Medicare Part D coverage · albuterol · RxCUI 197318
albuterol 4 MG Oral Tablet
Per the CMS 2026 Part D formulary file, albuterol 4 MG Oral Tablet is covered by 4,649 Medicare Part D plans (92% of enrollable products), averaging Tier 3.1, with prior authorization required on 0% of covering formularies.
- 92%
- Plan coverage
- 4,649
- Plans covering
- T3.1
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for albuterol 4 MG Oral Tablet
Per the CMS 2026 Part D formulary file, albuterol 4 MG Oral Tablet (RxNorm concept RXCUI 197318, generic name albuterol) appears on 232 distinct formulary files spanning 4,649 Medicare Part D plan offerings - 92% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.1.
Real-world access to albuterol 4 MG Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,487 Part D beneficiaries filled albuterol 4 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $925,019 and an average per-beneficiary annual cost of $622.07. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry albuterol 4 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 232
- Plans covering
- 4,649
- Coverage rate
- 92%
- 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
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,487
- Total spending
- $925,019
- Avg per beneficiary
- $622.07
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering albuterol 4 MG Oral Tablet
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 | No | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| Freedom VIP Care (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Savings (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Freedom Medi-Medi Partial (HMO D-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Medi-Medi Full (HMO D-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Optimum Emerald Partial (HMO D-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Emerald Full (HMO D-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
Show the next 30 plans
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Máximo (HMO-POS) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Máximo (HMO-POS) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Platinum Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Gold Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Rewards COPD (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Savings COPD (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Gold Plus Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Rewards COPD (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | No | $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 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | No | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | No | $0 | AZ |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is albuterol 4 MG Oral Tablet covered by Medicare Part D?
Yes, albuterol 4 MG Oral Tablet is covered by 4,649 Medicare Part D plans (92% of all Part D formularies).
What tier is albuterol 4 MG Oral Tablet on Medicare Part D plans?
albuterol 4 MG Oral Tablet averages Tier 3.1 across Part D plans, ranging from Tier 1 to Tier 4.
Does albuterol 4 MG Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for albuterol 4 MG Oral Tablet. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on albuterol 4 MG Oral Tablet?
In 2023, total Medicare Part D spending on albuterol 4 MG Oral Tablet was $925,019, covering 1,487 beneficiaries. The average spend per beneficiary was $622.07.
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
- clomipramine hydrochloride 25 MG Oral Capsule T3.1
- erythromycin 500 MG Delayed Release Oral Tablet T3.1
- 1 ML epoetin alfa 2000 UNT/ML Injection [Procrit] T3.1
- loteprednol etabonate 0.0038 MG/MG Ophthalmic Gel [Lotemax] T3.1
- 0.25 ML somatropin 0.8 MG/ML Prefilled Syringe [Genotropin] T3.1
- prednisolone 1.2 MG/ML Ophthalmic Suspension [Pred Mild] T3.1