elbasvir 50 MG / grazoprevir 100 MG Oral Tablet [Zepatier]

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elbasvir

RxCUI: 1734642

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.
1.7%
Plan Coverage
86
Plans Covering
T3.7
Avg Tier
100%
Prior Auth Required

What the CMS Formulary Data Shows for elbasvir 50 MG / grazoprevir 100 MG Oral Tablet [Zepatier]

Per the CMS 2026 Part D formulary file, elbasvir 50 MG / grazoprevir 100 MG Oral Tablet [Zepatier] (RxNorm concept RXCUI 1734642, generic name elbasvir) appears on 11 distinct formulary files spanning 86 Medicare Part D plan offerings - 1.7% 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 3.7.

Real-world access to elbasvir 50 MG / grazoprevir 100 MG Oral Tablet [Zepatier] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 18.2% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 23 Part D beneficiaries filled elbasvir 50 MG / grazoprevir 100 MG Oral Tablet [Zepatier] in 2023, with total plan-and-beneficiary spending of $467,651 and an average per-beneficiary annual cost of $20,332.66. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry elbasvir 50 MG / grazoprevir 100 MG Oral Tablet [Zepatier] today.

Coverage Details

Formularies covering
11
Plans covering
86
Coverage rate
1.7%
Tier range
Tier 1 – Tier 5
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
100% of formularies
Step therapy required
0% of formularies
Quantity limits
18.2% of formularies

2023 Medicare Spending

Beneficiaries
23
Total spending
$467,651
Avg per beneficiary
$20,332.66

Tier Distribution Across Plans

3 plans
Tier 1, Preferred Generic
2 plans
Tier 2, Generic
81 plans
Tier 5, Specialty

Standalone Drug Plans (PDP) Covering elbasvir 50 MG / grazoprevir 100 MG Oral Tablet [Zepatier]

4 standalone prescription drug plans include this drug.

Plan Insurer Tier PA ST Premium States
Blue MedicareRx Essentials (PDP) BLUE CROSS AND BLUE SHIELD OF KANSAS T5 Yes No $0 -
Blue Cross MedicareRx Value (PDP) Health Care Service Corporation T5 Yes No $111.30 -
BlueRx Enhanced Plus (PDP) BCBS OF ALABAMA & UTIC INSURANCE COMPANY T5 Yes No $129.50 -
BlueMedicare Complete Rx (PDP) BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. T5 Yes No $217.00 -

Medicare Advantage Plans (MA-PD) Covering elbasvir 50 MG / grazoprevir 100 MG Oral Tablet [Zepatier]

