Sitagliptin (Januvia) — 2026 Medicare Part D coverage
sitagliptin — sold as Januvia: 9 forms appear in Medicare Part D formularies for 2026. This page reports what plans filed with CMS; it does not recommend a plan.
Medicare-negotiated price for Januvia in 2026
Januvia is one of the first 10 drugs whose price Medicare negotiated with the manufacturer under the Inflation Reduction Act. From January 1, 2026, Part D plans and pharmacies pay the negotiated price.
Commonly used for diabetes. The negotiated price is what the plan and pharmacy pay, not your copay. What you pay still depends on your plan: a flat copay usually stays the same, while coinsurance (a percentage) is calculated on the lower price, and the Part D deductible and the annual out-of-pocket cap still apply. It covers the brand-name drug named here, not generics or biosimilars. Source: CMS, Medicare Drug Price Negotiation Program: Negotiated Prices for 2026.
Which plans in your county cover sitagliptin?
Pick a county to see every Medicare Advantage plan filed there and every stand-alone Part D plan in its region, with this drug's tier, restrictions and tier cost sharing.
How to read drug coverage
Tier is the cost-sharing tier the plan assigned the drug in its CMS formulary filing; lower tiers usually cost less. PA = prior authorization, ST = step therapy (try another drug first), QL = quantity limit. Not on formulary means the plan did not list this exact form; the plan may cover another strength or a formulary exception may be possible. Cost sharing is the plan's initial-coverage amount for the tier as filed with CMS; the deductible, the $2,100 annual out-of-pocket cap, the $35 insulin cap and negotiated prices for selected drugs can change what you actually pay. Formularies change during the year; the plan's formulary document and Medicare.gov govern.
What the star rating under each Medicare Advantage plan means
What the star rating means. CMS rates every Medicare Advantage contract (the "H" number in the plan ID — all plans under it share the rating) on a 1-to-5 scale each October, from about 40 measures of care quality, member experience, complaints and appeals, customer service and, for plans with drug coverage, drug safety and pricing. The 2026 rating is largely based on performance measured in 2024.
5 Excellent4 Above average3 Average2 Below average1 Poor
Not rated means CMS published no overall rating — usually a contract too new to be measured or with too few members ("not enough data"); it is not a low score. A 5-star contract can be joined outside the normal enrollment windows (the 5-star Special Enrollment Period, Dec 8 – Nov 30). Medicare.gov flags contracts rated below 3 stars for three years running as low-performing. Stars describe the contract's past performance as CMS measured it; they are not a recommendation, and they do not tell you whether a plan's network, drugs or costs fit you.
Forms and strengths in 2026 formularies
| Form | Formularies listing it | Most common tier | PA | ST | QL |
|---|---|---|---|---|---|
| SITagliptin phosphate 100 MG Oral Tablet generic · RxCUI 2709603 | 229 (70%) | 3 | 0 | 0 | 222 |
| SITagliptin phosphate 25 MG Oral Tablet generic · RxCUI 2709612 | 229 (70%) | 3 | 0 | 0 | 225 |
| SITagliptin phosphate 50 MG Oral Tablet generic · RxCUI 2709608 | 229 (70%) | 3 | 0 | 0 | 225 |
| Januvia 100 MG Oral Tablet brand · RxCUI 665036 | 219 (67%) | 3 | 1 | 0 | 211 |
| Januvia 25 MG Oral Tablet brand · RxCUI 665040 | 219 (67%) | 3 | 1 | 0 | 214 |
| Januvia 50 MG Oral Tablet brand · RxCUI 665044 | 219 (67%) | 3 | 1 | 0 | 214 |
| SITagliptin 100 MG Oral Tablet generic · RxCUI 665033 | 13 (4%) | 3 | 0 | 0 | 11 |
| SITagliptin 25 MG Oral Tablet generic · RxCUI 665038 | 13 (4%) | 3 | 0 | 0 | 11 |
| SITagliptin 50 MG Oral Tablet generic · RxCUI 665042 | 13 (4%) | 3 | 0 | 0 | 11 |
Counts are formularies (of 328) in the CMS file that list the form, and how many of those apply prior authorization (PA), step therapy (ST) or a quantity limit (QL). Many plans share one formulary, so plan counts in a county will differ.
How to read drug coverage
Tier is the cost-sharing tier the plan assigned the drug in its CMS formulary filing; lower tiers usually cost less. PA = prior authorization, ST = step therapy (try another drug first), QL = quantity limit. Not on formulary means the plan did not list this exact form; the plan may cover another strength or a formulary exception may be possible. Cost sharing is the plan's initial-coverage amount for the tier as filed with CMS; the deductible, the $2,100 annual out-of-pocket cap, the $35 insulin cap and negotiated prices for selected drugs can change what you actually pay. Formularies change during the year; the plan's formulary document and Medicare.gov govern.
What the star rating under each Medicare Advantage plan means
What the star rating means. CMS rates every Medicare Advantage contract (the "H" number in the plan ID — all plans under it share the rating) on a 1-to-5 scale each October, from about 40 measures of care quality, member experience, complaints and appeals, customer service and, for plans with drug coverage, drug safety and pricing. The 2026 rating is largely based on performance measured in 2024.
5 Excellent4 Above average3 Average2 Below average1 Poor
Not rated means CMS published no overall rating — usually a contract too new to be measured or with too few members ("not enough data"); it is not a low score. A 5-star contract can be joined outside the normal enrollment windows (the 5-star Special Enrollment Period, Dec 8 – Nov 30). Medicare.gov flags contracts rated below 3 stars for three years running as low-performing. Stars describe the contract's past performance as CMS measured it; they are not a recommendation, and they do not tell you whether a plan's network, drugs or costs fit you.