albuterol 0.4 MG/ML Oral Solution
albuterol
RxCUI: 755497
What the CMS Formulary Data Shows for albuterol 0.4 MG/ML Oral Solution
Per the CMS 2026 Part D formulary file, albuterol 0.4 MG/ML Oral Solution (RxNorm concept RXCUI 755497, generic name albuterol) appears on 273 distinct formulary files spanning 4,796 Medicare Part D plan offerings - 94.7% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.1.
Real-world access to albuterol 0.4 MG/ML Oral Solution depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0.7% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,487 Part D beneficiaries filled albuterol 0.4 MG/ML Oral Solution 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 0.4 MG/ML Oral Solution today.
Coverage Details
- Formularies covering
- 273
- Plans covering
- 4,796
- Coverage rate
- 94.7%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0.7% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,487
- Total spending
- $925,019
- Avg per beneficiary
- $622.07
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering albuterol 0.4 MG/ML Oral Solution
5 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Anthem Full Dual Advantage (PPO D-SNP) | ANTHEM HEALTH PLANS, INC. | T1 | No | No | $0 | CT |
| Anthem Dual Advantage (PPO D-SNP) | ANTHEM HEALTH PLANS, INC. | T1 | No | No | $0 | CT |
| Anthem Kidney Care (HMO-POS C-SNP) | ANTHEM HEALTH PLANS, INC. | T1 | No | No | $0 | CT |
| Anthem Full Dual Advantage Select (HMO D-SNP) | ANTHEM HEALTH PLANS, INC. | T1 | No | No | $0 | CT |
| Anthem Dual Advantage (HMO D-SNP) | ANTHEM HEALTH PLANS, INC. | T1 | No | No | $0 | CT |
Medicare Advantage Plans (MA-PD) Covering albuterol 0.4 MG/ML Oral Solution
95 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Community Blue Medicare HMO Signature (HMO) | Highmark Western and Northeastern New York Inc. | T1 | No | $0 | NY |
| Community Blue Medicare HMO Merit (HMO) | Highmark Western and Northeastern New York Inc. | T1 | No | $0 | NY |
| Community Blue Medicare PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T1 | No | $0 | PA |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T1 | No | $0 | PA |
| Community Blue Medicare Plus PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T1 | No | $0 | PA |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T1 | No | $0 | PA |
| Complete Blue PPO Merit (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T1 | No | $0 | PA |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T1 | No | $0 | PA |
| Complete Blue PPO Distinct (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T1 | No | $0 | PA |
| Community Blue Medicare Plus PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T1 | No | $0 | PA |
| Complete Blue Plus PPO Merit (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T1 | No | $0 | PA |
| Community Blue Medicare PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T1 | No | $0 | PA |
| Complete Blue PPO Merit (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T1 | No | $0 | PA |
| Community Blue Medicare HMO Signature (HMO) | HIGHMARK CHOICE COMPANY | T1 | No | $0 | PA |
| Security Blue HMO-POS ValueRx (HMO-POS) | HIGHMARK CHOICE COMPANY | T1 | No | $0 | PA |
| Community Blue Medicare HMO Signature (HMO) | HIGHMARK CHOICE COMPANY | T1 | No | $0 | PA |
| Together Blue Medicare HMO Signature (HMO) | HIGHMARK CHOICE COMPANY | T1 | No | $0 | PA |
| Community Blue Medicare HMO Distinct (HMO) | HIGHMARK CHOICE COMPANY | T1 | No | $0 | PA |
| Complete Blue HMO Distinct (HMO) | HIGHMARK CHOICE COMPANY | T1 | No | $0 | PA |
