0.5 ML peginterferon beta-1a 0.25 MG/ML Auto-Injector [Plegridy]
peginterferon
RxCUI: 1649593
What the CMS Formulary Data Shows for 0.5 ML peginterferon beta-1a 0.25 MG/ML Auto-Injector [Plegridy]
Per the CMS 2026 Part D formulary file, 0.5 ML peginterferon beta-1a 0.25 MG/ML Auto-Injector [Plegridy] (RxNorm concept RXCUI 1649593, generic name peginterferon) appears on 139 distinct formulary files spanning 586 Medicare Part D plan offerings - 11.6% 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 peginterferon beta-1a 0.25 MG/ML Auto-Injector [Plegridy] depends on utilization management as much as tier placement: 77.7% of covering formularies require prior authorization. 0% require step therapy. 97.1% 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 peginterferon beta-1a 0.25 MG/ML Auto-Injector [Plegridy] today.
Coverage Details
- Formularies covering
- 139
- Plans covering
- 586
- Coverage rate
- 11.6%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 77.7% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 97.1% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 0.5 ML peginterferon beta-1a 0.25 MG/ML Auto-Injector [Plegridy]
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 |
| 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 |
| 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 |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. | T1 | Yes | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | Yes | $0 | DE |
| Tufts Health One Care (HMO D-SNP) | TUFTS HEALTH PUBLIC PLANS, INC. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | TUFTS HEALTH PUBLIC PLANS, INC. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION | T1 | No | $0 | MA |
| 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 |
| 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 |
| 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 |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $13.10 | PA |
| 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 |
Frequently Asked Questions
Is 0.5 ML peginterferon beta-1a 0.25 MG/ML Auto-Injector [Plegridy] covered by Medicare Part D?
Yes, 0.5 ML peginterferon beta-1a 0.25 MG/ML Auto-Injector [Plegridy] is covered by 586 Medicare Part D plans (11.6% of all Part D formularies).
What tier is 0.5 ML peginterferon beta-1a 0.25 MG/ML Auto-Injector [Plegridy] on Medicare Part D plans?
0.5 ML peginterferon beta-1a 0.25 MG/ML Auto-Injector [Plegridy] averages Tier 3.9 across Part D plans, ranging from Tier 1 to Tier 5.
Does 0.5 ML peginterferon beta-1a 0.25 MG/ML Auto-Injector [Plegridy] require prior authorization?
77.7% of Part D formularies require prior authorization for 0.5 ML peginterferon beta-1a 0.25 MG/ML Auto-Injector [Plegridy]. Step therapy: 0%. Quantity limits: 97.1%.
Read our methodology - how this data is sourced, computed, and verified.