Medicare Part D coverage · {28 · RxCUI 1999389
{28 (ivacaftor 150 MG / tezacaftor 100 MG Oral Tablet) / 28 (ivacaftor 150 MG Oral Tablet) } Pack [Symdeko (100 MG / 150 MG; 150 MG)]
Per the CMS 2026 Part D formulary file, {28 (ivacaftor 150 MG / tezacaftor 100 MG Oral Tablet) / 28 (ivacaftor 150 MG Oral Tablet) } Pack [Symdeko (100 MG / 150 MG; 150 MG)] is covered by 1,401 Medicare Part D plans (27.7% of enrollable products), averaging Tier 4, with prior authorization required on 98.7% of covering formularies.
- 27.7%
- Plan coverage
- 1,401
- Plans covering
- T4
- Avg tier
- 98.7%
- Prior auth required
What the CMS Formulary Data Shows for {28 (ivacaftor 150 MG / tezacaftor 100 MG Oral Tablet) / 28 (ivacaftor 150 MG Oral Tablet) } Pack [Symdeko (100 MG / 150 MG; 150 MG)]
Per the CMS 2026 Part D formulary file, {28 (ivacaftor 150 MG / tezacaftor 100 MG Oral Tablet) / 28 (ivacaftor 150 MG Oral Tablet) } Pack [Symdeko (100 MG / 150 MG; 150 MG)] (RxNorm concept RXCUI 1999389, generic name {28) appears on 156 distinct formulary files spanning 1,401 Medicare Part D plan offerings - 27.7% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.
Real-world access to {28 (ivacaftor 150 MG / tezacaftor 100 MG Oral Tablet) / 28 (ivacaftor 150 MG Oral Tablet) } Pack [Symdeko (100 MG / 150 MG; 150 MG)] depends on utilization management as much as tier placement: 98.7% of covering formularies require prior authorization. 0% require step therapy. 91% 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 {28 (ivacaftor 150 MG / tezacaftor 100 MG Oral Tablet) / 28 (ivacaftor 150 MG Oral Tablet) } Pack [Symdeko (100 MG / 150 MG; 150 MG)] today.
Coverage Details
- Formularies covering
- 156
- Plans covering
- 1,401
- Coverage rate
- 27.7%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 98.7% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 91% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering {28 (ivacaftor 150 MG / tezacaftor 100 MG Oral Tablet) / 28 (ivacaftor 150 MG Oral Tablet) } Pack [Symdeko (100 MG / 150 MG; 150 MG)]
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 |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | Yes | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | Yes | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | Yes | $0 | NJ |
| 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 |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | Yes | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | Yes | $0 | GA |
| 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 |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | Yes | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | Yes | $0 | GA |
Show the next 30 plans
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | Yes | $0 | AL |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | Yes | $0 | MA |
| 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 |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| 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 |
| Florida Complete Care (HMO I-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Florida Complete Care- In The Community (HMO-POS I-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Senior Care (HMO I-SNP) | Align Senior Care Florida, Inc. | T1 | Yes | $4.80 | FL |
| ProCare Advantage (HMO-POS I-SNP) | Procare Advantage, LLC | T1 | Yes | $4.80 | TX |
| ProCare Advantage - Kidney Care (HMO-POS C-SNP) | Procare Advantage, LLC | T1 | Yes | $4.80 | TX |
| American Health Advantage of Florida (HMO I-SNP) | American Health Plan OF FL, Inc. | T1 | Yes | $4.80 | FL |
| SECUR Advantage (HMO I-SNP) | Secur Inc | T1 | Yes | $4.80 | FL |
| SECUR Enhanced (HMO I-SNP) | Secur Inc | T1 | Yes | $4.80 | FL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | Yes | $4.80 | FL |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Michigan, Inc. | T1 | Yes | $8.80 | MI |
| Senior Care (HMO I-SNP) | Align Senior Care MI, LLC | T1 | Yes | $8.80 | MI |
| AgeRight Advantage Health Plan (HMO I-SNP) | Marquis Advantage, Inc. | T1 | Yes | $10.50 | OR, WA |
| Senior Care (HMO I-SNP) | Align Senior Care California Inc. | T1 | Yes | $12.00 | CA |
| Liberty Medicare Dual Plan (HMO D-SNP) | Liberty Advantage, LLC | T1 | Yes | $14.70 | NC |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Illinois, Inc. | T1 | Yes | $15.20 | IL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | Yes | $17.00 | AZ |
| WellSense Added Value (HMO) | Boston Medical Center Health Plan, Inc. | T1 | Yes | $21.70 | NH |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is {28 (ivacaftor 150 MG / tezacaftor 100 MG Oral Tablet) / 28 (ivacaftor 150 MG Oral Tablet) } Pack [Symdeko (100 MG / 150 MG; 150 MG)] covered by Medicare Part D?
Yes, {28 (ivacaftor 150 MG / tezacaftor 100 MG Oral Tablet) / 28 (ivacaftor 150 MG Oral Tablet) } Pack [Symdeko (100 MG / 150 MG; 150 MG)] is covered by 1,401 Medicare Part D plans (27.7% of all Part D formularies).
What tier is {28 (ivacaftor 150 MG / tezacaftor 100 MG Oral Tablet) / 28 (ivacaftor 150 MG Oral Tablet) } Pack [Symdeko (100 MG / 150 MG; 150 MG)] on Medicare Part D plans?
{28 (ivacaftor 150 MG / tezacaftor 100 MG Oral Tablet) / 28 (ivacaftor 150 MG Oral Tablet) } Pack [Symdeko (100 MG / 150 MG; 150 MG)] averages Tier 4 across Part D plans, ranging from Tier 1 to Tier 5.
Does {28 (ivacaftor 150 MG / tezacaftor 100 MG Oral Tablet) / 28 (ivacaftor 150 MG Oral Tablet) } Pack [Symdeko (100 MG / 150 MG; 150 MG)] require prior authorization?
98.7% of Part D formularies require prior authorization for {28 (ivacaftor 150 MG / tezacaftor 100 MG Oral Tablet) / 28 (ivacaftor 150 MG Oral Tablet) } Pack [Symdeko (100 MG / 150 MG; 150 MG)]. Step therapy: 0%. Quantity limits: 91%.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
Similar prior-authorization rate
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- upadacitinib 1 MG/ML Oral Solution [Rinvoq] 98.7% PA
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- immunoglobulin G, human 5000 MG Injection [Gammagard] 98.7% PA