Medicare Part D coverage · 0.5 · RxCUI 2585717
0.5 ML acellular pertussis vaccine, inactivated 96 UNT/ML / diphtheria toxoid vaccine, inactivated 30 UNT/ML / Haemophilus influenzae type b, capsular polysaccharide inactivated tetanus toxoid conjugate vaccine 68 UNT/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 58 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 14 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 52 UNT/ML / tetanus toxoid vaccine, inactivated 20 UNT/ML Injection [Pentacel]
Per the CMS 2026 Part D formulary file, 0.5 ML acellular pertussis vaccine, inactivated 96 UNT/ML / diphtheria toxoid vaccine, inactivated 30 UNT/ML / Haemophilus influenzae type b, capsular polysaccharide inactivated tetanus toxoid conjugate vaccine 68 UNT/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 58 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 14 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 52 UNT/ML / tetanus toxoid vaccine, inactivated 20 UNT/ML Injection [Pentacel] is covered by 5,052 Medicare Part D plans (100% of enrollable products), averaging Tier 2.3, with prior authorization required on 0% of covering formularies.
- 100%
- Plan coverage
- 5,052
- Plans covering
- T2.3
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for 0.5 ML acellular pertussis vaccine, inactivated 96 UNT/ML / diphtheria toxoid vaccine, inactivated 30 UNT/ML / Haemophilus influenzae type b, capsular polysaccharide inactivated tetanus toxoid conjugate vaccine 68 UNT/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 58 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 14 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 52 UNT/ML / tetanus toxoid vaccine, inactivated 20 UNT/ML Injection [Pentacel]
Per the CMS 2026 Part D formulary file, 0.5 ML acellular pertussis vaccine, inactivated 96 UNT/ML / diphtheria toxoid vaccine, inactivated 30 UNT/ML / Haemophilus influenzae type b, capsular polysaccharide inactivated tetanus toxoid conjugate vaccine 68 UNT/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 58 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 14 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 52 UNT/ML / tetanus toxoid vaccine, inactivated 20 UNT/ML Injection [Pentacel] (RxNorm concept RXCUI 2585717, generic name 0.5) appears on 328 distinct formulary files spanning 5,052 Medicare Part D plan offerings - 100% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 2.3.
Real-world access to 0.5 ML acellular pertussis vaccine, inactivated 96 UNT/ML / diphtheria toxoid vaccine, inactivated 30 UNT/ML / Haemophilus influenzae type b, capsular polysaccharide inactivated tetanus toxoid conjugate vaccine 68 UNT/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 58 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 14 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 52 UNT/ML / tetanus toxoid vaccine, inactivated 20 UNT/ML Injection [Pentacel] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 1.5% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 363 Part D beneficiaries filled 0.5 ML acellular pertussis vaccine, inactivated 96 UNT/ML / diphtheria toxoid vaccine, inactivated 30 UNT/ML / Haemophilus influenzae type b, capsular polysaccharide inactivated tetanus toxoid conjugate vaccine 68 UNT/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 58 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 14 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 52 UNT/ML / tetanus toxoid vaccine, inactivated 20 UNT/ML Injection [Pentacel] in 2023, with total plan-and-beneficiary spending of $70,409 and an average per-beneficiary annual cost of $193.96. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 0.5 ML acellular pertussis vaccine, inactivated 96 UNT/ML / diphtheria toxoid vaccine, inactivated 30 UNT/ML / Haemophilus influenzae type b, capsular polysaccharide inactivated tetanus toxoid conjugate vaccine 68 UNT/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 58 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 14 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 52 UNT/ML / tetanus toxoid vaccine, inactivated 20 UNT/ML Injection [Pentacel] today.
Coverage Details
- Formularies covering
- 328
- Plans covering
- 5,052
- Coverage rate
- 100%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 1.5% of formularies
2023 Medicare Spending
- Beneficiaries
- 363
- Total spending
- $70,409
- Avg per beneficiary
- $193.96
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 0.5 ML acellular pertussis vaccine, inactivated 96 UNT/ML / diphtheria toxoid vaccine, inactivated 30 UNT/ML / Haemophilus influenzae type b, capsular polysaccharide inactivated tetanus toxoid conjugate vaccine 68 UNT/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 58 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 14 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 52 UNT/ML / tetanus toxoid vaccine, inactivated 20 UNT/ML Injection [Pentacel]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Aetna Medicare Signature (HMO) | Aetna Health OF California Inc. | T1 | No | $0 | CA |
| Aetna Medicare Signature (HMO) | Aetna Health OF California Inc. | T1 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF California Inc. | T1 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T1 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T1 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T1 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T1 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T1 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T1 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T1 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T1 | No | $0 | CA |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | No | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | No | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | No | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | No | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | No | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | No | $0 | KY |
| Aetna Medicare HIDE (HMO D-SNP) | Aetna Health OF Ohio Inc. | T1 | No | $0 | KY |
| Aetna Medicare Dual Care (HMO D-SNP) | Aetna Health OF Ohio Inc. | T1 | No | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | No | $0 | OH |
Show the next 30 plans
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | No | $0 | OH |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T1 | No | $0 | KY |
| Aetna Medicare Partial Dual (HMO D-SNP) | Aetna Health OF Ohio Inc. | T1 | No | $0 | KY |
| Aetna Medicare Partial Dual (HMO D-SNP) | Aetna Health OF Ohio Inc. | T1 | No | $0 | OH |
| Aetna Medicare Signature (HMO) | Aetna Health Inc. (GA) | T1 | No | $0 | GA |
