24 HR ketoprofen 200 MG Extended Release Oral Capsule

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ketoprofen

RxCUI: 359697

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.
1.1%
Plan Coverage
57
Plans Covering
T2.6
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for 24 HR ketoprofen 200 MG Extended Release Oral Capsule

Per the CMS 2026 Part D formulary file, 24 HR ketoprofen 200 MG Extended Release Oral Capsule (RxNorm concept RXCUI 359697, generic name ketoprofen) appears on 11 distinct formulary files spanning 57 Medicare Part D plan offerings - 1.1% 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 2.6.

Real-world access to 24 HR ketoprofen 200 MG Extended Release Oral Capsule depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 27.3% 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 24 HR ketoprofen 200 MG Extended Release Oral Capsule today.

Coverage Details

Formularies covering
11
Plans covering
57
Coverage rate
1.1%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
0% of formularies
Step therapy required
0% of formularies
Quantity limits
27.3% of formularies

Tier Distribution Across Plans

9 plans
Tier 1, Preferred Generic
19 plans
Tier 2, Generic
29 plans
Tier 4, Non-Preferred

Standalone Drug Plans (PDP) Covering 24 HR ketoprofen 200 MG Extended Release Oral Capsule

2 standalone prescription drug plans include this drug.

Plan Insurer Tier PA ST Premium States
Blue Rx PDP Complete (PDP) HM HEALTH INSURANCE COMPANY T2 No No $164.80 -
Blue Rx PDP Plus (PDP) HM HEALTH INSURANCE COMPANY T2 No No $193.20 -

Medicare Advantage Plans (MA-PD) Covering 24 HR ketoprofen 200 MG Extended Release Oral Capsule

55 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
PHP (HMO C-SNP) AIDS HEALTHCARE FOUNDATION T1 No $0 CA
VNS Health Total (HMO D-SNP) VNS CHOICE T1 No $0 NY
Leon MediExtra (HMO) LEON HEALTH, INC. T1 No $0 FL
Leon MediDual (HMO D-SNP) LEON HEALTH, INC. T1 No $0 FL
Leon MediMore (HMO) LEON HEALTH, INC. T1 No $0 FL
Leon MediMax (HMO D-SNP) LEON HEALTH, INC. T1 No $0 FL
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T1 No $4.80 FL
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF ARIZONA T1 No $17.00 AZ
VNS Health EasyCare Plus (HMO D-SNP) VNS CHOICE T1 No $51.60 NY
Gold Heart & Diabetes (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T2 No $0 FL
Gold Heart & Diabetes Complete (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T2 No $0 FL
Gold Dialysis & Kidney (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T2 No $0 FL
Gold Health (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T2 No $0 FL
Gold Dialysis & Kidney (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T2 No $0 FL
Gold Heart & Diabetes (HMO-POS C-SNP) GOLD KIDNEY OF ARIZONA T2 No $0 AZ
Gold Dialysis & Kidney (HMO-POS C-SNP) GOLD KIDNEY OF ARIZONA T2 No $0 AZ
Gold Heart & Diabetes (HMO-POS C-SNP) GOLD KIDNEY OF ARIZONA T2 No $0 AZ
Gold Dialysis & Kidney (HMO-POS C-SNP) GOLD KIDNEY OF ARIZONA T2 No $0 AZ
Security Blue HMO-POS Standard (HMO-POS) HIGHMARK CHOICE COMPANY T2 No $51.80 PA
Freedom Blue PPO Select (PPO) HIGHMARK SENIOR HEALTH COMPANY T2 No $95.70 PA
Security Blue HMO-POS Deluxe (HMO-POS) HIGHMARK CHOICE COMPANY T2 No $95.90 PA
Freedom Blue PPO Standard (PPO) HIGHMARK SENIOR HEALTH COMPANY T2 No $98.20 PA
Freedom Blue PPO Select (PPO) HIGHMARK SENIOR HEALTH COMPANY T2 No $115.70 PA
Freedom Blue PPO Deluxe (PPO) HIGHMARK SENIOR HEALTH COMPANY T2 No $122.40 PA
Freedom Blue PPO Classic (PPO) HIGHMARK SENIOR HEALTH COMPANY T2 No $140.90 PA
Freedom Blue PPO Classic (PPO) HIGHMARK SENIOR HEALTH COMPANY T2 No $145.40 PA
Medicare BlueEssential (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $0 NY
Medicare BlueActive (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $0 NY
Medicare BlueVital (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $0 NY
Univera SeniorChoice Basic (HMO) EXCELLUS HEALTH PLAN, INC. T4 No $0 NY
Univera SeniorChoice Extra (HMO) EXCELLUS HEALTH PLAN, INC. T4 No $0 NY
Medicare Blue Choice Core (HMO) EXCELLUS HEALTH PLAN, INC. T4 No $0 NY
Univera Medicare Dual (HMO D-SNP) EXCELLUS HEALTH PLAN COMMUNITY CARE LLC T4 No $0 NY
Medicare Blue Dual (HMO D-SNP) EXCELLUS HEALTH PLAN COMMUNITY CARE LLC T4 No $0 NY
SummaCare Medicare Topaz (HMO) SUMMACARE INC. T4 No $0 OH
SummaCare Medicare Quartz (HMO) SUMMACARE INC. T4 No $0 OH
VillageCareMAX Medicare Health Advantage Plan (HMO D-SNP) VILLAGE SENIOR SERVICES CORPORATION T4 No $0 NY
VillageCareMAX Medicare Total Advantage Plan (HMO D-SNP) VILLAGE SENIOR SERVICES CORPORATION T4 No $0 NY
CDPHP $0 Medicare Rx (HMO) CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. T4 No $0 NY
Univera SeniorChoice Core (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $33.00 NY
SummaCare Medicare Garnet (HMO) SUMMACARE INC. T4 No $35.00 OH
Univera SeniorChoice Advanced (HMO-POS) EXCELLUS HEALTH PLAN, INC. T4 No $36.90 NY
SummaCare Medicare Ruby (HMO) SUMMACARE INC. T4 No $50.00 OH
Medicare BlueClassic (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $51.00 NY
Univera SeniorChoice Secure (HMO-POS) EXCELLUS HEALTH PLAN, INC. T4 No $54.90 NY
Medicare BlueBalanced (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $55.00 NY
Medicare Blue Choice Prime (HMO) EXCELLUS HEALTH PLAN, INC. T4 No $55.00 NY
Univera SeniorChoice Value Plus (HMO-POS) EXCELLUS HEALTH PLAN, INC. T4 No $58.60 NY
Medicare BlueEnhanced (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $70.30 NY
SummaCare Medicare Sapphire (HMO-POS) SUMMACARE INC. T4 No $83.00 OH

Frequently Asked Questions

Is 24 HR ketoprofen 200 MG Extended Release Oral Capsule covered by Medicare Part D?

Yes, 24 HR ketoprofen 200 MG Extended Release Oral Capsule is covered by 57 Medicare Part D plans (1.1% of all Part D formularies).

What tier is 24 HR ketoprofen 200 MG Extended Release Oral Capsule on Medicare Part D plans?

24 HR ketoprofen 200 MG Extended Release Oral Capsule averages Tier 2.6 across Part D plans, ranging from Tier 1 to Tier 4.

Does 24 HR ketoprofen 200 MG Extended Release Oral Capsule require prior authorization?

0% of Part D formularies require prior authorization for 24 HR ketoprofen 200 MG Extended Release Oral Capsule. Step therapy: 0%. Quantity limits: 27.3%.

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