Is metformin hydrochloride / saxagliptin covered by Medicare Part D?
358 of 5,052 Medicare Part D plan offerings (7.1%) list metformin hydrochloride / saxagliptin on their 2026 formulary, most often on tier 3; 0% of the formularies that cover it require prior authorization. Part D spending on it was $6 million in 2024 for 2,488 people: what plans and patients paid at the pharmacy, before manufacturer rebates (CMS Part D Spending by Drug).
- Plans that cover it
- 7.1%
- 358 of 5,052 offerings; the median drug: 76%
- Usual tier
- Tier 3
- from tier 1 to tier 4
- Prior authorization
- 0%
- of formularies that cover it; the median drug: 1%
- Quantity limits
- 78.6%
- of formularies that cover it; the median drug: 30%
2.4% of the formularies that cover it require step therapy (trying another drug first).
Source: CMS Part D formulary file, 2026 second quarter: the formularies in use in 2026. A plan's 2027 formulary can differ; check your own plan's coverage in Medicare Plan Finder.
What does it cost under Part D in 2027?
- Your yearly cap in 2027
- Out-of-pocket spending on covered Part D drugs stops at $2,400 in 2027 ($2,100 in 2026); after that, you pay nothing for covered drugs for the rest of the year.
- The deductible
- A plan's drug deductible is at most $700 in 2027 ($615 in 2026); many plans charge less or none.
Source: CMS, Announcement of calendar year 2027 Part D parameters; Medicare.gov, “How much does Medicare drug coverage cost?” (read Oct. 7, 2026).
How much does Medicare spend on it?
Part D spending by year
2,488 people filled it under Part D in 2024, in 9,249 claims. The amounts are what plans and patients paid at the pharmacy, before manufacturer rebates.
Source: CMS Medicare Part D Spending by Drug, 2020 to 2024 (published June 2026). Row used: Saxagliptin-Metformin ER (Saxagliptin HCl/Metformin HCl).
Which forms and strengths are counted?
- 24 hour metformin hydrochloride 1000 mg / saxagliptin 2.5 mg extended-release oral tablet
- 24 hour metformin hydrochloride 1000 mg / saxagliptin 5 mg extended-release oral tablet
- 24 hour metformin hydrochloride 500 mg / saxagliptin 5 mg extended-release oral tablet
What else should you check?
- Stand-alone drug plans for 2027Premiums and deductibles
- Drugs Medicare spends the most onThe 2024 spending list
- 2027 costs and limitsDeductibles and out-of-pocket limits
Data, not medical advice. Coverage is the share of plan formularies listing the drug; your plan's formulary, tier and pharmacy decide what you pay.