Medicare Part D coverage · {56 · RxCUI 2274816
{56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton]
Per the CMS 2026 Part D formulary file, {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton] is covered by 1,180 Medicare Part D plans (23.4% of enrollable products), averaging Tier 4.5, with prior authorization required on 90.5% of covering formularies.
- 23.4%
- Plan coverage
- 1,180
- Plans covering
- T4.5
- Avg tier
- 90.5%
- Prior auth required
What the CMS Formulary Data Shows for {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton]
Per the CMS 2026 Part D formulary file, {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton] (RxNorm concept RXCUI 2274816, generic name {56) appears on 21 distinct formulary files spanning 1,180 Medicare Part D plan offerings - 23.4% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.5.
Real-world access to {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton] depends on utilization management as much as tier placement: 90.5% of covering formularies require prior authorization. 0% require step therapy. 47.6% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 486 Part D beneficiaries filled {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton] in 2023, with total plan-and-beneficiary spending of $76,164,444 and an average per-beneficiary annual cost of $156,716.96. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton] today.
Coverage Details
- Formularies covering
- 21
- Plans covering
- 1,180
- Coverage rate
- 23.4%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 5, Specialty
Restrictions
- Prior authorization required
- 90.5% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 47.6% of formularies
2023 Medicare Spending
- Beneficiaries
- 486
- Total spending
- $76,164,444
- Avg per beneficiary
- $156,716.96
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton]
9 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T5 | Yes | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T5 | Yes | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T5 | Yes | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T5 | Yes | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T5 | Yes | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T5 | Yes | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T5 | Yes | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T5 | Yes | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T5 | Yes | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton]
91 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $0 | NY |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| Hamaspik Medicare Select (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $34.50 | NY |
| Health First Rewards H1099-014 (HMO) | Health First Health Plans | T4 | No | $0 | FL |
| Health First SunSaver H1099-016 (HMO) | Health First Health Plans | T4 | No | $0 | FL |
| Health First Complete Care H1099-023 (HMO) | Health First Health Plans | T4 | No | $0 | FL |
| Health First Emerald Plus H1099-024 (HMO) | Health First Health Plans | T4 | No | $0 | FL |
| Health First Premier Access H1099-025 (HMO-POS) | Health First Health Plans | T4 | No | $0 | FL |
| Health First Emerald Plus H1099-026 (HMO) | Health First Health Plans | T4 | No | $0 | FL |
| Health First Premier Access H1099-027 (HMO-POS) | Health First Health Plans | T4 | No | $0 | FL |
| Health First Emerald Plus H1099-028 (HMO) | Health First Health Plans | T4 | No | $0 | FL |
| Leon MediExtra (HMO) | Leon Health, Inc. | T4 | Yes | $0 | FL |
| Leon MediDual (HMO D-SNP) | Leon Health, Inc. | T4 | Yes | $0 | FL |
| Leon MediMore (HMO) | Leon Health, Inc. | T4 | Yes | $0 | FL |
| Leon MediMax (HMO D-SNP) | Leon Health, Inc. | T4 | Yes | $0 | FL |
| Health First Value H1099-006 (HMO) | Health First Health Plans | T4 | No | $15.00 | FL |
| Health First Classic H1099-001 (HMO-POS) | Health First Health Plans | T4 | No | $49.40 | FL |
| HealthSpring Preferred (HMO) | Bravo Health Pennsylvania, Inc. | T5 | Yes | $0 | AZ |
| HealthSpring Alliance (HMO) | Bravo Health Pennsylvania, Inc. | T5 | Yes | $0 | AZ |
| HealthSpring Preferred Savings (HMO) | Bravo Health Pennsylvania, Inc. | T5 | Yes | $0 | AZ |
Show the next 30 plans
| HealthSpring Preferred Full Savings (HMO) | Bravo Health Pennsylvania, Inc. | T5 | Yes | $0 | AZ |
| HealthSpring Preferred GA (HMO) | Healthspring Life & Health Insurance Company, Inc. | T5 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T5 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T5 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T5 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T5 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T5 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T5 | Yes | $0 | GA |
