Medicare Part D coverage · ambrisentan · RxCUI 722116

ambrisentan 10 MG Oral Tablet

Per the CMS 2026 Part D formulary file, ambrisentan 10 MG Oral Tablet is covered by 4,903 Medicare Part D plans (97.1% of enrollable products), averaging Tier 4.1, with prior authorization required on 98.9% of covering formularies.

97.1%
Plan coverage
4,903
Plans covering
T4.1
Avg tier
98.9%
Prior auth required

Verify with CMS →

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.

What the CMS Formulary Data Shows for ambrisentan 10 MG Oral Tablet

Per the CMS 2026 Part D formulary file, ambrisentan 10 MG Oral Tablet (RxNorm concept RXCUI 722116, generic name ambrisentan) appears on 281 distinct formulary files spanning 4,903 Medicare Part D plan offerings - 97.1% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 4.1.

Real-world access to ambrisentan 10 MG Oral Tablet depends on utilization management as much as tier placement: 98.9% of covering formularies require prior authorization. 0% require step therapy. 90.7% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 6,456 Part D beneficiaries filled ambrisentan 10 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $246,059,319 and an average per-beneficiary annual cost of $38,113.28. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry ambrisentan 10 MG Oral Tablet today.

Coverage Details

Formularies covering
281
Plans covering
4,903
Coverage rate
97.1%
Tier range
Tier 1 – Tier 6
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
98.9% of formularies
Step therapy required
0% of formularies
Quantity limits
90.7% of formularies

2023 Medicare Spending

Beneficiaries
6,456
Total spending
$246,059,319
Avg per beneficiary
$38,113.28

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering ambrisentan 10 MG Oral Tablet

