albuterol 0.21 MG/ML Inhalation Solution
albuterol
RxCUI: 351137
What the CMS Formulary Data Shows for albuterol 0.21 MG/ML Inhalation Solution
Per the CMS 2026 Part D formulary file, albuterol 0.21 MG/ML Inhalation Solution (RxNorm concept RXCUI 351137, generic name albuterol) appears on 329 distinct formulary files spanning 5,066 Medicare Part D plan offerings - 100% 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.
Real-world access to albuterol 0.21 MG/ML Inhalation Solution depends on utilization management as much as tier placement: 99.7% of covering formularies require prior authorization. 0% require step therapy. 10% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,487 Part D beneficiaries filled albuterol 0.21 MG/ML Inhalation 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 0.21 MG/ML Inhalation Solution today.
Coverage Details
- Formularies covering
- 329
- Plans covering
- 5,066
- Coverage rate
- 100%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 99.7% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 10% 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 0.21 MG/ML Inhalation Solution
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 | Yes | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | SENTARA HEALTH PLANS | T1 | Yes | $0 | VA |
| Anthem I CareMore Medicare Advantage 2 (HMO-POS) | BLUE CROSS OF CALIFORNIA | T1 | Yes | $0 | CA |
| Anthem I CareMore Chronic Care (HMO-POS C-SNP) | BLUE CROSS OF CALIFORNIA | T1 | Yes | $0 | CA |
| Anthem I CareMore Home Care (HMO I-SNP) | BLUE CROSS OF CALIFORNIA | T1 | Yes | $0 | CA |
| Anthem I CareMore Chronic Care (HMO-POS C-SNP) | BLUE CROSS OF CALIFORNIA | T1 | Yes | $0 | CA |
| Anthem I CareMore Lung Care (HMO-POS C-SNP) | BLUE CROSS OF CALIFORNIA | T1 | Yes | $0 | CA |
| Anthem I CareMore Kidney Care (HMO-POS C-SNP) | BLUE CROSS OF CALIFORNIA | T1 | Yes | $0 | CA |
| Anthem I CareMore Lung Care (HMO-POS C-SNP) | BLUE CROSS OF CALIFORNIA | T1 | Yes | $0 | CA |
| Anthem I CareMore Kidney Care (HMO-POS C-SNP) | BLUE CROSS OF CALIFORNIA | T1 | Yes | $0 | CA |
| Wellpoint Lung Care (HMO-POS C-SNP) | WELLPOINT HEALTH PLANS, INC. | T1 | Yes | $0 | AZ |
| Wellpoint Chronic Care (HMO-POS C-SNP) | WELLPOINT HEALTH PLANS, INC. | T1 | Yes | $0 | AZ |
| Wellpoint Medicare Advantage 1 (HMO-POS) | WELLPOINT HEALTH PLANS, INC. | T1 | Yes | $0 | AZ |
| Wellpoint Premium Savings (HMO) | WELLPOINT HEALTH PLANS, INC. | T1 | Yes | $0 | AZ |
| Wellpoint I CareMore Home Care (HMO I-SNP) | WELLPOINT HEALTH PLANS, INC. | T1 | Yes | $0 | AZ |
| Wellpoint I CareMore Home Care (HMO I-SNP) | WELLPOINT HEALTH PLANS, INC. | T1 | Yes | $0 | AZ |
| Wellpoint Medicare Advantage 2 (HMO-POS) | WELLPOINT TEXAS, INC. | T1 | Yes | $0 | AZ |
| Wellpoint I CareMore Home Care 2 (HMO I-SNP) | WELLPOINT TEXAS, INC. | T1 | Yes | $0 | AZ |
| Wellpoint Lung Care 2 (HMO-POS C-SNP) | WELLPOINT TEXAS, INC. | T1 | Yes | $0 | AZ |
| Wellpoint Chronic Care 2 (HMO-POS C-SNP) | WELLPOINT TEXAS, INC. | T1 | Yes | $0 | AZ |
| Wellpoint I CareMore Kidney Care (HMO-POS C-SNP) | WELLPOINT TEXAS, INC. | T1 | Yes | $0 | AZ |
| Anthem Chronic Care (HMO-POS C-SNP) | HealthKeepers, Inc. | T1 | Yes | $0 | VA |