| Complete Blue PPO Distinct (PPO) | HIGHMARK SENIOR SOLUTIONS COMPANY | T1 | No | $0 | WV |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR SOLUTIONS COMPANY | T1 | No | $0 | WV |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR SOLUTIONS COMPANY | T1 | No | $0 | WV |
| Complete Blue PPO Merit (PPO) | HIGHMARK SENIOR SOLUTIONS COMPANY | T1 | No | $0 | WV |
| Complete Blue PPO Signature (PPO) | HIGHMARK BCBSD INC. | T1 | No | $0 | DE |
| 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 |
| Anthem Medicare Advantage (HMO-POS) | BLUE CROSS OF CALIFORNIA | T1 | No | $0 | CA |
| Anthem Medicare Advantage (HMO-POS) | BLUE CROSS OF CALIFORNIA | T1 | No | $0 | CA |
| Anthem Medicare Advantage (HMO-POS) | BLUE CROSS OF CALIFORNIA | T1 | No | $0 | CA |
| Anthem Medicare Advantage (HMO-POS) | BLUE CROSS OF CALIFORNIA | T1 | No | $0 | CA |
| Anthem Full Dual Advantage (HMO D-SNP) | ANTHEM INSURANCE COMPANIES, INC. | T1 | No | $0 | IN |
| Anthem I PathWays Dual Care Advantage (HMO D-SNP) | ANTHEM INSURANCE COMPANIES, INC. | T1 | No | $0 | IN |
| Anthem I PathWays Dual Care Advantage NFLOC (HMO D-SNP) | ANTHEM INSURANCE COMPANIES, INC. | T1 | No | $0 | IN |
| Wellpoint Full Dual Advantage (HMO-POS D-SNP) | WELLPOINT IOWA, INC. | T1 | No | $0 | IA |
| Wellpoint Full Dual Advantage 2 (HMO-POS D-SNP) | WELLPOINT IOWA, INC. | T1 | No | $0 | IA |
| Wellpoint Full Dual Advantage (HMO D-SNP) | WELLPOINT WEST VIRGINIA , INC. | T1 | No | $0 | WV |
| Wellpoint Full Dual Advantage (HMO D-SNP) | WELLPOINT WASHINGTON, INC. | T1 | No | $0 | WA |
| Wellpoint Dual Advantage (HMO D-SNP) | WELLPOINT WASHINGTON, INC. | T1 | No | $0 | WA |
| Healthy Blue Dual Advantage (HMO D-SNP) | COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC. | T1 | No | $0 | LA |
| Healthy Blue Dual Advantage 2 (HMO D-SNP) | COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC. | T1 | No | $0 | LA |
| Anthem Dual Advantage (PPO D-SNP) | ANTHEM INSURANCE COMPANIES, INC. | T1 | No | $0 | VA |
| Wellpoint Medicare Advantage 2 (HMO-POS) | WELLPOINT TEXAS, INC. | T1 | No | $0 | TX |
| Wellpoint Kidney Care (HMO-POS C-SNP) | WELLPOINT TEXAS, INC. | T1 | No | $0 | TX |
| Wellpoint Dual Advantage 2 (HMO D-SNP) | WELLPOINT TEXAS, INC. | T1 | No | $0 | TX |
| Wellpoint Kidney Care (HMO-POS C-SNP) | WELLPOINT TEXAS, INC. | T1 | No | $0 | TX |
| Wellpoint Full Dual Advantage Aligned (HMO D-SNP) | WELLPOINT TEXAS, INC. | T1 | No | $0 | TX |
| Wellpoint Full Dual Advantage Aligned (HMO D-SNP) | WELLPOINT TEXAS, INC. | T1 | No | $0 | TX |
| Wellpoint Full Dual Advantage Aligned (HMO D-SNP) | WELLPOINT TEXAS, INC. | T1 | No | $0 | TX |
| Wellpoint Full Dual Advantage Aligned (HMO D-SNP) | WELLPOINT TEXAS, INC. | T1 | No | $0 | TX |
| Wellpoint Full Dual Advantage 2 (HMO D-SNP) | WELLPOINT TEXAS, INC. | T1 | No | $0 | TX |
Frequently Asked Questions
Is albuterol 0.4 MG/ML Oral Solution covered by Medicare Part D?
Yes, albuterol 0.4 MG/ML Oral Solution is covered by 4,796 Medicare Part D plans (94.7% of all Part D formularies).
What tier is albuterol 0.4 MG/ML Oral Solution on Medicare Part D plans?
albuterol 0.4 MG/ML Oral Solution averages Tier 2.1 across Part D plans, ranging from Tier 1 to Tier 4.
Does albuterol 0.4 MG/ML Oral Solution require prior authorization?
0% of Part D formularies require prior authorization for albuterol 0.4 MG/ML Oral Solution. Step therapy: 0%. Quantity limits: 0.7%.
How much does Medicare spend on albuterol 0.4 MG/ML Oral Solution?
In 2023, total Medicare Part D spending on albuterol 0.4 MG/ML Oral Solution 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.