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

Plan Insurer Tier PA Premium States
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 Yes $0 NY
Community Care's Partnership Program (HMO D-SNP) COMMUNITY CARE HEALTH PLAN, INC. T1 Yes $0 WI
Hamaspik Medicare Select (HMO D-SNP) HAMASPIK, INC. T1 Yes $34.50 NY
CareAdvantage (HMO D-SNP) SAN MATEO HEALTH COMMISSION T2 Yes $0 CA
CalOptima Health OneCare Complete (HMO D-SNP) ORANGE COUNTY HEALTH AUTHORITY T2 Yes $0 CA
Network Health Select (PPO) NETWORK HEALTH INSURANCE CORPORATION T5 Yes $0 WI
Network Health Go (PPO) NETWORK HEALTH INSURANCE CORPORATION T5 Yes $0 WI
Network Health Anywhere (PPO) NETWORK HEALTH INSURANCE CORPORATION T5 Yes $0 WI
Network Health Choice (PPO) NETWORK HEALTH INSURANCE CORPORATION T5 Yes $0 WI
Network Health Zero (PPO) NETWORK HEALTH INSURANCE CORPORATION T5 Yes $0 WI
Alignment Health the ONE + Walgreens (HMO) ALIGNMENT HEALTH PLAN OF ARIZONA, INC. T5 Yes $0 AZ
Alignment Health the ONE + Walgreens (HMO) ALIGNMENT HEALTH PLAN OF ARIZONA, INC. T5 Yes $0 AZ
Alignment Health Heart & Diabetes (HMO C-SNP) ALIGNMENT HEALTH PLAN OF ARIZONA, INC. T5 Yes $0 AZ
Alignment Health smartHMO (HMO) ALIGNMENT HEALTH PLAN OF ARIZONA, INC. T5 Yes $0 AZ
Alignment Health My Choice (HMO) ALIGNMENT HEALTH PLAN T5 Yes $0 CA
Alignment Health Platinum + Instacart (HMO) ALIGNMENT HEALTH PLAN T5 Yes $0 CA
Alignment Health Heart & Diabetes (HMO C-SNP) ALIGNMENT HEALTH PLAN T5 Yes $0 CA
Alignment Health AllCare Preferred (HMO) ALIGNMENT HEALTH PLAN T5 Yes $0 CA
Alignment Health smartHMO (HMO) ALIGNMENT HEALTH PLAN T5 Yes $0 CA
Alignment Health Platinum + Instacart (HMO-POS) ALIGNMENT HEALTH PLAN T5 Yes $0 CA
Alignment Health My Choice (HMO) ALIGNMENT HEALTH PLAN T5 Yes $0 CA
Alignment Health Harmony (HMO) ALIGNMENT HEALTH PLAN T5 Yes $0 CA
Alignment Health Balance (HMO C-SNP) ALIGNMENT HEALTH PLAN T5 Yes $0 CA
Alignment Health the ONE (HMO) ALIGNMENT HEALTH PLAN T5 Yes $0 CA
Alignment Health the ONE + Walgreens (HMO) ALIGNMENT HEALTH PLAN T5 Yes $0 CA
Alignment Health smartHMO (HMO) ALIGNMENT HEALTH PLAN T5 Yes $0 CA
Alignment Health smartHMO (HMO) ALIGNMENT HEALTH PLAN T5 Yes $0 CA
Alignment Health CommUnity (HMO) ALIGNMENT HEALTH PLAN T5 Yes $0 CA
Alignment Health smartSavings (HMO) ALIGNMENT HEALTH PLAN T5 Yes $0 CA
Alignment Health Heart & Diabetes Care (HMO C-SNP) ALIGNMENT HEALTH PLAN T5 Yes $0 CA
Alignment Health My Choice Select (HMO) ALIGNMENT HEALTH PLAN T5 Yes $0 CA
Alignment Health My Choice CalCare (HMO) ALIGNMENT HEALTH PLAN T5 Yes $0 CA
Alignment Health Honor+ Plan (HMO) ALIGNMENT HEALTH PLAN T5 Yes $0 CA
Alignment Health ValorCare (HMO) ALIGNMENT HEALTH PLAN T5 Yes $0 CA
Alignment Health Heart & Diabetes Care (HMO C-SNP) ALIGNMENT HEALTH PLAN T5 Yes $0 CA
Alignment Health L.A. Premium Giveback (HMO) ALIGNMENT HEALTH PLAN T5 Yes $0 CA
Alignment Health S.D. Premium Giveback (HMO) ALIGNMENT HEALTH PLAN T5 Yes $0 CA
Alignment Health Platinum (HMO) ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. T5 Yes $0 NC
Alignment Health NC Duals (HMO-POS D-SNP) ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. T5 Yes $0 NC
Alignment Health smartHMO (HMO) ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. T5 Yes $0 NC
Alignment Health Platinum + Instacart (HMO) ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. T5 Yes $0 NV
Alignment Health smartHMO (HMO) ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. T5 Yes $0 NV
Alignment Health Platinum Select (HMO) ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. T5 Yes $0 NC
Alignment Health Heart & Diabetes Care (HMO C-SNP) ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. T5 Yes $0 NC
Alignment Health the ONE + Walgreens (HMO-POS) ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC T5 Yes $0 TX
Alignment Health Heart & Diabetes (HMO-POS C-SNP) ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC T5 Yes $0 TX
Alignment Health smartHMO (HMO-POS) ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC T5 Yes $0 TX
Alignment Health Dual Select+ (HMO-POS D-SNP) ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC T5 Yes $0 TX
Alignment Health Total Dual+ (HMO-POS D-SNP) ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC T5 Yes $0 TX
Alignment Health smartSavings (HMO-POS) ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC T5 Yes $0 TX

Frequently Asked Questions

Is elbasvir 50 MG / grazoprevir 100 MG Oral Tablet [Zepatier] covered by Medicare Part D?

Yes, elbasvir 50 MG / grazoprevir 100 MG Oral Tablet [Zepatier] is covered by 86 Medicare Part D plans (1.7% of all Part D formularies).

What tier is elbasvir 50 MG / grazoprevir 100 MG Oral Tablet [Zepatier] on Medicare Part D plans?

elbasvir 50 MG / grazoprevir 100 MG Oral Tablet [Zepatier] averages Tier 3.7 across Part D plans, ranging from Tier 1 to Tier 5.

Does elbasvir 50 MG / grazoprevir 100 MG Oral Tablet [Zepatier] require prior authorization?

100% of Part D formularies require prior authorization for elbasvir 50 MG / grazoprevir 100 MG Oral Tablet [Zepatier]. Step therapy: 0%. Quantity limits: 18.2%.

How much does Medicare spend on elbasvir 50 MG / grazoprevir 100 MG Oral Tablet [Zepatier]?

In 2023, total Medicare Part D spending on elbasvir 50 MG / grazoprevir 100 MG Oral Tablet [Zepatier] was $467,651, covering 23 beneficiaries. The average spend per beneficiary was $20,332.66.

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