Medicare Part D coverage · 1 · RxCUI 205917
1 ML epoetin alfa 2000 UNT/ML Injection [Epogen]
Per the CMS 2026 Part D formulary file, 1 ML epoetin alfa 2000 UNT/ML Injection [Epogen] is covered by 72 Medicare Part D plans (1.4% of enrollable products), averaging Tier 3.5, with prior authorization required on 100% of covering formularies.
- 1.4%
- Plan coverage
- 72
- Plans covering
- T3.5
- Avg tier
- 100%
- Prior auth required
What the CMS Formulary Data Shows for 1 ML epoetin alfa 2000 UNT/ML Injection [Epogen]
Per the CMS 2026 Part D formulary file, 1 ML epoetin alfa 2000 UNT/ML Injection [Epogen] (RxNorm concept RXCUI 205917, generic name 1) appears on 19 distinct formulary files spanning 72 Medicare Part D plan offerings - 1.4% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.5.
Real-world access to 1 ML epoetin alfa 2000 UNT/ML Injection [Epogen] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 5.3% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 4,041 Part D beneficiaries filled 1 ML epoetin alfa 2000 UNT/ML Injection [Epogen] in 2023, with total plan-and-beneficiary spending of $7,680,197 and an average per-beneficiary annual cost of $1,900.57. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 1 ML epoetin alfa 2000 UNT/ML Injection [Epogen] today.
Coverage Details
- Formularies covering
- 19
- Plans covering
- 72
- Coverage rate
- 1.4%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 5.3% of formularies
2023 Medicare Spending
- Beneficiaries
- 4,041
- Total spending
- $7,680,197
- Avg per beneficiary
- $1,900.57
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 1 ML epoetin alfa 2000 UNT/ML Injection [Epogen]
72 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T2 | Yes | $0 | CA |
| Geisinger Gold Preferred Complete Rx (PPO) | Geisinger Indemnity Insurance Company | T3 | Yes | $0 | PA |
| Geisinger Gold Secure Rx (HMO D-SNP) | Geisinger Health Plan | T3 | Yes | $0 | PA |
| Geisinger Gold Classic 360 Rx (HMO) | Geisinger Health Plan | T3 | Yes | $0 | PA |
| Geisinger Gold Classic Essential Rx (HMO) | Geisinger Health Plan | T3 | Yes | $0 | PA |
| Geisinger Gold Value Rx (HMO) | Geisinger Health Plan | T3 | Yes | $23.00 | PA |
| Geisinger Gold Classic Complete Rx (HMO) | Geisinger Health Plan | T3 | Yes | $48.00 | PA |
| Geisinger Gold Classic Advantage Rx (HMO) | Geisinger Health Plan | T3 | Yes | $99.30 | PA |
| Geisinger Gold Preferred Advantage Rx (PPO) | Geisinger Indemnity Insurance Company | T3 | Yes | $112.00 | PA |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T4 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T4 | Yes | $0 | NV |
| Select Health Medicare Dual (HMO D-SNP) | Selecthealth, Inc. | T4 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T4 | Yes | $0 | UT |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T4 | Yes | $0 | NV |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T4 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T4 | Yes | $0 | CO |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T4 | Yes | $0 | CO |
Show the next 30 plans
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T4 | Yes | $0 | CO |
| Select Health Medicare Flex (HMO) | Selecthealth, Inc. | T4 | Yes | $0 | CO |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T4 | Yes | $0 | CO |
| Select Health Medicare Active (HMO) | Selecthealth, Inc. | T4 | Yes | $0 | CO |
| Select Health Medicare Dual (HMO D-SNP) | Selecthealth, Inc. | T4 | Yes | $0 | NV |