| Anthem I CareMore Medicare Advantage (HMO-POS) | BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. | T1 | Yes | $0 | CA |
| Anthem I CareMore Premium Savings (HMO-POS) | BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. | T1 | Yes | $0 | CA |
| Anthem I CareMore Medicare Advantage (HMO-POS) | BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. | T1 | Yes | $0 | CA |
| Anthem I CareMore Chronic Care 2 (HMO-POS C-SNP) | BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. | T1 | Yes | $0 | CA |
| Anthem I CareMore Chronic Care 2 (HMO-POS C-SNP) | BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. | T1 | Yes | $0 | CA |
| Anthem I CareMore Lung Care 2 (HMO-POS C-SNP) | BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. | T1 | Yes | $0 | CA |
| Anthem I CareMore Lung Care 2 (HMO-POS C-SNP) | BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. | T1 | Yes | $0 | CA |
| Anthem I CareMore Medicare Advantage (HMO-POS) | HMO COLORADO, INC. | T1 | Yes | $0 | NV |
| Anthem I CareMore Lung Care (HMO-POS C-SNP) | HMO COLORADO, INC. | T1 | Yes | $0 | NV |
| Anthem I CareMore Chronic Care (HMO-POS C-SNP) | HMO COLORADO, INC. | T1 | Yes | $0 | NV |
| Anthem I CareMore Home Care (HMO I-SNP) | HMO COLORADO, INC. | T1 | Yes | $0 | NV |
| Anthem I CareMore Kidney Care (HMO-POS C-SNP) | HMO COLORADO, INC. | T1 | Yes | $0 | NV |
| Wellpoint Chronic Care (HMO-POS C-SNP) | WELLPOINT INSURANCE COMPANY | T1 | Yes | $0 | TX |
| Wellpoint Chronic Care (HMO-POS C-SNP) | WELLPOINT INSURANCE COMPANY | T1 | Yes | $0 | TX |
| Wellpoint Lung Care (HMO-POS C-SNP) | WELLPOINT INSURANCE COMPANY | T1 | Yes | $0 | TX |
| Freedom VIP Care (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | Yes | $0 | FL |
| Optimum Diamond Savings (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | Yes | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | Yes | $0 | FL |
| Optimum Diamond (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | Yes | $0 | FL |
| Freedom Medi-Medi Partial (HMO D-SNP) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Freedom Medi-Medi Full (HMO D-SNP) | FREEDOM HEALTH, INC. | T1 | Yes | $0 | FL |
| Optimum Emerald Partial (HMO D-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | Yes | $0 | FL |
| Optimum Emerald Full (HMO D-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | Yes | $0 | FL |
Frequently Asked Questions
Is albuterol 0.21 MG/ML Inhalation Solution covered by Medicare Part D?
Yes, albuterol 0.21 MG/ML Inhalation Solution is covered by 5,066 Medicare Part D plans (100% of all Part D formularies).
What tier is albuterol 0.21 MG/ML Inhalation Solution on Medicare Part D plans?
albuterol 0.21 MG/ML Inhalation Solution averages Tier 2 across Part D plans, ranging from Tier 1 to Tier 4.
Does albuterol 0.21 MG/ML Inhalation Solution require prior authorization?
99.7% of Part D formularies require prior authorization for albuterol 0.21 MG/ML Inhalation Solution. Step therapy: 0%. Quantity limits: 10%.
How much does Medicare spend on albuterol 0.21 MG/ML Inhalation Solution?
In 2023, total Medicare Part D spending on albuterol 0.21 MG/ML Inhalation 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.