay for a 30-day supply at a preferred retail pharmacy after the deductible — median $41, 89 of them $0; 4,742 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: 5,153 of 5,496 plans covered it (93.8%); 2027: 5,217 of 5,492 (95%).
Of 4,367 plans offered in both years, 133 added it to the formulary and 27 dropped it.
Among plans covering it both years, 63 moved it to a higher tier and 422 to a lower one; 0 added prior authorization and 0 removed it.
| Tier | Plans |
|---|---|
| Tier 1 | 114 |
| Tier 2 | 313 |
| Tier 3 | 2,165 |
| Tier 4 | 2,625 |
| Plan type | Plans covering | Share | Prior auth |
|---|---|---|---|
| Stand-alone Part D (PDP) | 323 of 323 | 100% | 0% |
| Medicare Advantage with drugs (MA-PD) | 3,058 of 3,200 | 95.6% | 0% |
| Special needs plans (SNP) | 1,836 of 1,969 | 93.2% | <0.1% |
| Carrier | Plans covering | Usual tier | Prior auth |
|---|---|---|---|
| Humana | 846 of 846 | Tier 4 | 0 |
| UnitedHealthcare | 830 of 830 | Tier 3 | 0 |
| Devoted Health | 728 of 728 | Tier 4 | 0 |
| Aetna Medicare | 558 of 631 | Tier 4 | 0 |
| Wellcare | 268 of 268 | Tier 2 | 0 |
| HealthSpring | 226 of 226 | Tier 3 | 0 |
| Kaiser Permanente | 112 of 112 | Tier 3 | 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 | 77 of 77 | Tier 3 | 0 |
| Anthem Blue Cross and Blue Shield | 74 of 74 | Tier 4 | 0 |
| Wellpoint | 58 of 63 | Tier 4 | 0 |
| Priority Health Medicare | 40 of 40 | Tier 3 | 0 |
| CarePlus Health Plans, Inc. | 37 of 37 | Tier 4 | 0 |
| Zing Health | 36 of 36 | Tier 4 | 0 |
| Capital Blue Cross | 35 of 35 | Tier 3 | 0 |
| Prominence Health Plan | 29 of 29 | Tier 3 | 0 |
| Medica | 1 of 27 | Tier 3 | 0 |
| Anthem HealthKeepers | 22 of 26 | Tier 4 | 0 |
| Blue Cross Blue Shield of Michigan | 26 of 26 | Tier 3 | 0 |
| State | Plans covering | Share |
|---|---|---|
| Alabama | 114 of 114 | 100% |
| Alaska | 9 of 9 | 100% |
| American Samoa | 1 of 1 | 100% |
| Arizona | 137 of 147 | 93.2% |
| Arkansas | 84 of 85 | 98.8% |
| California | 326 of 397 | 82.1% |
| Colorado | 105 of 106 | 99.1% |
| Connecticut | 53 of 54 | 98.1% |
| Delaware | 41 of 43 | 95.3% |
| District of Columbia | 12 of 12 | 100% |
| Florida | 529 of 545 | 97.1% |
| Georgia | 148 of 149 | 99.3% |
| Guam | 1 of 1 | 100% |
| Hawaii | 50 of 50 | 100% |
| Idaho | 37 of 45 | 82.2% |
| Illinois | 130 of 132 | 98.5% |
| Indiana | 134 of 138 | 97.1% |
| Iowa | 62 of 64 | 96.9% |
| Kansas | 82 of 84 | 97.6% |
| Kentucky | 118 of 121 | 97.5% |
| Louisiana | 124 of 125 | 99.2% |
| Maine | 52 of 52 | 100% |
| Maryland | 49 of 49 | 100% |
| Massachusetts | 89 of 89 | 100% |
| Michigan | 169 of 182 | 92.9% |
| Minnesota | 43 of 63 | 68.3% |
| Mississippi | 104 of 104 | 100% |
| Missouri | 167 of 170 | 98.2% |
| Montana | 25 of 27 | 92.6% |
| Nebraska | 49 of 51 | 96.1% |
| Nevada | 95 of 100 | 95% |
| New Hampshire | 25 of 25 | 100% |
| New Jersey | 73 of 73 | 100% |
| New Mexico | 65 of 68 | 95.6% |
| New York | 197 of 215 | 91.6% |
| North Carolina | 173 of 176 | 98.3% |
| North Dakota | 20 of 26 | 76.9% |
| Northern Mariana Islands | 1 of 1 | 100% |
| Ohio | 163 of 171 | 95.3% |
| Oklahoma | 81 of 81 | 100% |
| Oregon | 90 of 92 | 97.8% |
| Pennsylvania | 317 of 323 | 98.1% |
| Puerto Rico | 47 of 64 | 73.4% |
| Rhode Island | 29 of 29 | 100% |
| South Carolina | 87 of 89 | 97.8% |
| South Dakota | 22 of 30 | 73.3% |
| Tennessee | 152 of 156 | 97.4% |
| Texas | 395 of 407 | 97.1% |
| U.S. Virgin Islands | 1 of 1 | 100% |
| Utah | 53 of 53 | 100% |
| Vermont | 14 of 14 | 100% |
| Virginia | 140 of 144 | 97.2% |
| Washington | 110 of 114 | 96.5% |
| West Virginia | 68 of 69 | 98.6% |
| Wisconsin | 83 of 96 | 86.5% |
| Wyoming | 13 of 13 | 100% |
Medicare Part D paid for 344,425 30-day fills of Zenpep in 2024 for about 58,349 enrollees, at an average total cost of $1,615.67 per 30-day fill (CMS Part D Prescribers by Geography and Drug, national).
Price Zenpep 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.