Medicare Part D coverage · atogepant · RxCUI 2571850
atogepant 60 MG Oral Tablet [Qulipta]
Per the CMS 2026 Part D formulary file, atogepant 60 MG Oral Tablet [Qulipta] is covered by 3,742 Medicare Part D plans (74.1% of enrollable products), averaging Tier 2.9, with prior authorization required on 98.1% of covering formularies.
- 74.1%
- Plan coverage
- 3,742
- Plans covering
- T2.9
- Avg tier
- 98.1%
- Prior auth required
What the CMS Formulary Data Shows for atogepant 60 MG Oral Tablet [Qulipta]
Per the CMS 2026 Part D formulary file, atogepant 60 MG Oral Tablet [Qulipta] (RxNorm concept RXCUI 2571850, generic name atogepant) appears on 207 distinct formulary files spanning 3,742 Medicare Part D plan offerings - 74.1% 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 2.9.
Real-world access to atogepant 60 MG Oral Tablet [Qulipta] depends on utilization management as much as tier placement: 98.1% of covering formularies require prior authorization. 0% require step therapy. 97.6% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 25,190 Part D beneficiaries filled atogepant 60 MG Oral Tablet [Qulipta] in 2023, with total plan-and-beneficiary spending of $137,880,798 and an average per-beneficiary annual cost of $5,473.63. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry atogepant 60 MG Oral Tablet [Qulipta] today.
Coverage Details
- Formularies covering
- 207
- Plans covering
- 3,742
- Coverage rate
- 74.1%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 98.1% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 97.6% of formularies
2023 Medicare Spending
- Beneficiaries
- 25,190
- Total spending
- $137,880,798
- Avg per beneficiary
- $5,473.63
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering atogepant 60 MG Oral Tablet [Qulipta]
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 |
| 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 |
Show the next 30 plans
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | Yes | $0 | MI |
| 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 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 |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| 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 |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | Yes | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | Yes | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | Yes | $0 | MA |
| Florida Complete Care (HMO I-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $4.80 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is atogepant 60 MG Oral Tablet [Qulipta] covered by Medicare Part D?
Yes, atogepant 60 MG Oral Tablet [Qulipta] is covered by 3,742 Medicare Part D plans (74.1% of all Part D formularies).
What tier is atogepant 60 MG Oral Tablet [Qulipta] on Medicare Part D plans?
atogepant 60 MG Oral Tablet [Qulipta] averages Tier 2.9 across Part D plans, ranging from Tier 1 to Tier 5.
Does atogepant 60 MG Oral Tablet [Qulipta] require prior authorization?
98.1% of Part D formularies require prior authorization for atogepant 60 MG Oral Tablet [Qulipta]. Step therapy: 0%. Quantity limits: 97.6%.
How much does Medicare spend on atogepant 60 MG Oral Tablet [Qulipta]?
In 2023, total Medicare Part D spending on atogepant 60 MG Oral Tablet [Qulipta] was $137,880,798, covering 25,190 beneficiaries. The average spend per beneficiary was $5,473.63.
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
- {56 (mitapivat 20 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 20 MG 4-Week] 98.1% PA
- {7 (mitapivat 5 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 5 MG Taper] 98.1% PA
- 1 ML ustekinumab 90 MG/ML Prefilled Syringe 98.1% PA
- 200 ML immunoglobulin G, human 50 MG/ML Injection [Gammaplex] 98.1% PA
- 1 ML tralokinumab-ldrm 150 MG/ML Prefilled Syringe [Adbry] 98.1% PA
- alanine 5.4 MG/ML / arginine 12 MG/ML / aspartate 3.2 MG/ML / cysteine 0.24 MG/ML / glutamate 5 MG/ML / glycine 3.6 MG/ML / histidine 4.8 MG/ML / isoleucine 8.2 MG/ML / leucine 1.4 MG/ML / lysine 1.2 MG/ML / methionine 3.4 MG/ML / phenylalanine 4.8 MG/ML / proline 6.8 MG/ML / serine 3.8 MG/ML / sodium acetate 0.097 MEQ/ML / sodium chloride 0.003 MEQ/ML / sodium metabisulfite 0.5 MG/ML / taurine 0.25 MG/ML / threonine 4.2 MG/ML / tryptophan 2 MG/ML / tyrosine 2.84 MG/ML / valine 7.8 MG/ML Injectable Solution [Trophamine 10 %] 98.1% PA