Medicare Part D coverage · 1 · RxCUI 1115464
1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron]
Per the CMS 2026 Part D formulary file, 1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron] is covered by 3,558 Medicare Part D plans (70.4% of enrollable products), averaging Tier 4.3, with prior authorization required on 89.6% of covering formularies.
- 70.4%
- Plan coverage
- 3,558
- Plans covering
- T4.3
- Avg tier
- 89.6%
- Prior auth required
What the CMS Formulary Data Shows for 1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron]
Per the CMS 2026 Part D formulary file, 1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron] (RxNorm concept RXCUI 1115464, generic name 1) appears on 230 distinct formulary files spanning 3,558 Medicare Part D plan offerings - 70.4% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 4.3.
Real-world access to 1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron] depends on utilization management as much as tier placement: 89.6% of covering formularies require prior authorization. 0% require step therapy. 41.3% 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 1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron] today.
Coverage Details
- Formularies covering
- 230
- Plans covering
- 3,558
- Coverage rate
- 70.4%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 89.6% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 41.3% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron]
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 |
| 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 |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| 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 |
| 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 |
Show the next 30 plans
| 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 |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | Yes | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | Yes | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | Yes | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | Yes | $0 | MO |
| 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 |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | Yes | $0 | WI |
| 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 |
| 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 |
| 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 |
| 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 |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Texas, Inc. | T1 | Yes | $4.80 | TX |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | Yes | $4.80 | TX |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron] covered by Medicare Part D?
Yes, 1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron] is covered by 3,558 Medicare Part D plans (70.4% of all Part D formularies).
What tier is 1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron] on Medicare Part D plans?
1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron] averages Tier 4.3 across Part D plans, ranging from Tier 1 to Tier 6.
Does 1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron] require prior authorization?
89.6% of Part D formularies require prior authorization for 1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron]. Step therapy: 0%. Quantity limits: 41.3%.
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
- 3 ML icatibant 10 MG/ML Prefilled Syringe [Sajazir] T4.3
- omadacycline 100 MG Injection [Nuzyra] T4.3
- sacrosidase 8500 UNT/ML Oral Solution [Sucraid] T4.3
- deflazacort 22.75 MG/ML Oral Suspension T4.3
- {28 (alpelisib 125 MG Oral Tablet [Vijoice]) } Pack [Vijoice 125 MG 28 Day] T4.3
- 0.5 ML interferon beta-1a 0.044 MG/ML Auto-Injector [Rebif] T4.3
Similar prior-authorization rate
- {112 (treprostinil 0.016 MG Inhalation Powder [Tyvaso]) / 112 (treprostinil 0.032 MG Inhalation Powder [Tyvaso]) / 28 (treprostinil 0.048 MG Inhalation Powder [Tyvaso]) } Pack [Tyvaso 16-32-48 MCG Titration Pack] 89.5% PA
- treprostinil 0.016 MG Inhalation Powder [Tyvaso] 89.5% PA
- 28 ACTUAT teriparatide 0.02 MG/ACTUAT Pen Injector 89.7% PA
- tretinoin 0.0005 MG/MG Topical Gel 89.4% PA
- 60 ACTUAT testosterone 20.25 MG/ACTUAT Topical Gel 89.9% PA
- rifaximin 200 MG Oral Tablet [XIFAXAN] 89.9% PA