Medicare Part D coverage · {14 · RxCUI 1373497
{14 (dimethyl fumarate 120 MG Delayed Release Oral Capsule) / 46 (dimethyl fumarate 240 MG Delayed Release Oral Capsule) } Pack
Per the CMS 2026 Part D formulary file, {14 (dimethyl fumarate 120 MG Delayed Release Oral Capsule) / 46 (dimethyl fumarate 240 MG Delayed Release Oral Capsule) } Pack is covered by 3,676 Medicare Part D plans (72.8% of enrollable products), averaging Tier 3, with prior authorization required on 77.7% of covering formularies.
- 72.8%
- Plan coverage
- 3,676
- Plans covering
- T3
- Avg tier
- 77.7%
- Prior auth required
What the CMS Formulary Data Shows for {14 (dimethyl fumarate 120 MG Delayed Release Oral Capsule) / 46 (dimethyl fumarate 240 MG Delayed Release Oral Capsule) } Pack
Per the CMS 2026 Part D formulary file, {14 (dimethyl fumarate 120 MG Delayed Release Oral Capsule) / 46 (dimethyl fumarate 240 MG Delayed Release Oral Capsule) } Pack (RxNorm concept RXCUI 1373497, generic name {14) appears on 260 distinct formulary files spanning 3,676 Medicare Part D plan offerings - 72.8% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 3.
Real-world access to {14 (dimethyl fumarate 120 MG Delayed Release Oral Capsule) / 46 (dimethyl fumarate 240 MG Delayed Release Oral Capsule) } Pack depends on utilization management as much as tier placement: 77.7% of covering formularies require prior authorization. 0% require step therapy. 71.5% 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 {14 (dimethyl fumarate 120 MG Delayed Release Oral Capsule) / 46 (dimethyl fumarate 240 MG Delayed Release Oral Capsule) } Pack today.
Coverage Details
- Formularies covering
- 260
- Plans covering
- 3,676
- Coverage rate
- 72.8%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 77.7% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 71.5% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering {14 (dimethyl fumarate 120 MG Delayed Release Oral Capsule) / 46 (dimethyl fumarate 240 MG Delayed Release Oral Capsule) } Pack
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 |
| 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 |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | Yes | $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 |
Show the next 30 plans
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | Yes | $0 | CA |
| PHP (HMO C-snp) | Aids Healthcare Foundation | 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 |
| 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 |
| DualConnect (HMO D-SNP) | Santa Clara County Health Authority | T1 | Yes | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | Yes | $0 | NY |
| 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 | No | $0 | WI |
| Platino Blindao (HMO D-SNP) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Enlace (HMO D-SNP) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Advance (HMO D-snp) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Plus (HMO D-snp) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| FHCP Medicare Classic (HMO) | Florida Blue Medicare, Inc. | T1 | Yes | $0 | FL |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | 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 |
| 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 |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | Yes | $4.80 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is {14 (dimethyl fumarate 120 MG Delayed Release Oral Capsule) / 46 (dimethyl fumarate 240 MG Delayed Release Oral Capsule) } Pack covered by Medicare Part D?
Yes, {14 (dimethyl fumarate 120 MG Delayed Release Oral Capsule) / 46 (dimethyl fumarate 240 MG Delayed Release Oral Capsule) } Pack is covered by 3,676 Medicare Part D plans (72.8% of all Part D formularies).
What tier is {14 (dimethyl fumarate 120 MG Delayed Release Oral Capsule) / 46 (dimethyl fumarate 240 MG Delayed Release Oral Capsule) } Pack on Medicare Part D plans?
{14 (dimethyl fumarate 120 MG Delayed Release Oral Capsule) / 46 (dimethyl fumarate 240 MG Delayed Release Oral Capsule) } Pack averages Tier 3 across Part D plans, ranging from Tier 1 to Tier 5.
Does {14 (dimethyl fumarate 120 MG Delayed Release Oral Capsule) / 46 (dimethyl fumarate 240 MG Delayed Release Oral Capsule) } Pack require prior authorization?
77.7% of Part D formularies require prior authorization for {14 (dimethyl fumarate 120 MG Delayed Release Oral Capsule) / 46 (dimethyl fumarate 240 MG Delayed Release Oral Capsule) } Pack. Step therapy: 0%. Quantity limits: 71.5%.
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
- {1 (aprepitant 125 MG Oral Capsule) / 2 (aprepitant 80 MG Oral Capsule) } Pack T3
- atovaquone 150 MG/ML Oral Suspension T3
- chlorpromazine hydrochloride 10 MG Oral Tablet T3
- nitroglycerin 0.004 MG/MG Rectal Ointment T3
- raltegravir 25 MG Chewable Tablet [Isentress] T3
- risperidone 2 MG Disintegrating Oral Tablet T3
Similar prior-authorization rate
- vigabatrin 500 MG Powder for Oral Solution 77.7% PA
- ruxolitinib 15 MG/ML Topical Cream [Opzelura] 77.8% PA
- deferiprone 100 MG/ML Oral Solution [Ferriprox] 77.8% PA
- 1.5 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron] 77.5% PA
- 0.5 ML peginterferon beta-1a 0.25 MG/ML Prefilled Syringe [Plegridy] 77.5% PA
- vigabatrin 500 MG Oral Tablet 77.4% PA