Medicare Part D coverage · albuterol · RxCUI 755497
albuterol 0.4 MG/ML Oral Solution
Per the CMS 2026 Part D formulary file, albuterol 0.4 MG/ML Oral Solution is covered by 4,794 Medicare Part D plans (94.9% of enrollable products), averaging Tier 2.1, with prior authorization required on 0% of covering formularies.
- 94.9%
- Plan coverage
- 4,794
- Plans covering
- T2.1
- Avg tier
- 0%
- Prior auth required
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 272 distinct formulary files spanning 4,794 Medicare Part D plan offerings - 94.9% 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
- 272
- Plans covering
- 4,794
- Coverage rate
- 94.9%
- 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
Medicare Advantage Plans (MA-PD) Covering albuterol 0.4 MG/ML Oral Solution
100 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 |
Show the next 30 plans
Showing top 50 of 100 plans.
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 4,794 Medicare Part D plans (94.9% 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.
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
- amoxicillin 250 MG / clavulanate 125 MG Oral Tablet T2.1
- testosterone cypionate 100 MG/ML Injectable Solution T2.1
- doxycycline monohydrate 50 MG Oral Tablet T2.1
- 1 ML testosterone cypionate 200 MG/ML Injection T2.1
- 24 HR propranolol hydrochloride 120 MG Extended Release Oral Capsule T2.1
- {21 (desogestrel 0.15 MG / ethinyl estradiol 0.03 MG Oral Tablet) / 7 (inert ingredients 1 MG Oral Tablet) } Pack [Cyred 28 Day] T2.1
Similar prior-authorization rate
- metronidazole 10 MG/ML Topical Cream [Noritate] 0% PA
- 24 HR minocycline 40 MG Extended Release Oral Capsule [Emrosi] 0% PA
- buspirone hydrochloride 10 MG Oral Capsule [Bucapsol] 0% PA
- diflunisal 375 MG Oral Tablet [Dolobid] 0% PA
- hydrocortisone 1 MG/ML Oral Solution [Khindivi] 0% PA
- indomethacin 50 MG Rectal Suppository [Indocin] 0% PA