Drug Coverage and Restrictions in 2025 by Insurance Type
Data as of February 2025. We calculated the medication coverage for each plan in each year by taking the number of drugs covered on that plan as a proportion of the drugs covered on the “best plan.” We deemed the “best plan” the total unique number of medications covered across all plans for each insurance type. To summarize, we took the average of all plans’ drug coverage proportions, weighted by plan enrollment. The share of medications with restrictions is the enrollment-weighted average proportion of covered medications with prior authorization, step therapy, and/or quantity limits.
Source: GoodRx analysis of CMS and MMIT data
