BCG, live, Tice strain 50 MG Injection

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BCG, live, Tice strain

RxCUI: 1653579

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.
100%
Plan Coverage
5,067
Plans Covering
T2.2
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for BCG, live, Tice strain 50 MG Injection

Per the CMS 2026 Part D formulary file, BCG, live, Tice strain 50 MG Injection (RxNorm concept RXCUI 1653579, generic name BCG, live, Tice strain) appears on 330 distinct formulary files spanning 5,067 Medicare Part D plan offerings - 100% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 2.2.

Real-world access to BCG, live, Tice strain 50 MG Injection depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 1.5% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 709 Part D beneficiaries filled BCG, live, Tice strain 50 MG Injection in 2023, with total plan-and-beneficiary spending of $721,870 and an average per-beneficiary annual cost of $1,018.15. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry BCG, live, Tice strain 50 MG Injection today.

Coverage Details

Formularies covering
330
Plans covering
5,067
Coverage rate
100%
Tier range
Tier 1 – Tier 6
Average tier
Tier 2, Generic

Restrictions

Prior authorization required
0% of formularies
Step therapy required
0% of formularies
Quantity limits
1.5% of formularies

2023 Medicare Spending

Beneficiaries
709
Total spending
$721,870
Avg per beneficiary
$1,018.15

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering BCG, live, Tice strain 50 MG Injection

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Aetna Medicare Signature (HMO) AETNA HEALTH OF CALIFORNIA INC. T1 No $0 CA
Aetna Medicare Signature (HMO) AETNA HEALTH OF CALIFORNIA INC. T1 No $0 CA
Aetna Medicare Signature Extra (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T1 No $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T1 No $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T1 No $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T1 No $0 CA
Aetna Medicare Signature Extra (HMO) AETNA HEALTH OF CALIFORNIA INC. T1 No $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T1 No $0 CA
Aetna Medicare Signature Extra (HMO) AETNA HEALTH OF CALIFORNIA INC. T1 No $0 CA
Aetna Medicare Signature Extra (HMO) AETNA HEALTH OF CALIFORNIA INC. T1 No $0 CA
Aetna Medicare Signature Extra (HMO) AETNA HEALTH OF CALIFORNIA INC. T1 No $0 CA
Aetna Medicare Signature Care (HMO-POS) AETNA HEALTH OF OHIO INC. T1 No $0 OH
Aetna Medicare Signature Extra (HMO-POS) AETNA HEALTH OF OHIO INC. T1 No $0 OH
Aetna Medicare Signature Care (HMO-POS) AETNA HEALTH OF OHIO INC. T1 No $0 OH
Aetna Medicare Signature Extra (HMO-POS) AETNA HEALTH OF OHIO INC. T1 No $0 KY
Aetna Medicare Signature (HMO-POS) AETNA HEALTH OF OHIO INC. T1 No $0 KY
Aetna Medicare Signature (HMO-POS) AETNA HEALTH OF OHIO INC. T1 No $0 KY
Aetna Medicare HIDE (HMO D-SNP) AETNA HEALTH OF OHIO INC. T1 No $0 KY
Aetna Medicare Dual Care (HMO D-SNP) AETNA HEALTH OF OHIO INC. T1 No $0 OH
Aetna Medicare Signature Care (HMO-POS) AETNA HEALTH OF OHIO INC. T1 No $0 OH
Aetna Medicare Signature (HMO-POS) AETNA HEALTH OF OHIO INC. T1 No $0 OH
Aetna Medicare Signature (HMO-POS) AETNA HEALTH OF OHIO INC. T1 No $0 KY
Aetna Medicare Partial Dual (HMO D-SNP) AETNA HEALTH OF OHIO INC. T1 No $0 KY
Aetna Medicare Partial Dual (HMO D-SNP) AETNA HEALTH OF OHIO INC. T1 No $0 OH
Aetna Medicare Signature (HMO) AETNA HEALTH INC.(GA) T1 No $0 GA
Aetna Medicare Signature (HMO-POS) COVENTRY HEALTH CARE OF ILLINOIS, INC. T1 No $0 WI
Aetna Medicare Signature (HMO-POS) COVENTRY HEALTH CARE OF ILLINOIS, INC. T1 No $0 IL
Aetna Medicare Prime Chronic Care (HMO C-SNP) COVENTRY HEALTH CARE OF ILLINOIS, INC. T1 No $0 IL
Aetna Medicare Signature Extra (HMO-POS) COVENTRY HEALTH CARE OF ILLINOIS, INC. T1 No $0 IL
Aetna Medicare Signature (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T1 No $0 IA
Aetna Medicare Signature (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T1 No $0 NE
Aetna Medicare Signature (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T1 No $0 KS, MO
Aetna Medicare Signature Extra (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T1 No $0 KS
Aetna Medicare Signature (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T1 No $0 KS, MO
Aetna Medicare Signature Plus (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T1 No $0 AR
Aetna Medicare Signature (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T1 No $0 KS
Aetna Medicare Advantra (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T1 No $0 OH
Aetna Medicare Advantra Signature Giveback (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T1 No $0 WV
Aetna Medicare Elite (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T1 No $0 IA
Aetna Medicare Signature Extra (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T1 No $0 NE
Aetna Medicare Advantra Signature (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T1 No $0 WV
Aetna Medicare Elite (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T1 No $0 IL, MO
Aetna Medicare Signature (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T1 No $0 MO
Aetna Medicare Elite (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T1 No $0 KS, MO
Aetna Medicare Elite (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T1 No $0 AR
Aetna Medicare Dual (PPO D-SNP) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T1 No $0 SD
Aetna Medicare Signature (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T1 No $0 MO
Aetna Medicare Signature (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T1 No $0 KS
Aetna Medicare Signature (PPO) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T1 No $0 KS
Aetna Medicare Dual Extra (PPO D-SNP) COVENTRY HEALTH AND LIFE INSURANCE COMPANY T1 No $0 AR

Frequently Asked Questions

Is BCG, live, Tice strain 50 MG Injection covered by Medicare Part D?

Yes, BCG, live, Tice strain 50 MG Injection is covered by 5,067 Medicare Part D plans (100% of all Part D formularies).

What tier is BCG, live, Tice strain 50 MG Injection on Medicare Part D plans?

BCG, live, Tice strain 50 MG Injection averages Tier 2.2 across Part D plans, ranging from Tier 1 to Tier 6.

Does BCG, live, Tice strain 50 MG Injection require prior authorization?

0% of Part D formularies require prior authorization for BCG, live, Tice strain 50 MG Injection. Step therapy: 0%. Quantity limits: 1.5%.

How much does Medicare spend on BCG, live, Tice strain 50 MG Injection?

In 2023, total Medicare Part D spending on BCG, live, Tice strain 50 MG Injection was $721,870, covering 709 beneficiaries. The average spend per beneficiary was $1,018.15.

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