1 ML galcanezumab-gnlm 100 MG/ML Prefilled Syringe [Emgality]

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galcanezumab-gnlm

RxCUI: 2170613

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
69.2%
Plan Coverage
3,506
Plans Covering
T2.8
Avg Tier
98.5%
Prior Auth Required

What the CMS Formulary Data Shows for 1 ML galcanezumab-gnlm 100 MG/ML Prefilled Syringe [Emgality]

Per the CMS 2026 Part D formulary file, 1 ML galcanezumab-gnlm 100 MG/ML Prefilled Syringe [Emgality] (RxNorm concept RXCUI 2170613, generic name galcanezumab-gnlm) appears on 274 distinct formulary files spanning 3,506 Medicare Part D plan offerings - 69.2% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 2.8.

Real-world access to 1 ML galcanezumab-gnlm 100 MG/ML Prefilled Syringe [Emgality] depends on utilization management as much as tier placement: 98.5% of covering formularies require prior authorization. 0% require step therapy. 97.4% apply quantity limits.

Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 1 ML galcanezumab-gnlm 100 MG/ML Prefilled Syringe [Emgality] today.

Coverage Details

Formularies covering
274
Plans covering
3,506
Coverage rate
69.2%
Tier range
Tier 1 – Tier 5
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
98.5% of formularies
Step therapy required
0% of formularies
Quantity limits
97.4% of formularies

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering 1 ML galcanezumab-gnlm 100 MG/ML Prefilled Syringe [Emgality]

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Florida Complete Care-Duals VIP (HMO-POS D-SNP) HPMP OF FLORIDA, INC. T1 Yes $0 FL
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 Yes $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 Yes $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 Yes $0 AZ
Elderplan Plus Long-Term Care (HMO-POS D-SNP) ELDERPLAN, INC. T1 Yes $0 NY
Health Choice Pathway (HMO D-SNP) HEALTH CHOICE ARIZONA, INC. T1 Yes $0 AZ
Healthfirst CompleteCare (HMO D-SNP) HEALTHFIRST HEALTH PLAN, INC. T1 Yes $0 NY
IMCare Classic (HMO D-SNP) ITASCA MEDICAL CARE T1 Yes $0 MN
Johns Hopkins Advantage MD D-SNP (HMO D-SNP) HOPKINS HEALTH ADVANTAGE, INC. T1 Yes $0 MD
MetroPlus UltraCare (HMO D-SNP) METROPLUS HEALTH PLAN, INC. T1 Yes $0 NY
Senior Whole Health SCO (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 Yes $0 MA
Senior Whole Health SCO NHC (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 Yes $0 MA
Molina One Care (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 Yes $0 MA
PruittHealth Premier D-SNP (HMO D-SNP) PRUITTHEALTH PREMIER, INC. T1 Yes $0 GA
Simpra Advantage Dual Care (PPO D-SNP) SIMPRA ADVANTAGE, INC. T1 Yes $0 AL
Gold Coast Health Plan Total Care Advantage (HMO D-SNP) Ventura County Medi-Cal Managed Care Commission T1 Yes $0 CA
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) Health Care Service Corporation T1 Yes $0 NM
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) Health Care Service Corporation T1 Yes $0 NM
Horizon NJ TotalCare (HMO D-SNP) HORIZON HEALTHCARE OF NEW JERSEY, INC. T1 Yes $0 NJ
SecureBlue (HMO D-SNP) HMO Minnesota T1 Yes $0 MN
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 Yes $0 NY
SeniorCare Complete (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 Yes $0 MN
AbilityCare (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 Yes $0 MN
Alameda Alliance Wellness (HMO D-SNP) ALAMEDA ALLIANCE FOR HEALTH T1 Yes $0 CA
CCA One Care (HMO D-SNP) COMMONWEALTH CARE ALLIANCE, INC. T1 Yes $0 MA
CCA Senior Care Options (HMO D-SNP) COMMONWEALTH CARE ALLIANCE, INC. T1 Yes $0 MA
Elevate Medicare Choice (HMO D-SNP) DENVER HEALTH MEDICAL PLAN, INC. T1 Yes $0 CO
AllCare Advantage Redwood Rx (HMO D-SNP) ALLCARE HEALTH PLAN, INC. T1 Yes $0 OR
PrimeWest Senior Health Complete (HMO D-SNP) PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE T1 Yes $0 MN
Prime Health Complete (HMO D-SNP) PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE T1 Yes $0 MN
Alterwood Advantage Dual Secure (HMO D-SNP) ALTERWOOD ADVANTAGE, INC. T1 Yes $0 MD
Nascentia Dual Advantage (HMO D-SNP) VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK T1 Yes $0 NY
Provider Partners Pennsylvania Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC T1 Yes $0 PA
Provider Partners North Carolina Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA T1 Yes $0 NC
Provider Partners Indiana Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF INDIANA T1 Yes $0 IN
Provider Partners Maryland Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN, INC. T1 Yes $0 MD
Provider Partners Missouri Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. T1 Yes $0 MO
Abilis Health Community (HMO I-SNP) SIGNATURE ADVANTAGE, LLC T1 Yes $0 KY, TN
Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) ARKANSAS SUPERIOR SELECT, INC. T1 Yes $0 AR
Platino Blindao (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
Platino Enlace (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
PLATINO ADVANCE (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
PLATINO PLUS (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
Mass General Brigham SCO (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 Yes $0 MA
Mass General Brigham One Care (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 Yes $0 MA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $0 PA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $0 PA
Highmark Health Options Duals (HMO D-SNP) HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. T1 Yes $0 WV
Highmark Health Options Duals (HMO D-SNP) HIGHMARK BCBSD, INC. T1 Yes $0 DE
Tufts Health One Care (HMO D-SNP) TUFTS HEALTH PUBLIC PLANS, INC. T1 Yes $0 MA

Frequently Asked Questions

Is 1 ML galcanezumab-gnlm 100 MG/ML Prefilled Syringe [Emgality] covered by Medicare Part D?

Yes, 1 ML galcanezumab-gnlm 100 MG/ML Prefilled Syringe [Emgality] is covered by 3,506 Medicare Part D plans (69.2% of all Part D formularies).

What tier is 1 ML galcanezumab-gnlm 100 MG/ML Prefilled Syringe [Emgality] on Medicare Part D plans?

1 ML galcanezumab-gnlm 100 MG/ML Prefilled Syringe [Emgality] averages Tier 2.8 across Part D plans, ranging from Tier 1 to Tier 5.

Does 1 ML galcanezumab-gnlm 100 MG/ML Prefilled Syringe [Emgality] require prior authorization?

98.5% of Part D formularies require prior authorization for 1 ML galcanezumab-gnlm 100 MG/ML Prefilled Syringe [Emgality]. Step therapy: 0%. Quantity limits: 97.4%.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial