Medicare Part D coverage · 0.375 · RxCUI 825325
0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard]
Per the CMS 2026 Part D formulary file, 0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard] is covered by 4,798 Medicare Part D plans (95% of enrollable products), averaging Tier 3.3, with prior authorization required on 83.1% of covering formularies.
- 95%
- Plan coverage
- 4,798
- Plans covering
- T3.3
- Avg tier
- 83.1%
- Prior auth required
What the CMS Formulary Data Shows for 0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard]
Per the CMS 2026 Part D formulary file, 0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard] (RxNorm concept RXCUI 825325, generic name 0.375) appears on 296 distinct formulary files spanning 4,798 Medicare Part D plan offerings - 95% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.3.
Real-world access to 0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard] depends on utilization management as much as tier placement: 83.1% of covering formularies require prior authorization. 1% require step therapy. 32.4% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 2,942 Part D beneficiaries filled 0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard] in 2023, with total plan-and-beneficiary spending of $9,868,106 and an average per-beneficiary annual cost of $3,354.22. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard] today.
Coverage Details
- Formularies covering
- 296
- Plans covering
- 4,798
- Coverage rate
- 95%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 83.1% of formularies
- Step therapy required
- 1% of formularies
- Quantity limits
- 32.4% of formularies
2023 Medicare Spending
- Beneficiaries
- 2,942
- Total spending
- $9,868,106
- Avg per beneficiary
- $3,354.22
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | Sentara Health Plans | T1 | Yes | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | Yes | $0 | VA |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $0 | FL |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | Yes | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | Yes | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | Yes | $0 | NJ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | Yes | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | Yes | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | Yes | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | Yes | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | Yes | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | Yes | $0 | NY |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | Yes | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | Yes | $0 | GA |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
Show the next 30 plans
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | Yes | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | No | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | No | $0 | AL |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | Yes | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare OF NEW Jersey, Inc. | T1 | Yes | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | Yes | $0 | MN |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $0 | NY |
| 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 |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | Yes | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | Yes | $0 | MA |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | Yes | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | Yes | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | Yes | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | Yes | $0 | NY |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | Yes | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | Yes | $0 | AR |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | Yes | $0 | WI |
| Platino Blindao (HMO D-SNP) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Enlace (HMO D-SNP) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Advance (HMO D-snp) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Plus (HMO D-snp) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| 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 |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard] covered by Medicare Part D?
Yes, 0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard] is covered by 4,798 Medicare Part D plans (95% of all Part D formularies).
What tier is 0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard] on Medicare Part D plans?
0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard] averages Tier 3.3 across Part D plans, ranging from Tier 1 to Tier 4.
Does 0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard] require prior authorization?
83.1% of Part D formularies require prior authorization for 0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard]. Step therapy: 1%. Quantity limits: 32.4%.
How much does Medicare spend on 0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard]?
In 2023, total Medicare Part D spending on 0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard] was $9,868,106, covering 2,942 beneficiaries. The average spend per beneficiary was $3,354.22.
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
- 0.25 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Eligard] T3.3
- alanine 27.6 MG/ML / arginine 19.6 MG/ML / aspartate 6 MG/ML / glutamate 10.2 MG/ML / glycine 20.6 MG/ML / histidine 11.8 MG/ML / isoleucine 10.8 MG/ML / leucine 10.8 MG/ML / lysine 13.5 MG/ML / methionine 7.6 MG/ML / phenylalanine 10 MG/ML / proline 13.4 MG/ML / serine 10.2 MG/ML / threonine 9.8 MG/ML / tryptophan 3.2 MG/ML / tyrosine 0.5 MG/ML / valine 14.4 MG/ML Injectable Solution [Prosol] T3.3
- bazedoxifene 20 MG / estrogens, conjugated (USP) 0.45 MG Oral Tablet [Duavee] T3.3
- triptorelin 3.75 MG Injection [Trelstar] T3.3
- dextroamphetamine sulfate 10 MG Oral Tablet [Zenzedi] T3.3
- naftifine hydrochloride 0.02 MG/MG Topical Gel T3.3
Similar prior-authorization rate
- 0.5 ML leuprolide acetate 60 MG/ML Prefilled Syringe [Eligard] 83.2% PA
- methotrexate 2 MG/ML Oral Solution [Jylamvo] 82.9% PA
- 1.2 ML garadacimab-gxii 167 MG/ML Auto-Injector [Andembry] 83.3% PA
- sofosbuvir 400 MG Oral Tablet [Sovaldi] 83.3% PA
- American house dust mite allergenic extract 6 SQ-HDM / European house dust mite allergenic extract 6 SQ-HDM Sublingual Tablet [Odactra] 83.3% PA
- estradiol 1 MG / progesterone 100 MG Oral Capsule [Bijuva] 83.3% PA