Medicare Part D coverage · 0.5 · RxCUI 2057205
0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym]
Per the CMS 2026 Part D formulary file, 0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym] is covered by 2,458 Medicare Part D plans (48.7% of enrollable products), averaging Tier 3.9, with prior authorization required on 76.7% of covering formularies.
- 48.7%
- Plan coverage
- 2,458
- Plans covering
- T3.9
- Avg tier
- 76.7%
- Prior auth required
What the CMS Formulary Data Shows for 0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym]
Per the CMS 2026 Part D formulary file, 0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym] (RxNorm concept RXCUI 2057205, generic name 0.5) appears on 176 distinct formulary files spanning 2,458 Medicare Part D plan offerings - 48.7% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 3.9.
Real-world access to 0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym] depends on utilization management as much as tier placement: 76.7% of covering formularies require prior authorization. 0% require step therapy. 0% 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 0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym] today.
Coverage Details
- Formularies covering
- 176
- Plans covering
- 2,458
- Coverage rate
- 48.7%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 76.7% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym]
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 |
| 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 |
| 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 |
| 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 |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| 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 |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | Yes | $0 | MN |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $0 | NY |
| 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 |
Show the next 30 plans
| 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 |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | Yes | $0 | CA |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Senior Care (HMO I-SNP) | Align Senior Care Florida, Inc. | T1 | No | $4.80 | FL |
| ProCare Advantage (HMO-POS I-SNP) | Procare Advantage, LLC | T1 | No | $4.80 | TX |
| ProCare Advantage - Kidney Care (HMO-POS C-SNP) | Procare Advantage, LLC | T1 | No | $4.80 | TX |
| American Health Advantage of Florida (HMO I-SNP) | American Health Plan OF FL, Inc. | T1 | No | $4.80 | FL |
| SECUR Advantage (HMO I-SNP) | Secur Inc | T1 | No | $4.80 | FL |
| SECUR Enhanced (HMO I-SNP) | Secur Inc | T1 | No | $4.80 | FL |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Hcsc Insurance Services Company | T1 | Yes | $4.80 | TX |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | Yes | $4.80 | FL |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | Yes | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | Yes | $4.80 | TX |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS Insurance Company | T1 | Yes | $5.00 | OK |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Michigan, Inc. | T1 | Yes | $8.80 | MI |
| Senior Care (HMO I-SNP) | Align Senior Care MI, LLC | T1 | No | $8.80 | MI |
| Tribute Select (HMO-POS I-SNP) | Arkansas Superior Select, Inc. | T1 | Yes | $8.90 | AR |
| AgeRight Advantage Health Plan (HMO I-SNP) | Marquis Advantage, Inc. | T1 | No | $10.50 | OR, WA |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | Yes | $10.50 | OR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | Yes | $10.50 | OR |
| Senior Care (HMO I-SNP) | Align Senior Care California Inc. | T1 | No | $12.00 | CA |
| Liberty Medicare Dual Plan (HMO D-SNP) | Liberty Advantage, LLC | T1 | No | $14.70 | NC |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Illinois, Inc. | T1 | Yes | $15.20 | IL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | Yes | $17.00 | AZ |
| WellSense Added Value (HMO) | Boston Medical Center Health Plan, Inc. | T1 | Yes | $21.70 | NH |
| KeyCare Advantage (HMO I-SNP) | Isnp Ventures, LLC | T1 | No | $23.20 | MD |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym] covered by Medicare Part D?
Yes, 0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym] is covered by 2,458 Medicare Part D plans (48.7% of all Part D formularies).
What tier is 0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym] on Medicare Part D plans?
0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym] averages Tier 3.9 across Part D plans, ranging from Tier 1 to Tier 5.
Does 0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym] require prior authorization?
76.7% of Part D formularies require prior authorization for 0.5 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym]. Step therapy: 0%. Quantity limits: 0%.
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
- mycophenolate mofetil 200 MG/ML Oral Suspension T3.9
- rufinamide 400 MG Oral Tablet T3.9
- ursodiol 200 MG Oral Capsule T3.9
- everolimus 0.5 MG Oral Tablet T3.9
- daptomycin 350 MG Injection T3.9
- bupropion hydrochloride 105 MG / dextromethorphan hydrobromide 45 MG Extended Release Oral Tablet [Auvelity] T3.9
Similar prior-authorization rate
- 0.8 ML filgrastim-aafi 0.6 MG/ML Prefilled Syringe [Nivestym] 76.7% PA
- 1 ML filgrastim-aafi 0.3 MG/ML Injection [Nivestym] 76.6% PA
- 1.6 ML filgrastim-aafi 0.3 MG/ML Injection [Nivestym] 76.6% PA
- 24 HR hydromorphone hydrochloride 12 MG Extended Release Oral Tablet 76.9% PA
- letermovir 120 MG Oral Pellet [Prevymis] 76.5% PA
- ospemifene 60 MG Oral Tablet [Osphena] 77.1% PA