Medicare Part D coverage · 1 · RxCUI 1654630
1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Glatopa]
Per the CMS 2026 Part D formulary file, 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Glatopa] is covered by 4,859 Medicare Part D plans (96.2% of enrollable products), averaging Tier 4, with prior authorization required on 79.5% of covering formularies.
- 96.2%
- Plan coverage
- 4,859
- Plans covering
- T4
- Avg tier
- 79.5%
- Prior auth required
What the CMS Formulary Data Shows for 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Glatopa]
Per the CMS 2026 Part D formulary file, 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Glatopa] (RxNorm concept RXCUI 1654630, generic name 1) appears on 292 distinct formulary files spanning 4,859 Medicare Part D plan offerings - 96.2% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.
Real-world access to 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Glatopa] depends on utilization management as much as tier placement: 79.5% of covering formularies require prior authorization. 0% require step therapy. 96.6% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 3,140 Part D beneficiaries filled 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Glatopa] in 2023, with total plan-and-beneficiary spending of $71,844,936 and an average per-beneficiary annual cost of $22,880.55. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Glatopa] today.
Coverage Details
- Formularies covering
- 292
- Plans covering
- 4,859
- Coverage rate
- 96.2%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 79.5% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 96.6% of formularies
2023 Medicare Spending
- Beneficiaries
- 3,140
- Total spending
- $71,844,936
- Avg per beneficiary
- $22,880.55
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Glatopa]
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 |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $0 | FL |
| 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 |
| 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 |
| 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 |
| 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 |
Show the next 30 plans
| 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 |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | Yes | $0 | CA |
| 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 |
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare OF NEW Jersey, Inc. | T1 | Yes | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | Yes | $0 | MN |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $0 | NY |
| 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 |
| 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 |
| 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 |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | Yes | $0 | AR |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | Yes | $0 | CA |
| 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 |
| 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 |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Glatopa] covered by Medicare Part D?
Yes, 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Glatopa] is covered by 4,859 Medicare Part D plans (96.2% of all Part D formularies).
What tier is 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Glatopa] on Medicare Part D plans?
1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Glatopa] averages Tier 4 across Part D plans, ranging from Tier 1 to Tier 5.
Does 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Glatopa] require prior authorization?
79.5% of Part D formularies require prior authorization for 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Glatopa]. Step therapy: 0%. Quantity limits: 96.6%.
How much does Medicare spend on 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Glatopa]?
In 2023, total Medicare Part D spending on 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Glatopa] was $71,844,936, covering 3,140 beneficiaries. The average spend per beneficiary was $22,880.55.
Read our methodology - how this data is sourced, computed, and verified.
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.
Closest average formulary tier
- lomustine 100 MG Oral Capsule T4
- posaconazole 40 MG/ML Oral Suspension T4
- 24 HR tacrolimus 5 MG Extended Release Oral Capsule [Astagraf] T4
- 0.6 ML pegfilgrastim-bmez 10 MG/ML Prefilled Syringe [Ziextenzo] T4
- tamoxifen 2 MG/ML Oral Solution [Soltamox] T4
- 0.5 ML benralizumab 20 MG/ML Prefilled Syringe [Fasenra] T4
Similar prior-authorization rate
- stiripentol 250 MG Oral Capsule [Diacomit] 79.6% PA
- sodium phenylbutyrate 500 MG Oral Tablet 79.7% PA
- 72 HR fentanyl 0.0875 MG/HR Transdermal System 79.1% PA
- 0.6 ML pegfilgrastim-jmdb 10 MG/ML Prefilled Syringe [Fulphila] 79.9% PA
- 72 HR fentanyl 0.0375 MG/HR Transdermal System 79% PA
- tazarotene 0.001 MG/MG Topical Gel 79% PA