Medicare Part D coverage · 0.25 · RxCUI 2728996

0.25 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Vabrinty]

Per the CMS 2026 Part D formulary file, 0.25 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Vabrinty] is covered by 8 Medicare Part D plans (0.2% of enrollable products), averaging Tier 5, with prior authorization required on 50% of covering formularies.

0.2%
Plan coverage
8
Plans covering
T5
Avg tier
50%
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 0.25 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Vabrinty]

Per the CMS 2026 Part D formulary file, 0.25 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Vabrinty] (RxNorm concept RXCUI 2728996, generic name 0.25) appears on 2 distinct formulary files spanning 8 Medicare Part D plan offerings - 0.2% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 5 to Tier 5, with a cross-plan average of Tier 5.

Real-world access to 0.25 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Vabrinty] depends on utilization management as much as tier placement: 50% of covering formularies require prior authorization. 0% require step therapy. 50% 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 0.25 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Vabrinty] today.

Coverage Details

Formularies covering
2
Plans covering
8
Coverage rate
0.2%
Tier range
Tier 5, Specialty
Average tier
Tier 5, Specialty

Restrictions

Prior authorization required
50% of formularies
Step therapy required
0% of formularies
Quantity limits
50% of formularies

Tier Distribution Across Plans

8 plans
Tier 5, Specialty

Medicare Advantage Plans (MA-PD) Covering 0.25 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Vabrinty]

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

Plan Insurer Tier PA Premium States
Health New England Medicare Compass (PPO) Health NEW England, Inc. T5 Yes $0 MA
Health New England Medicare Value (HMO) Health NEW England, Inc. T5 Yes $0 MA
Presbyterian Senior Care Plan 2 with Rx (HMO) Presbyterian Health Plan T5 No $0 NM
Presbyterian Dual Plus (HMO D-SNP) Presbyterian Health Plan T5 No $0 NM
Presbyterian Senior Care Extra Health Plan with Rx (HMO) Presbyterian Health Plan T5 No $0 NM
Health New England Medicare Premium (HMO) Health NEW England, Inc. T5 Yes $15.80 MA
Health New England Medicare Plus (HMO) Health NEW England, Inc. T5 Yes $58.40 MA
Presbyterian Senior Care Plan 3 with Rx (HMO) Presbyterian Health Plan T5 No $65.80 NM

Frequently Asked Questions

Is 0.25 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Vabrinty] covered by Medicare Part D?

Yes, 0.25 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Vabrinty] is covered by 8 Medicare Part D plans (0.2% of all Part D formularies).

What tier is 0.25 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Vabrinty] on Medicare Part D plans?

0.25 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Vabrinty] averages Tier 5 across Part D plans, ranging from Tier 5 to Tier 5.

Does 0.25 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Vabrinty] require prior authorization?

50% of Part D formularies require prior authorization for 0.25 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Vabrinty]. Step therapy: 0%. Quantity limits: 50%.

Read our methodology - how this data is sourced, computed, and verified.

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.

Closest average formulary tier

Similar prior-authorization rate

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