0.98 ML teriparatide 0.3 MG/ML Pen Injector [Yorvipath]

Verify with CMS →

teriparatide

RxCUI: 2693646

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.
2.8%
Plan Coverage
143
Plans Covering
T4.2
Avg Tier
100%
Prior Auth Required

What the CMS Formulary Data Shows for 0.98 ML teriparatide 0.3 MG/ML Pen Injector [Yorvipath]

Per the CMS 2026 Part D formulary file, 0.98 ML teriparatide 0.3 MG/ML Pen Injector [Yorvipath] (RxNorm concept RXCUI 2693646, generic name teriparatide) appears on 29 distinct formulary files spanning 143 Medicare Part D plan offerings - 2.8% 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 4.2.

Real-world access to 0.98 ML teriparatide 0.3 MG/ML Pen Injector [Yorvipath] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 58.6% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 109,257 Part D beneficiaries filled 0.98 ML teriparatide 0.3 MG/ML Pen Injector [Yorvipath] in 2023, with total plan-and-beneficiary spending of $7,578,780 and an average per-beneficiary annual cost of $69.37. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 0.98 ML teriparatide 0.3 MG/ML Pen Injector [Yorvipath] today.

Coverage Details

Formularies covering
29
Plans covering
143
Coverage rate
2.8%
Tier range
Tier 1 – Tier 5
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
100% of formularies
Step therapy required
0% of formularies
Quantity limits
58.6% of formularies

2023 Medicare Spending

Beneficiaries
109,257
Total spending
$7,578,780
Avg per beneficiary
$69.37

Tier Distribution Across Plans

6 plans
Tier 1, Preferred Generic
1 plans
Tier 2, Generic
93 plans
Tier 5, Specialty

Medicare Advantage Plans (MA-PD) Covering 0.98 ML teriparatide 0.3 MG/ML Pen Injector [Yorvipath]

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

Plan Insurer Tier PA Premium States
NaviCare (HMO D-SNP) FALLON COMMUNITY HEALTH PLAN T1 Yes $0 MA
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
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
CalOptima Health OneCare Complete (HMO D-SNP) ORANGE COUNTY HEALTH AUTHORITY T2 Yes $0 CA
Community Blue Medicare HMO Signature (HMO) Highmark Western and Northeastern New York Inc. T5 Yes $0 NY
Community Blue Medicare HMO Merit (HMO) Highmark Western and Northeastern New York Inc. T5 Yes $0 NY
Community Blue Medicare PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Complete Blue PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Community Blue Medicare Plus PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Complete Blue PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Complete Blue PPO Merit (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Complete Blue PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Complete Blue PPO Distinct (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Community Blue Medicare Plus PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Complete Blue Plus PPO Merit (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Community Blue Medicare PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Complete Blue PPO Merit (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Community Blue Medicare HMO Signature (HMO) HIGHMARK CHOICE COMPANY T5 Yes $0 PA
Security Blue HMO-POS ValueRx (HMO-POS) HIGHMARK CHOICE COMPANY T5 Yes $0 PA
Community Blue Medicare HMO Signature (HMO) HIGHMARK CHOICE COMPANY T5 Yes $0 PA
Together Blue Medicare HMO Signature (HMO) HIGHMARK CHOICE COMPANY T5 Yes $0 PA
Community Blue Medicare HMO Distinct (HMO) HIGHMARK CHOICE COMPANY T5 Yes $0 PA
Complete Blue HMO Distinct (HMO) HIGHMARK CHOICE COMPANY T5 Yes $0 PA
Complete Blue PPO Distinct (PPO) HIGHMARK SENIOR SOLUTIONS COMPANY T5 Yes $0 WV
Complete Blue PPO Signature (PPO) HIGHMARK SENIOR SOLUTIONS COMPANY T5 Yes $0 WV
Complete Blue PPO Signature (PPO) HIGHMARK SENIOR SOLUTIONS COMPANY T5 Yes $0 WV
Complete Blue PPO Merit (PPO) HIGHMARK SENIOR SOLUTIONS COMPANY T5 Yes $0 WV
Complete Blue PPO Signature (PPO) HIGHMARK BCBSD INC. T5 Yes $0 DE
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T5 Yes $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T5 Yes $0 NV
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T5 Yes $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T5 Yes $0 UT
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T5 Yes $0 NV
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T5 Yes $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T5 Yes $0 CO
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T5 Yes $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T5 Yes $0 CO
Select Health Medicare Flex (HMO) SELECTHEALTH, INC. T5 Yes $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T5 Yes $0 CO
Select Health Medicare Active (HMO) SELECTHEALTH, INC. T5 Yes $0 CO
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T5 Yes $0 NV
Select Health Medicare Wellness (HMO) SELECTHEALTH, INC. T5 Yes $0 NV
Fallon Medicare Plus Orange (HMO) FALLON COMMUNITY HEALTH PLAN T5 Yes $0 MA
UPMC for Life HMO Premier Rx (HMO) UPMC HEALTH PLAN, INC. T5 Yes $0 PA
UPMC for Life Complete Care (HMO D-SNP) UPMC FOR YOU, INC T5 Yes $0 PA
UPMC for Life Complete Care (HMO D-SNP) UPMC FOR YOU, INC T5 Yes $0 PA
UPMC for Life PPO Premier Rx (PPO) UPMC HEALTH NETWORK, INC. T5 Yes $0 PA

Frequently Asked Questions

Is 0.98 ML teriparatide 0.3 MG/ML Pen Injector [Yorvipath] covered by Medicare Part D?

Yes, 0.98 ML teriparatide 0.3 MG/ML Pen Injector [Yorvipath] is covered by 143 Medicare Part D plans (2.8% of all Part D formularies).

What tier is 0.98 ML teriparatide 0.3 MG/ML Pen Injector [Yorvipath] on Medicare Part D plans?

0.98 ML teriparatide 0.3 MG/ML Pen Injector [Yorvipath] averages Tier 4.2 across Part D plans, ranging from Tier 1 to Tier 5.

Does 0.98 ML teriparatide 0.3 MG/ML Pen Injector [Yorvipath] require prior authorization?

100% of Part D formularies require prior authorization for 0.98 ML teriparatide 0.3 MG/ML Pen Injector [Yorvipath]. Step therapy: 0%. Quantity limits: 58.6%.

How much does Medicare spend on 0.98 ML teriparatide 0.3 MG/ML Pen Injector [Yorvipath]?

In 2023, total Medicare Part D spending on 0.98 ML teriparatide 0.3 MG/ML Pen Injector [Yorvipath] was $7,578,780, covering 109,257 beneficiaries. The average spend per beneficiary was $69.37.

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