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
Florida Complete Care-Duals VIP (HMO-POS D-SNP) Hpmp OF Florida, Inc. T1 Yes $0 FL
ElderServe MAP (HMO D-SNP) Elderserve Health, Inc. T1 Yes $0 NY
Cooperative Advantage (HMO D-SNP) Group Health Cooperative OF EAU Claire T1 Yes $0 WI
Longevity Health Plan (PPO I-SNP) Longevity Health Plan OF NEW Jersey Insurance Comp T1 Yes $0 NJ
Mercy Care Advantage (HMO D-SNP) Mercy Care T1 Yes $0 AZ
Mercy Care Advantage (HMO D-SNP) Mercy Care T1 Yes $0 AZ
Mercy Care Advantage (HMO D-SNP) Mercy Care T1 Yes $0 AZ
Elderplan Plus Long-Term Care (HMO-POS D-SNP) Elderplan, Inc. T1 Yes $0 NY
Health Choice Pathway (HMO D-SNP) Health Choice Arizona, Inc. T1 Yes $0 AZ
Healthfirst CompleteCare (HMO D-SNP) Healthfirst Health Plan, Inc. T1 Yes $0 NY
IMCare Classic (HMO D-SNP) Itasca Medical Care T1 Yes $0 MN
Johns Hopkins Advantage MD D-SNP (HMO D-SNP) Hopkins Health Advantage, Inc. T1 Yes $0 MD
MetroPlus UltraCare (HMO D-SNP) Metroplus Health Plan, Inc. T1 Yes $0 NY
Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) Upper Peninsula Health Plan, LLC T1 Yes $0 MI
CareSource Dual Advantage (HMO D-SNP) Caresource Georgia Co. T1 Yes $0 GA
Senior Whole Health SCO (HMO D-SNP) Senior Whole Health, LLC T1 Yes $0 MA
Senior Whole Health SCO NHC (HMO D-SNP) Senior Whole Health, LLC T1 Yes $0 MA
Molina One Care (HMO D-SNP) Senior Whole Health, LLC T1 Yes $0 MA
Show the next 30 plans
HAP CareSource MI Coordinated Health (HMO D-SNP) HAP Caresource T1 Yes $0 MI
PruittHealth Premier D-SNP (HMO D-SNP) Pruitthealth Premier, Inc. T1 Yes $0 GA
Simpra Advantage Dual Care (PPO D-SNP) Simpra Advantage, Inc. T1 Yes $0 AL
CareAdvantage (HMO D-SNP) SAN Mateo Health Commission T1 Yes $0 CA
Gold Coast Health Plan Total Care Advantage (HMO D-SNP) Ventura County Medi-Cal Managed Care Commission T1 Yes $0 CA
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) Health Care Service Corporation T1 Yes $0 NM
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) Health Care Service Corporation T1 Yes $0 NM
Horizon NJ TotalCare (HMO D-SNP) Horizon Healthcare OF NEW Jersey, Inc. T1 Yes $0 NJ
SecureBlue (HMO D-SNP) HMO Minnesota T1 Yes $0 MN
NaviCare (HMO D-SNP) Fallon Community Health Plan T1 Yes $0 MA
Hamaspik Medicare Choice (HMO D-SNP) Hamaspik, Inc. T1 Yes $0 NY
SeniorCare Complete (HMO D-SNP) South Country Health Alliance T1 Yes $0 MN
AbilityCare (HMO D-SNP) South Country Health Alliance T1 Yes $0 MN
Alameda Alliance Wellness (HMO D-SNP) Alameda Alliance FOR Health T1 Yes $0 CA
CCA One Care (HMO D-SNP) Commonwealth Care Alliance, Inc. T1 Yes $0 MA
CCA Senior Care Options (HMO D-SNP) Commonwealth Care Alliance, Inc. T1 Yes $0 MA
Provider Partners Pennsylvania Community Plan (HMO I-SNP) Provider Partners Health Plan OF Pennsylvania, Inc T1 Yes $0 PA
Provider Partners North Carolina Community Plan (HMO I-SNP) Provider Partners Health Plan OF North Carolina T1 Yes $0 NC
Provider Partners Indiana Community Plan (HMO I-SNP) Provider Partners Health Plan OF Indiana T1 Yes $0 IN
Provider Partners Missouri Community Plan (HMO I-SNP) Provider Partners Health Plan OF Missouri, Inc. T1 Yes $0 MO
Community Care's Partnership Program (HMO D-SNP) Community Care Health Plan, Inc. T1 No $0 WI
CalOptima Health OneCare Complete (HMO D-SNP) Orange County Health Authority T1 Yes $0 CA
Mass General Brigham SCO (HMO D-SNP) Mass General Brigham Health Plan, Inc T1 Yes $0 MA
Mass General Brigham One Care (HMO D-SNP) Mass General Brigham Health Plan, Inc T1 Yes $0 MA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) Gateway Health Plan, Inc. T1 Yes $0 PA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) Gateway Health Plan, Inc. T1 Yes $0 PA
Highmark Health Options Duals (HMO D-SNP) Highmark Health Options West Virginia Inc. T1 Yes $0 WV
Highmark Health Options Duals (HMO D-SNP) Highmark Bcbsd, Inc. T1 Yes $0 DE
Tufts Health One Care (HMO D-SNP) Tufts Health Public Plans, Inc. T1 Yes $0 MA
Tufts Health One Care CW (HMO D-SNP) Tufts Health Public Plans, Inc. T1 Yes $0 MA

Showing top 50 of 100 plans.

Frequently Asked Questions

Is ambrisentan 10 MG Oral Tablet covered by Medicare Part D?

Yes, ambrisentan 10 MG Oral Tablet is covered by 4,903 Medicare Part D plans (97.1% of all Part D formularies).

What tier is ambrisentan 10 MG Oral Tablet on Medicare Part D plans?

ambrisentan 10 MG Oral Tablet averages Tier 4.1 across Part D plans, ranging from Tier 1 to Tier 6.

Does ambrisentan 10 MG Oral Tablet require prior authorization?

98.9% of Part D formularies require prior authorization for ambrisentan 10 MG Oral Tablet. Step therapy: 0%. Quantity limits: 90.7%.

How much does Medicare spend on ambrisentan 10 MG Oral Tablet?

In 2023, total Medicare Part D spending on ambrisentan 10 MG Oral Tablet was $246,059,319, covering 6,456 beneficiaries. The average spend per beneficiary was $38,113.28.

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.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare