Medicare Part D coverage · 1 · RxCUI 1111642

1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Copaxone]

Per the CMS 2026 Part D formulary file, 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Copaxone] is covered by 744 Medicare Part D plans (14.7% of enrollable products), averaging Tier 4.2, with prior authorization required on 93.8% of covering formularies.

14.7%
Plan coverage
744
Plans covering
T4.2
Avg tier
93.8%
Prior auth required

Verify with CMS →

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.

What the CMS Formulary Data Shows for 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Copaxone]

Per the CMS 2026 Part D formulary file, 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Copaxone] (RxNorm concept RXCUI 1111642, generic name 1) appears on 65 distinct formulary files spanning 744 Medicare Part D plan offerings - 14.7% 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 4.2.

Real-world access to 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Copaxone] depends on utilization management as much as tier placement: 93.8% of covering formularies require prior authorization. 1.5% require step therapy. 100% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 6,385 Part D beneficiaries filled 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Copaxone] in 2023, with total plan-and-beneficiary spending of $369,370,974 and an average per-beneficiary annual cost of $57,849.80. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Copaxone] today.

Coverage Details

Formularies covering
65
Plans covering
744
Coverage rate
14.7%
Tier range
Tier 1 – Tier 5
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
93.8% of formularies
Step therapy required
1.5% of formularies
Quantity limits
100% of formularies

2023 Medicare Spending

Beneficiaries
6,385
Total spending
$369,370,974
Avg per beneficiary
$57,849.80

Tier Distribution Across Plans

33 plans
Tier 1, Preferred Generic
3 plans
Tier 4, Non-Preferred
64 plans
Tier 5, Specialty

Medicare Advantage Plans (MA-PD) Covering 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Copaxone]

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

Plan Insurer Tier PA Premium States
Florida Complete Care-Duals VIP (HMO-POS D-SNP) Hpmp OF Florida, Inc. T1 Yes $0 FL
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
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
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
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
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) Gateway Health Plan, Inc. T1 Yes $0 PA
Show the next 30 plans
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
Florida Complete Care (HMO I-SNP) Hpmp OF Florida, Inc. T1 Yes $4.80 FL
Florida Complete Care- In The Community (HMO-POS I-SNP) Hpmp OF Florida, Inc. T1 Yes $4.80 FL
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) Gateway Health Plan, Inc. T1 Yes $13.10 PA
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) Gateway Health Plan, Inc. T1 Yes $17.60 PA
Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) Elderplan, Inc. T1 Yes $22.70 NY
VIVA Medicare Extra Value (HMO D-SNP) Viva Health, Inc. T1 Yes $27.70 AL
VIVA Medicare Extra Care (HMO D-SNP) Viva Health, Inc. T1 Yes $27.70 AL
Highmark Health Options Duals Select (HMO D-SNP) Highmark Bcbsd, Inc. T1 Yes $31.20 DE
Elderplan Advantage For Nursing Home Residents (HMO-POS I-SNP) Elderplan, Inc. T1 Yes $44.80 NY
MetroPlus Platinum Plan (HMO) Metroplus Health Plan, Inc. T1 Yes $58.80 NY
BlueCare Plus (HMO D-SNP) Volunteer State Health Plan T4 Yes $0 TN
BlueCare Plus Choice (HMO D-SNP) Volunteer State Health Plan T4 Yes $0 TN
BlueCare Plus Select (HMO D-SNP) Volunteer State Health Plan T4 Yes $0 TN
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

Showing top 50 of 100 plans.

Frequently Asked Questions

Is 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Copaxone] covered by Medicare Part D?

Yes, 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Copaxone] is covered by 744 Medicare Part D plans (14.7% of all Part D formularies).

What tier is 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Copaxone] on Medicare Part D plans?

1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Copaxone] averages Tier 4.2 across Part D plans, ranging from Tier 1 to Tier 5.

Does 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Copaxone] require prior authorization?

93.8% of Part D formularies require prior authorization for 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Copaxone]. Step therapy: 1.5%. Quantity limits: 100%.

How much does Medicare spend on 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Copaxone]?

In 2023, total Medicare Part D spending on 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Copaxone] was $369,370,974, covering 6,385 beneficiaries. The average spend per beneficiary was $57,849.80.

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.

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