| HealthSpring Preferred Savings (HMO) | Healthspring Life & Health Insurance Company, Inc. | T5 | Yes | $0 | GA |
| HealthSpring Preferred Savings (HMO) | Healthspring Life & Health Insurance Company, Inc. | T5 | Yes | $0 | GA |
| HealthSpring Preferred Savings (HMO) | Healthspring Life & Health Insurance Company, Inc. | T5 | Yes | $0 | GA |
| HealthSpring Preferred Savings (HMO) | Healthspring Life & Health Insurance Company, Inc. | T5 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T5 | Yes | $0 | MO |
| HealthSpring Preferred Savings (HMO) | Healthspring Life & Health Insurance Company, Inc. | T5 | Yes | $0 | MO |
| HealthSpring Premier (HMO-POS) | Healthspring Life & Health Insurance Company, Inc. | T5 | Yes | $0 | UT |
| HealthSpring Preferred (HMO) | Healthspring Healthcare OF Colorado, Inc. | T5 | Yes | $0 | NM |
| HealthSpring Preferred (HMO) | Healthspring Healthcare OF Colorado, Inc. | T5 | Yes | $0 | OH |
| HealthSpring Preferred (HMO) | Healthspring Healthcare OF Colorado, Inc. | T5 | Yes | $0 | KY, OH |
| HealthSpring Preferred Savings (HMO) | Healthspring Healthcare OF Colorado, Inc. | T5 | Yes | $0 | OH |
| HealthSpring Preferred Savings (HMO) | Healthspring Healthcare OF Colorado, Inc. | T5 | Yes | $0 | KY, OH |
| HealthSpring Preferred (HMO) | Healthspring Healthcare OF Colorado, Inc. | T5 | Yes | $0 | CO |
| HealthSpring Preferred (HMO) | Bravo Health Mid-atlantic, Inc. | T5 | Yes | $0 | DC, DE |
| HealthSpring Preferred PA (HMO) | Bravo Health Pennsylvania, Inc. | T5 | Yes | $0 | PA |
| HealthSpring Preferred (HMO) | Bravo Health Pennsylvania, Inc. | T5 | Yes | $0 | PA |
| HealthSpring Preferred (HMO) | Bravo Health Pennsylvania, Inc. | T5 | Yes | $0 | PA |
| HealthSpring Preferred (HMO) | Bravo Health Pennsylvania, Inc. | T5 | Yes | $0 | PA |
| HealthSpring Preferred (HMO) | Bravo Health Pennsylvania, Inc. | T5 | Yes | $0 | PA |
| HealthSpring Preferred (HMO) | Bravo Health Pennsylvania, Inc. | T5 | Yes | $0 | PA |
| HealthSpring Preferred Savings (HMO) | Bravo Health Pennsylvania, Inc. | T5 | Yes | $0 | PA |
| HealthSpring Preferred (HMO) | Bravo Health Pennsylvania, Inc. | T5 | Yes | $0 | NJ |
Showing top 50 of 91 plans.
Frequently Asked Questions
Is {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton] covered by Medicare Part D?
Yes, {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton] is covered by 1,180 Medicare Part D plans (23.4% of all Part D formularies).
What tier is {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton] on Medicare Part D plans?
{56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton] averages Tier 4.5 across Part D plans, ranging from Tier 1 to Tier 5.
Does {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton] require prior authorization?
90.5% of Part D formularies require prior authorization for {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton]. Step therapy: 0%. Quantity limits: 47.6%.
How much does Medicare spend on {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton]?
In 2023, total Medicare Part D spending on {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton] was $76,164,444, covering 486 beneficiaries. The average spend per beneficiary was $156,716.96.
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
- {7 (mitapivat 5 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 5 MG Taper] T4.5
- {28 (tolvaptan 30 MG Oral Tablet [Jynarque]) / 28 (tolvaptan 60 MG Oral Tablet [Jynarque]) } Pack [Jynarque 60/30 Carton] T4.5
- phenoxybenzamine hydrochloride 10 MG Oral Capsule T4.5
- deferiprone 100 MG/ML Oral Solution [Ferriprox] T4.5
- 0.6 ML pegfilgrastim-cbqv 10 MG/ML Prefilled Syringe [Udenyca] T4.5
- 3 ML apomorphine hydrochloride 10 MG/ML Cartridge T4.5
Similar prior-authorization rate
- alanine 8.8 MG/ML / arginine 4.89 MG/ML / calcium chloride 0.004 MEQ/ML / dibasic potassium phosphate 2.61 MG/ML / glucose 50 MG/ML / glycine 4.38 MG/ML / histidine 2.04 MG/ML / isoleucine 2.55 MG/ML / leucine 3.11 MG/ML / lysine 2.47 MG/ML / magnesium chloride 0.01 MEQ/ML / methionine 1.7 MG/ML / phenylalanine 2.38 MG/ML / proline 2.89 MG/ML / serine 2.13 MG/ML / sodium acetate trihydrate 2.97 MG/ML / sodium chloride 0.013 MEQ/ML / threonine 1.79 MG/ML / tryptophan 0.77 MG/ML / tyrosine 0.17 MG/ML / valine 2.47 MG/ML Injectable Solution [Clinimix E 4.25/5] 90.5% PA
- elafibranor 80 MG Oral Tablet [Iqirvo] 90.5% PA
- 0.2 ML adalimumab-adbm 50 MG/ML Prefilled Syringe 90.7% PA
- 0.4 ML adalimumab-adbm 50 MG/ML Prefilled Syringe 90.7% PA
- 0.8 ML adalimumab-adbm 50 MG/ML Prefilled Syringe 90.7% PA
- 60 ACTUAT testosterone 12.5 MG/ACTUAT Topical Gel 90.2% PA