almotriptan 12.5 MG Oral Tablet
almotriptan
RxCUI: 284205
What the CMS Formulary Data Shows for almotriptan 12.5 MG Oral Tablet
Per the CMS 2026 Part D formulary file, almotriptan 12.5 MG Oral Tablet (RxNorm concept RXCUI 284205, generic name almotriptan) appears on 11 distinct formulary files spanning 100 Medicare Part D plan offerings - 2% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.9.
Real-world access to almotriptan 12.5 MG Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 9.1% require step therapy. 81.8% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,289 Part D beneficiaries filled almotriptan 12.5 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $1,749,909 and an average per-beneficiary annual cost of $1,357.57. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry almotriptan 12.5 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 11
- Plans covering
- 100
- Coverage rate
- 2%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 9.1% of formularies
- Quantity limits
- 81.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,289
- Total spending
- $1,749,909
- Avg per beneficiary
- $1,357.57
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering almotriptan 12.5 MG Oral Tablet
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Blue Rx PDP Complete (PDP) | HM HEALTH INSURANCE COMPANY | T2 | No | No | $164.80 | - |
| Blue Rx PDP Plus (PDP) | HM HEALTH INSURANCE COMPANY | T2 | No | No | $193.20 | - |
Medicare Advantage Plans (MA-PD) Covering almotriptan 12.5 MG Oral Tablet
98 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Mass General Brigham SCO (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | No | $0 | MA |
| HealthSun HealthAdvantage Plan (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun MediMax (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun MediSun Plus (HMO D-SNP) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun MediSun Extra (HMO D-SNP) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun MediSun Full Dual Plus (HMO D-SNP) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun MediSun Full Dual Extra (HMO D-SNP) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply More (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply More (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply More (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply More (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply More (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply More (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Extra (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Extra Platinum (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply More Platinum (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Complete Platinum (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Extra Platinum (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Extra Platinum (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Extra Platinum (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply More Platinum (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Complete Platinum (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
Frequently Asked Questions
Is almotriptan 12.5 MG Oral Tablet covered by Medicare Part D?
Yes, almotriptan 12.5 MG Oral Tablet is covered by 100 Medicare Part D plans (2% of all Part D formularies).
What tier is almotriptan 12.5 MG Oral Tablet on Medicare Part D plans?
almotriptan 12.5 MG Oral Tablet averages Tier 2.9 across Part D plans, ranging from Tier 1 to Tier 4.
Does almotriptan 12.5 MG Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for almotriptan 12.5 MG Oral Tablet. Step therapy: 9.1%. Quantity limits: 81.8%.
How much does Medicare spend on almotriptan 12.5 MG Oral Tablet?
In 2023, total Medicare Part D spending on almotriptan 12.5 MG Oral Tablet was $1,749,909, covering 1,289 beneficiaries. The average spend per beneficiary was $1,357.57.
Read our methodology - how this data is sourced, computed, and verified.