Medicare Part D coverage · 3 · RxCUI 897122
3 ML liraglutide 6 MG/ML Pen Injector
Per the CMS 2026 Part D formulary file, 3 ML liraglutide 6 MG/ML Pen Injector is covered by 705 Medicare Part D plans (14% of enrollable products), averaging Tier 2.2, with prior authorization required on 99% of covering formularies.
- 14%
- Plan coverage
- 705
- Plans covering
- T2.2
- Avg tier
- 99%
- Prior auth required
What the CMS Formulary Data Shows for 3 ML liraglutide 6 MG/ML Pen Injector
Per the CMS 2026 Part D formulary file, 3 ML liraglutide 6 MG/ML Pen Injector (RxNorm concept RXCUI 897122, generic name 3) appears on 96 distinct formulary files spanning 705 Medicare Part D plan offerings - 14% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 2.2.
Real-world access to 3 ML liraglutide 6 MG/ML Pen Injector depends on utilization management as much as tier placement: 99% of covering formularies require prior authorization. 0% require step therapy. 96.9% 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 3 ML liraglutide 6 MG/ML Pen Injector today.
Coverage Details
- Formularies covering
- 96
- Plans covering
- 705
- Coverage rate
- 14%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 99% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 96.9% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 3 ML liraglutide 6 MG/ML Pen Injector
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | Sentara Health Plans | T1 | Yes | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | Yes | $0 | VA |
| 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 |
| 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 |
| 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 |
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | Yes | $0 | AL |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| 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 |
| 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 |
| 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 |
Show the next 30 plans
| 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 |
| 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 |
| WellSense Added Value (HMO) | Boston Medical Center Health Plan, Inc. | T1 | Yes | $21.70 | NH |
| KeyCare Advantage (HMO I-SNP) | Isnp Ventures, LLC | T1 | Yes | $23.20 | MD |
| American Health Advantage of Mississippi (HMO I-SNP) | American Health Plan OF MS, Inc. | T1 | Yes | $23.80 | MS |
| Senior Care (HMO I-SNP) | Lifeworks Advantage, LLC | T1 | Yes | $24.60 | VA |
| PruittHealth Premier (HMO I-SNP) | Pruitthealth Premier, Inc. | T1 | Yes | $25.40 | GA |
| Georgia Health Advantage (HMO I-SNP) | Georgia Assurance, Inc. | T1 | Yes | $25.40 | GA |
| Georgia Health Advantage Choice (HMO I-SNP) | Georgia Assurance, Inc. | T1 | Yes | $25.40 | GA |
| American Health Advantage of Tennessee (HMO I-SNP) | American Health Plan, Inc. | T1 | Yes | $27.70 | TN |
| Simpra Advantage Nursing Home Plan (PPO I-SNP) | Simpra Advantage, Inc. | T1 | Yes | $27.70 | AL |
| American Health Advantage of Oklahoma (HMO I-SNP) | Oklahoma Superior Select, Inc. | T1 | Yes | $28.20 | OK |
| NHC Advantage (HMO I-SNP) | NHC Advantage, LLC | T1 | Yes | $31.00 | MO, NC, SC, TN |
| Perennial Advantage Strive (HMO I-SNP) | Perennial Advantage OF Ohio, Inc. | T1 | Yes | $31.40 | OH |
| Perennial Advantage Strive (HMO I-SNP) | Perennial Advantage OF Colorado, Inc. | T1 | Yes | $32.70 | PA |
| American Health Advantage of Pennsylvania (HMO I-SNP) | American Health Plan OF Pennsylvania Inc | T1 | Yes | $32.70 | PA |
| Lagniappe Advantage (PPO I-SNP) | Lagniappe Advantage Insurance Company | T1 | Yes | $32.90 | LA |
| American Health Advantage of Louisiana (HMO I-SNP) | Dignity Care Corporation | T1 | Yes | $32.90 | LA |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Colorado, Inc. | T1 | Yes | $35.20 | CO |
| Perennial Advantage Strive (HMO I-SNP) | Perennial Advantage OF Colorado, Inc. | T1 | Yes | $35.20 | CO |
| PruittHealth Premier (HMO I-SNP) | Pruitthealth Premier North Carolina, LLC | T1 | Yes | $35.70 | SC |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF North Carolina, Inc. | T1 | Yes | $36.20 | NC |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 3 ML liraglutide 6 MG/ML Pen Injector covered by Medicare Part D?
Yes, 3 ML liraglutide 6 MG/ML Pen Injector is covered by 705 Medicare Part D plans (14% of all Part D formularies).
What tier is 3 ML liraglutide 6 MG/ML Pen Injector on Medicare Part D plans?
3 ML liraglutide 6 MG/ML Pen Injector averages Tier 2.2 across Part D plans, ranging from Tier 1 to Tier 6.
Does 3 ML liraglutide 6 MG/ML Pen Injector require prior authorization?
99% of Part D formularies require prior authorization for 3 ML liraglutide 6 MG/ML Pen Injector. Step therapy: 0%. Quantity limits: 96.9%.
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
- 0.5 ML typhoid Vi polysaccharide vaccine, S typhi Ty2 strain 0.05 MG/ML Prefilled Syringe [Typhim VI] T2.2
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- imiquimod 50 MG/ML Topical Cream T2.2
- Salmonella typhi Ty21a live antigen 2000000000 UNT Delayed Release Oral Capsule [Vivotif] T2.2
Similar prior-authorization rate
- 0.5 ML ustekinumab 90 MG/ML Injection [Stelara] 99% PA
- selexipag 1.6 MG Oral Tablet [Uptravi] 99% PA
- {140 (selexipag 0.2 MG Oral Tablet [Uptravi]) / 60 (selexipag 0.8 MG Oral Tablet [Uptravi]) } Pack [Uptravi Titration Pack] 99% PA
- selexipag 1 MG Oral Tablet [Uptravi] 99% PA
- edaravone 21 MG/ML Oral Suspension [Radicava] 99% PA
- 500 ML soybean oil 200 MG/ML Injection [Nutrilipid] 99% PA