Medicare Part D coverage · 3.5 · RxCUI 2725610

3.5 ML elamipretide 80 MG/ML Injection [Forzinity]

Per the CMS 2026 Part D formulary file, 3.5 ML elamipretide 80 MG/ML Injection [Forzinity] is covered by 36 Medicare Part D plans (0.7% of enrollable products), averaging Tier 5, with prior authorization required on 100% of covering formularies.

0.7%
Plan coverage
36
Plans covering
T5
Avg tier
100%
Prior auth required

Verify with CMS →

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.

What the CMS Formulary Data Shows for 3.5 ML elamipretide 80 MG/ML Injection [Forzinity]

Per the CMS 2026 Part D formulary file, 3.5 ML elamipretide 80 MG/ML Injection [Forzinity] (RxNorm concept RXCUI 2725610, generic name 3.5) appears on 5 distinct formulary files spanning 36 Medicare Part D plan offerings - 0.7% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 5 to Tier 5, with a cross-plan average of Tier 5.

Real-world access to 3.5 ML elamipretide 80 MG/ML Injection [Forzinity] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 80% 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 3.5 ML elamipretide 80 MG/ML Injection [Forzinity] today.

Coverage Details

Formularies covering
5
Plans covering
36
Coverage rate
0.7%
Tier range
Tier 5, Specialty
Average tier
Tier 5, Specialty

Restrictions

Prior authorization required
100% of formularies
Step therapy required
0% of formularies
Quantity limits
80% of formularies

Tier Distribution Across Plans

36 plans
Tier 5, Specialty

Medicare Advantage Plans (MA-PD) Covering 3.5 ML elamipretide 80 MG/ML Injection [Forzinity]

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

Plan Insurer Tier PA Premium States
Health First Rewards H1099-014 (HMO) Health First Health Plans T5 Yes $0 FL
Health First SunSaver H1099-016 (HMO) Health First Health Plans T5 Yes $0 FL
Health First Complete Care H1099-023 (HMO) Health First Health Plans T5 Yes $0 FL
Health First Emerald Plus H1099-024 (HMO) Health First Health Plans T5 Yes $0 FL
Health First Premier Access H1099-025 (HMO-POS) Health First Health Plans T5 Yes $0 FL
Health First Emerald Plus H1099-026 (HMO) Health First Health Plans T5 Yes $0 FL
Health First Premier Access H1099-027 (HMO-POS) Health First Health Plans T5 Yes $0 FL
Health First Emerald Plus H1099-028 (HMO) Health First Health Plans T5 Yes $0 FL
Prominence Plus (HMO) Prominence Healthfirst T5 Yes $0 NV
Prominence Plus (HMO) Prominence Healthfirst T5 Yes $0 NV
Prominence Dual (HMO D-SNP) Prominence Healthfirst T5 Yes $0 NV
Prominence Dual (HMO D-SNP) Prominence Healthfirst T5 Yes $0 NV
Prominence Giveback (HMO) Prominence Healthfirst T5 Yes $0 NV
Prominence Plus (HMO) Prominence Healthfirst OF Florida Inc T5 Yes $0 FL
Prominence Giveback (HMO) Prominence Healthfirst OF Florida Inc T5 Yes $0 FL
Prominence Plus (HMO) Prominence Healthfirst OF Texas T5 Yes $0 TX
Prominence Plus (HMO) Prominence Healthfirst OF Texas T5 Yes $0 TX
Prominence Dual (HMO D-SNP) Prominence Healthfirst OF Texas T5 Yes $0 TX
Prominence Extra Help (HMO) Prominence Healthfirst OF Texas T5 Yes $0 TX
Prominence Beyond (HMO) Prominence Healthfirst OF Texas T5 Yes $0 TX
Show the next 16 plans
Prominence Giveback (HMO) Prominence Healthfirst OF Texas T5 Yes $0 TX
Prominence Giveback (HMO) Prominence Healthfirst OF Texas T5 Yes $0 TX
Prominence Dual (HMO D-SNP) Prominence Healthfirst OF Texas T5 Yes $0 TX
Prominence Beyond (HMO-POS) Prominence Healthfirst OF Texas T5 Yes $0 TX
Prominence Dual (HMO D-SNP) Prominence Healthfirst OF Florida Inc T5 Yes $0 FL
Prominence Diabetes and Heart Giveback (HMO C-SNP) Prominence Healthfirst T5 Yes $0 NV
Prominence Diabetes and Heart Giveback (HMO C-SNP) Prominence Healthfirst OF Florida Inc T5 Yes $0 FL
Prominence Diabetes and Heart Giveback (HMO C-SNP) Prominence Healthfirst OF Texas T5 Yes $0 TX
Prominence Diabetes and Heart Care Plus (HMO C-SNP) Prominence Healthfirst OF Texas T5 Yes $0 TX
Prominence Diabetes and Heart Giveback (HMO C-SNP) Prominence Healthfirst OF Texas T5 Yes $0 TX
Prominence Extra Help (HMO) Prominence Healthfirst T5 Yes $4.20 NV
Prominence Extra Help (HMO) Prominence Healthfirst OF Florida Inc T5 Yes $4.80 FL
Prominence Extra Help (HMO) Prominence Healthfirst OF Texas T5 Yes $4.80 TX
Prominence Extra Help (HMO) Prominence Healthfirst T5 Yes $9.50 NV
Health First Value H1099-006 (HMO) Health First Health Plans T5 Yes $15.00 FL
Health First Classic H1099-001 (HMO-POS) Health First Health Plans T5 Yes $49.40 FL

Frequently Asked Questions

Is 3.5 ML elamipretide 80 MG/ML Injection [Forzinity] covered by Medicare Part D?

Yes, 3.5 ML elamipretide 80 MG/ML Injection [Forzinity] is covered by 36 Medicare Part D plans (0.7% of all Part D formularies).

What tier is 3.5 ML elamipretide 80 MG/ML Injection [Forzinity] on Medicare Part D plans?

3.5 ML elamipretide 80 MG/ML Injection [Forzinity] averages Tier 5 across Part D plans, ranging from Tier 5 to Tier 5.

Does 3.5 ML elamipretide 80 MG/ML Injection [Forzinity] require prior authorization?

100% of Part D formularies require prior authorization for 3.5 ML elamipretide 80 MG/ML Injection [Forzinity]. Step therapy: 0%. Quantity limits: 80%.

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.

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