Medicare Part D coverage · mavorixafor · RxCUI 2684032

mavorixafor 100 MG Oral Capsule [Xolremdi]

Per the CMS 2026 Part D formulary file, mavorixafor 100 MG Oral Capsule [Xolremdi] is covered by 1,032 Medicare Part D plans (20.4% of enrollable products), averaging Tier 4.5, with prior authorization required on 100% of covering formularies.

20.4%
Plan coverage
1,032
Plans covering
T4.5
Avg tier
100%
Prior auth required

Verify with CMS →

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.

What the CMS Formulary Data Shows for mavorixafor 100 MG Oral Capsule [Xolremdi]

Per the CMS 2026 Part D formulary file, mavorixafor 100 MG Oral Capsule [Xolremdi] (RxNorm concept RXCUI 2684032, generic name mavorixafor) appears on 49 distinct formulary files spanning 1,032 Medicare Part D plan offerings - 20.4% 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 4.5.

Real-world access to mavorixafor 100 MG Oral Capsule [Xolremdi] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 77.6% 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 mavorixafor 100 MG Oral Capsule [Xolremdi] today.

Coverage Details

Formularies covering
49
Plans covering
1,032
Coverage rate
20.4%
Tier range
Tier 1 – Tier 6
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
100% of formularies
Step therapy required
0% of formularies
Quantity limits
77.6% of formularies

Tier Distribution Across Plans

27 plans
Tier 1, Preferred Generic
1 plans
Tier 2, Generic
72 plans
Tier 5, Specialty

Standalone Drug Plans (PDP) Covering mavorixafor 100 MG Oral Capsule [Xolremdi]

5 standalone prescription drug plans include this drug.

Plan Insurer Tier PA ST Premium States
AARP Medicare Rx Preferred from UHC (PDP) Unitedhealthcare INS. Co. & UHC INS. Co. OF NY T5 Yes No $0 -
AARP Medicare Rx Preferred from UHC (PDP) Unitedhealthcare INS. Co. & UHC INS. Co. OF NY T5 Yes No $0 -
AARP Medicare Rx Saver from UHC (PDP) Unitedhealthcare INS. Co. & UHC INS. Co. OF NY T5 Yes No $0 -
AARP Medicare Rx Saver from UHC (PDP) Unitedhealthcare INS. Co. & UHC INS. Co. OF NY T5 Yes No $0 -
AARP Medicare Rx Saver from UHC (PDP) Unitedhealthcare INS. Co. & UHC INS. Co. OF NY T5 Yes No $0 -

Medicare Advantage Plans (MA-PD) Covering mavorixafor 100 MG Oral Capsule [Xolremdi]