| Aetna Medicare Signature (HMO-POS) | Coventry Health Care OF Illinois, Inc. | T1 | No | $0 | WI |
| Aetna Medicare Signature (HMO-POS) | Coventry Health Care OF Illinois, Inc. | T1 | No | $0 | IL |
| Aetna Medicare Prime Chronic Care (HMO C-SNP) | Coventry Health Care OF Illinois, Inc. | T1 | No | $0 | IL |
| Aetna Medicare Signature Extra (HMO-POS) | Coventry Health Care OF Illinois, Inc. | T1 | No | $0 | IL |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | IA |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | NE |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | KS, MO |
| Aetna Medicare Signature Extra (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | KS |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | KS, MO |
| Aetna Medicare Signature Plus (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | AR |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | KS |
| Aetna Medicare Advantra (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | OH |
| Aetna Medicare Advantra Signature Giveback (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | WV |
| Aetna Medicare Elite (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | IA |
| Aetna Medicare Signature Extra (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | NE |
| Aetna Medicare Advantra Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | WV |
| Aetna Medicare Elite (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | IL, MO |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | MO |
| Aetna Medicare Elite (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | KS, MO |
| Aetna Medicare Elite (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | AR |
| Aetna Medicare Dual (PPO D-SNP) | Coventry Health AND Life Insurance Company | T1 | No | $0 | SD |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | MO |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | KS |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T1 | No | $0 | KS |
| Aetna Medicare Dual Extra (PPO D-SNP) | Coventry Health AND Life Insurance Company | T1 | No | $0 | AR |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 0.5 ML acellular pertussis vaccine, inactivated 96 UNT/ML / diphtheria toxoid vaccine, inactivated 30 UNT/ML / Haemophilus influenzae type b, capsular polysaccharide inactivated tetanus toxoid conjugate vaccine 68 UNT/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 58 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 14 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 52 UNT/ML / tetanus toxoid vaccine, inactivated 20 UNT/ML Injection [Pentacel] covered by Medicare Part D?
Yes, 0.5 ML acellular pertussis vaccine, inactivated 96 UNT/ML / diphtheria toxoid vaccine, inactivated 30 UNT/ML / Haemophilus influenzae type b, capsular polysaccharide inactivated tetanus toxoid conjugate vaccine 68 UNT/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 58 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 14 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 52 UNT/ML / tetanus toxoid vaccine, inactivated 20 UNT/ML Injection [Pentacel] is covered by 5,052 Medicare Part D plans (100% of all Part D formularies).
What tier is 0.5 ML acellular pertussis vaccine, inactivated 96 UNT/ML / diphtheria toxoid vaccine, inactivated 30 UNT/ML / Haemophilus influenzae type b, capsular polysaccharide inactivated tetanus toxoid conjugate vaccine 68 UNT/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 58 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 14 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 52 UNT/ML / tetanus toxoid vaccine, inactivated 20 UNT/ML Injection [Pentacel] on Medicare Part D plans?
0.5 ML acellular pertussis vaccine, inactivated 96 UNT/ML / diphtheria toxoid vaccine, inactivated 30 UNT/ML / Haemophilus influenzae type b, capsular polysaccharide inactivated tetanus toxoid conjugate vaccine 68 UNT/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 58 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 14 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 52 UNT/ML / tetanus toxoid vaccine, inactivated 20 UNT/ML Injection [Pentacel] averages Tier 2.3 across Part D plans, ranging from Tier 1 to Tier 6.
Does 0.5 ML acellular pertussis vaccine, inactivated 96 UNT/ML / diphtheria toxoid vaccine, inactivated 30 UNT/ML / Haemophilus influenzae type b, capsular polysaccharide inactivated tetanus toxoid conjugate vaccine 68 UNT/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 58 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 14 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 52 UNT/ML / tetanus toxoid vaccine, inactivated 20 UNT/ML Injection [Pentacel] require prior authorization?
0% of Part D formularies require prior authorization for 0.5 ML acellular pertussis vaccine, inactivated 96 UNT/ML / diphtheria toxoid vaccine, inactivated 30 UNT/ML / Haemophilus influenzae type b, capsular polysaccharide inactivated tetanus toxoid conjugate vaccine 68 UNT/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 58 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 14 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 52 UNT/ML / tetanus toxoid vaccine, inactivated 20 UNT/ML Injection [Pentacel]. Step therapy: 0%. Quantity limits: 1.5%.
How much does Medicare spend on 0.5 ML acellular pertussis vaccine, inactivated 96 UNT/ML / diphtheria toxoid vaccine, inactivated 30 UNT/ML / Haemophilus influenzae type b, capsular polysaccharide inactivated tetanus toxoid conjugate vaccine 68 UNT/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 58 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 14 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 52 UNT/ML / tetanus toxoid vaccine, inactivated 20 UNT/ML Injection [Pentacel]?
In 2023, total Medicare Part D spending on 0.5 ML acellular pertussis vaccine, inactivated 96 UNT/ML / diphtheria toxoid vaccine, inactivated 30 UNT/ML / Haemophilus influenzae type b, capsular polysaccharide inactivated tetanus toxoid conjugate vaccine 68 UNT/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 58 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 14 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 52 UNT/ML / tetanus toxoid vaccine, inactivated 20 UNT/ML Injection [Pentacel] was $70,409, covering 363 beneficiaries. The average spend per beneficiary was $193.96.
Read our methodology - how this data is sourced, computed, and verified.
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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.
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Similar prior-authorization rate
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