| Select Health Medicare Wellness (HMO) | Selecthealth, Inc. | T4 | Yes | $0 | NV |
| HAP Medicare Explore (PPO) | Alliance Health AND Life Insurance Company | T4 | Yes | $0 | MI |
| HAP Medicare Prime (PPO) | Alliance Health AND Life Insurance Company | T4 | Yes | $0 | MI |
| HAP Medicare Connect (HMO) | Health Alliance Plan OF Michigan | T4 | Yes | $0 | MI |
| HAP Medicare Complete Duals (HMO D-SNP) | Health Alliance Plan OF Michigan | T4 | Yes | $0 | MI |
| HAP Medicare Superior (HMO) | Health Alliance Plan OF Michigan | T4 | Yes | $0 | MI |
| Henry Ford Select (HMO) | Health Alliance Plan OF Michigan | T4 | Yes | $0 | MI |
| UPMC for Life HMO Premier Rx (HMO) | Upmc Health Plan, Inc. | T4 | Yes | $0 | PA |
| UPMC for Life Complete Care (HMO D-SNP) | Upmc FOR YOU, Inc | T4 | Yes | $0 | PA |
| UPMC for Life Complete Care (HMO D-SNP) | Upmc FOR YOU, Inc | T4 | Yes | $0 | PA |
| UPMC for Life PPO Premier Rx (PPO) | Upmc Health Network, Inc. | T4 | Yes | $0 | PA |
| UPMC for Life PPO Premier Rx (PPO) | Upmc Health Network, Inc. | T4 | Yes | $0 | PA |
| UPMC for Life PPO Essential Care Rx (PPO) | Upmc Health Network, Inc. | T4 | Yes | $0 | PA |
| UPMC for Life Complete Care (HMO D-SNP) | Upmc Health Coverage, Inc. | T4 | Yes | $0 | PA |
| Troy Medicare (HMO) | Troy Health, Inc. | T4 | Yes | $0 | NC |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | Troy Health, Inc. | T4 | Yes | $0 | NC |
| Contra Costa Health Care Plus (HMO D-SNP) | Contra Costa County Medical Service DBA Contra Costa Health | T4 | Yes | $0 | CA |
| Keystone First VIP Choice (HMO D-SNP) | Vista Health Plan, Inc. | T4 | Yes | $0 | PA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Vista Health Plan, Inc. | T4 | Yes | $0 | PA |
| First Choice VIP Care (HMO D-SNP) | Select Health OF South Carolina, Inc. | T4 | Yes | $0 | SC |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T4 | Yes | $0 | DE |
| AmeriHealth Caritas VIP Care Choice (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T4 | Yes | $0 | DE |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Amerihealth Caritas Florida, Inc. | T4 | Yes | $0 | FL |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Amerihealth Caritas Louisiana, Inc. | T4 | Yes | $0 | LA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Amerihealth Caritas North Carolina, Inc. | T4 | Yes | $0 | NC |
Showing top 50 of 72 plans.
Frequently Asked Questions
Is 1 ML epoetin alfa 2000 UNT/ML Injection [Epogen] covered by Medicare Part D?
Yes, 1 ML epoetin alfa 2000 UNT/ML Injection [Epogen] is covered by 72 Medicare Part D plans (1.4% of all Part D formularies).
What tier is 1 ML epoetin alfa 2000 UNT/ML Injection [Epogen] on Medicare Part D plans?
1 ML epoetin alfa 2000 UNT/ML Injection [Epogen] averages Tier 3.5 across Part D plans, ranging from Tier 1 to Tier 4.
Does 1 ML epoetin alfa 2000 UNT/ML Injection [Epogen] require prior authorization?
100% of Part D formularies require prior authorization for 1 ML epoetin alfa 2000 UNT/ML Injection [Epogen]. Step therapy: 0%. Quantity limits: 5.3%.
How much does Medicare spend on 1 ML epoetin alfa 2000 UNT/ML Injection [Epogen]?
In 2023, total Medicare Part D spending on 1 ML epoetin alfa 2000 UNT/ML Injection [Epogen] was $7,680,197, covering 4,041 beneficiaries. The average spend per beneficiary was $1,900.57.
Read our methodology - how this data is sourced, computed, and verified.
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