Medicare Part D coverage · albuterol · RxCUI 245314
albuterol 5 MG/ML Inhalation Solution
Per the CMS 2026 Part D formulary file, albuterol 5 MG/ML Inhalation Solution is covered by 5,035 Medicare Part D plans (99.7% of enrollable products), averaging Tier 1.9, with prior authorization required on 99.7% of covering formularies.
- 99.7%
- Plan coverage
- 5,035
- Plans covering
- T1.9
- Avg tier
- 99.7%
- Prior auth required
What the CMS Formulary Data Shows for albuterol 5 MG/ML Inhalation Solution
Per the CMS 2026 Part D formulary file, albuterol 5 MG/ML Inhalation Solution (RxNorm concept RXCUI 245314, generic name albuterol) appears on 325 distinct formulary files spanning 5,035 Medicare Part D plan offerings - 99.7% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 1.9.
Real-world access to albuterol 5 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. 10.2% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,487 Part D beneficiaries filled albuterol 5 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 5 MG/ML Inhalation Solution today.
Coverage Details
- Formularies covering
- 325
- Plans covering
- 5,035
- Coverage rate
- 99.7%
- 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
- 10.2% 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 5 MG/ML Inhalation Solution
100 Medicare Advantage plans with Part D drug coverage include this drug.
Show the next 30 plans
| 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 |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is albuterol 5 MG/ML Inhalation Solution covered by Medicare Part D?
Yes, albuterol 5 MG/ML Inhalation Solution is covered by 5,035 Medicare Part D plans (99.7% of all Part D formularies).
What tier is albuterol 5 MG/ML Inhalation Solution on Medicare Part D plans?
albuterol 5 MG/ML Inhalation Solution averages Tier 1.9 across Part D plans, ranging from Tier 1 to Tier 4.
Does albuterol 5 MG/ML Inhalation Solution require prior authorization?
99.7% of Part D formularies require prior authorization for albuterol 5 MG/ML Inhalation Solution. Step therapy: 0%. Quantity limits: 10.2%.
How much does Medicare spend on albuterol 5 MG/ML Inhalation Solution?
In 2023, total Medicare Part D spending on albuterol 5 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.
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
- azelastine hydrochloride 0.137 MG/ACTUAT Metered Dose Nasal Spray T1.9
- dexamethasone 0.75 MG Oral Tablet T1.9
- duloxetine 20 MG Delayed Release Oral Capsule T1.9
- ipratropium bromide 0.021 MG/ACTUAT Metered Dose Nasal Spray T1.9
- nystatin 100000 UNT/ML Oral Suspension T1.9
- valproic acid 50 MG/ML Oral Solution T1.9
Similar prior-authorization rate
- {4 (selinexor 80 MG Oral Tablet [Xpovio]) } Pack [Xpovio 80 MG Once Weekly Carton-80 MG Tablet] 99.7% PA
- mifepristone 300 MG Oral Tablet 99.7% PA
- dornase alfa 1 MG/ML Inhalation Solution [Pulmozyme] 99.7% PA
- sofosbuvir 400 MG / velpatasvir 100 MG / voxilaprevir 100 MG Oral Tablet [Vosevi] 99.7% PA
- ivacaftor 150 MG Oral Tablet [Kalydeco] 99.7% PA
- deutetrabenazine 12 MG Oral Tablet [Austedo] 99.7% PA