{224 (tobramycin 28 MG Inhalation Powder [Tobi]) } Pack [TOBI Podhaler Kit]

Verify with CMS →

tobramycin

RxCUI: 1374574

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.
54.6%
Plan Coverage
2,766
Plans Covering
T4.1
Avg Tier
50.5%
Prior Auth Required

What the CMS Formulary Data Shows for {224 (tobramycin 28 MG Inhalation Powder [Tobi]) } Pack [TOBI Podhaler Kit]

Per the CMS 2026 Part D formulary file, {224 (tobramycin 28 MG Inhalation Powder [Tobi]) } Pack [TOBI Podhaler Kit] (RxNorm concept RXCUI 1374574, generic name tobramycin) appears on 188 distinct formulary files spanning 2,766 Medicare Part D plan offerings - 54.6% 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 4.1.

Real-world access to {224 (tobramycin 28 MG Inhalation Powder [Tobi]) } Pack [TOBI Podhaler Kit] depends on utilization management as much as tier placement: 50.5% of covering formularies require prior authorization. 0% require step therapy. 57.4% 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 {224 (tobramycin 28 MG Inhalation Powder [Tobi]) } Pack [TOBI Podhaler Kit] today.

Coverage Details

Formularies covering
188
Plans covering
2,766
Coverage rate
54.6%
Tier range
Tier 1 – Tier 5
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
50.5% of formularies
Step therapy required
0% of formularies
Quantity limits
57.4% of formularies

Tier Distribution Across Plans

71 plans
Tier 1, Preferred Generic
1 plans
Tier 2, Generic
10 plans
Tier 4, Non-Preferred
18 plans
Tier 5, Specialty

Standalone Drug Plans (PDP) Covering {224 (tobramycin 28 MG Inhalation Powder [Tobi]) } Pack [TOBI Podhaler Kit]

5 standalone prescription drug plans include this drug.

Plan Insurer Tier PA ST Premium States
AARP Medicare Rx Preferred from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T5 Yes No $0 -
AARP Medicare Rx Preferred from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T5 Yes No $0 -
AARP Medicare Rx Saver from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T5 Yes No $0 -
AARP Medicare Rx Saver from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T5 Yes No $0 -
AARP Medicare Rx Saver from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T5 Yes No $0 -

Medicare Advantage Plans (MA-PD) Covering {224 (tobramycin 28 MG Inhalation Powder [Tobi]) } Pack [TOBI Podhaler Kit]

95 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 No $0 VA
Sentara Community Complete (HMO D-SNP) SENTARA HEALTH PLANS T1 No $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 No $0 NY
Cooperative Advantage (HMO D-SNP) GROUP HEALTH COOPERATIVE OF EAU CLAIRE T1 No $0 WI
Longevity Health Plan (PPO I-SNP) LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP T1 No $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 No $0 MI
CareSource Dual Advantage (HMO D-SNP) CARESOURCE GEORGIA CO. T1 No $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
HAP CareSource MI Coordinated Health (HMO D-SNP) HAP CARESOURCE T1 No $0 MI
Horizon NJ TotalCare (HMO D-SNP) HORIZON HEALTHCARE OF NEW JERSEY, INC. T1 Yes $0 NJ
NaviCare (HMO D-SNP) FALLON COMMUNITY HEALTH PLAN T1 No $0 MA
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 No $0 CO
AllCare Advantage Redwood Rx (HMO D-SNP) ALLCARE HEALTH PLAN, INC. T1 No $0 OR
PrimeWest Senior Health Complete (HMO D-SNP) PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE T1 No $0 MN
Prime Health Complete (HMO D-SNP) PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE T1 No $0 MN
Alterwood Advantage Dual Secure (HMO D-SNP) ALTERWOOD ADVANTAGE, INC. T1 No $0 MD
Nascentia Dual Advantage (HMO D-SNP) VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK T1 No $0 NY
Abilis Health Community (HMO I-SNP) SIGNATURE ADVANTAGE, LLC T1 No $0 KY, TN
Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) ARKANSAS SUPERIOR SELECT, INC. T1 No $0 AR
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
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
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 No $4.80 FL
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T1 No $4.80 FL
Texas Independence Health Plan, Inc. (HMO I-SNP) TEXAS INDEPENDENCE HEALTH PLAN, INC. T1 No $4.80 TX
Texas Independence Community Plan (HMO I-SNP) TEXAS INDEPENDENCE HEALTH PLAN, INC. T1 No $4.80 TX
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF MICHIGAN, INC. T1 No $8.80 MI
Tribute Select (HMO-POS I-SNP) ARKANSAS SUPERIOR SELECT, INC. T1 No $8.90 AR

Frequently Asked Questions

Is {224 (tobramycin 28 MG Inhalation Powder [Tobi]) } Pack [TOBI Podhaler Kit] covered by Medicare Part D?

Yes, {224 (tobramycin 28 MG Inhalation Powder [Tobi]) } Pack [TOBI Podhaler Kit] is covered by 2,766 Medicare Part D plans (54.6% of all Part D formularies).

What tier is {224 (tobramycin 28 MG Inhalation Powder [Tobi]) } Pack [TOBI Podhaler Kit] on Medicare Part D plans?

{224 (tobramycin 28 MG Inhalation Powder [Tobi]) } Pack [TOBI Podhaler Kit] averages Tier 4.1 across Part D plans, ranging from Tier 1 to Tier 5.

Does {224 (tobramycin 28 MG Inhalation Powder [Tobi]) } Pack [TOBI Podhaler Kit] require prior authorization?

50.5% of Part D formularies require prior authorization for {224 (tobramycin 28 MG Inhalation Powder [Tobi]) } Pack [TOBI Podhaler Kit]. Step therapy: 0%. Quantity limits: 57.4%.

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