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

Plan Insurer Tier PA Premium States
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
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
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
Provider Partners Texas Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF Texas, Inc. T1 Yes $4.80 TX
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) Gateway Health Plan, Inc. T1 Yes $13.10 PA
Provider Partners Illinois Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF Illinois T1 Yes $15.20 IL
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) Gateway Health Plan, Inc. T1 Yes $17.60 PA
Highmark Health Options Duals Select (HMO D-SNP) Highmark Bcbsd, Inc. T1 Yes $31.20 DE
Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF Pennsylvania, Inc T1 Yes $32.70 PA
Provider Partners Pennsylvania Essential Plan (HMO I-SNP) Provider Partners Health Plan OF Pennsylvania, Inc T1 Yes $32.70 PA
Show the next 30 plans
Provider Partners North Carolina Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF North Carolina T1 Yes $36.20 NC
Provider Partners North Carolina Essential Plan (HMO I-SNP) Provider Partners Health Plan OF North Carolina T1 Yes $36.20 NC
Provider Partners Indiana Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF Indiana T1 Yes $38.40 IN
Provider Partners Indiana Essential Plan (HMO I-SNP) Provider Partners Health Plan OF Indiana T1 Yes $38.40 IN
Provider Partners Kentucky Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF Kentucky T1 Yes $38.40 KY
Provider Partners Missouri Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF Missouri, Inc. T1 Yes $43.00 MO
Provider Partners Missouri Essential Plan (HMO I-SNP) Provider Partners Health Plan OF Missouri, Inc. T1 Yes $43.00 MO
CalOptima Health OneCare Complete (HMO D-SNP) Orange County Health Authority T2 Yes $0 CA
UHC Dual Complete IA-S001 (HMO-POS D-SNP) Unitedhealthcare OF Wisconsin, Inc. T5 Yes $0 IA
UHC Dual Complete MO-S001 (HMO-POS D-SNP) Unitedhealthcare OF Wisconsin, Inc. T5 Yes $0 MO
UHC Dual Complete NE-S001 (HMO-POS D-SNP) Unitedhealthcare OF Wisconsin, Inc. T5 Yes $0 NE
UHC Dual Complete KS-S001 (HMO-POS D-SNP) Unitedhealthcare OF Wisconsin, Inc. T5 Yes $0 KS
UHC Dual Complete MO-S3 (HMO-POS D-SNP) Unitedhealthcare OF Wisconsin, Inc. T5 Yes $0 MO
UHC Dual Complete KS-Q1 (HMO-POS D-SNP) Unitedhealthcare OF Wisconsin, Inc. T5 Yes $0 KS
UHC Dual Complete TN-S001 (HMO-POS D-SNP) Unitedhealthcare Plan OF THE River Valley, Inc. T5 Yes $0 TN
UHC Dual Complete TN-Y001 (HMO-POS D-SNP) Unitedhealthcare Plan OF THE River Valley, Inc. T5 Yes $0 TN
UHC Dual Complete TN-Y2 (HMO-POS D-SNP) Unitedhealthcare Plan OF THE River Valley, Inc. T5 Yes $0 TN
AARP Medicare Advantage from UHC MI-0001 (PPO) Unitedhealthcare Insurance Company T5 Yes $0 MI
UHC Dual Complete NM-Y1 (PPO D-SNP) Unitedhealthcare Insurance Company T5 Yes $0 NM
UHC Dual Complete NM-S1 (PPO D-SNP) Unitedhealthcare Insurance Company T5 Yes $0 NM
UHC Dual Complete NM-V1 (PPO D-SNP) Unitedhealthcare Insurance Company T5 Yes $0 NM
UHC Dual Complete AZ-S001 (HMO-POS D-SNP) Arizona Physicians IPA, Inc. T5 Yes $0 AZ
UHC Dual Complete AZ-Y001 (HMO-POS D-SNP) Arizona Physicians IPA, Inc. T5 Yes $0 AZ
UHC Dual Complete VA-Y4 (PPO D-SNP) Care Improvement Plus South Central Insurance Co. T5 Yes $0 VA
AARP Medicare Advantage from UHC AL-0001 (HMO-POS) Unitedhealthcare OF THE Midlands, Inc. T5 Yes $0 AL
AARP Medicare Advantage from UHC CA-0002 (HMO-POS) UHC OF California T5 Yes $0 CA
UHC Sharp Medicare Advantage CA-001P (HMO-POS) UHC OF California T5 Yes $0 CA
AARP Medicare Advantage from UHC CA-003P (HMO-POS) UHC OF California T5 Yes $0 CA
AARP Medicare Advantage from UHC CA-0012 (HMO-POS) UHC OF California T5 Yes $0 CA
AARP Medicare Advantage from UHC CA-004P (HMO-POS) UHC OF California T5 Yes $0 CA

Showing top 50 of 95 plans.

Frequently Asked Questions

Is mavorixafor 100 MG Oral Capsule [Xolremdi] covered by Medicare Part D?

Yes, mavorixafor 100 MG Oral Capsule [Xolremdi] is covered by 1,032 Medicare Part D plans (20.4% of all Part D formularies).

What tier is mavorixafor 100 MG Oral Capsule [Xolremdi] on Medicare Part D plans?

mavorixafor 100 MG Oral Capsule [Xolremdi] averages Tier 4.5 across Part D plans, ranging from Tier 1 to Tier 6.

Does mavorixafor 100 MG Oral Capsule [Xolremdi] require prior authorization?

100% of Part D formularies require prior authorization for mavorixafor 100 MG Oral Capsule [Xolremdi]. Step therapy: 0%. Quantity limits: 77.6%.

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.

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