Medicare Part D coverage · bempedoic acid · RxCUI 2283236
bempedoic acid 180 MG / ezetimibe 10 MG Oral Tablet [Nexlizet]
Per the CMS 2026 Part D formulary file, bempedoic acid 180 MG / ezetimibe 10 MG Oral Tablet [Nexlizet] is covered by 4,265 Medicare Part D plans (84.4% of enrollable products), averaging Tier 2.7, with prior authorization required on 56% of covering formularies.
- 84.4%
- Plan coverage
- 4,265
- Plans covering
- T2.7
- Avg tier
- 56%
- Prior auth required
What the CMS Formulary Data Shows for bempedoic acid 180 MG / ezetimibe 10 MG Oral Tablet [Nexlizet]
Per the CMS 2026 Part D formulary file, bempedoic acid 180 MG / ezetimibe 10 MG Oral Tablet [Nexlizet] (RxNorm concept RXCUI 2283236, generic name bempedoic acid) appears on 257 distinct formulary files spanning 4,265 Medicare Part D plan offerings - 84.4% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.7.
Real-world access to bempedoic acid 180 MG / ezetimibe 10 MG Oral Tablet [Nexlizet] depends on utilization management as much as tier placement: 56% of covering formularies require prior authorization. 20.6% require step therapy. 86.8% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 18,619 Part D beneficiaries filled bempedoic acid 180 MG / ezetimibe 10 MG Oral Tablet [Nexlizet] in 2023, with total plan-and-beneficiary spending of $45,523,814 and an average per-beneficiary annual cost of $2,445.02. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry bempedoic acid 180 MG / ezetimibe 10 MG Oral Tablet [Nexlizet] today.
Coverage Details
- Formularies covering
- 257
- Plans covering
- 4,265
- Coverage rate
- 84.4%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 56% of formularies
- Step therapy required
- 20.6% of formularies
- Quantity limits
- 86.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 18,619
- Total spending
- $45,523,814
- Avg per beneficiary
- $2,445.02
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering bempedoic acid 180 MG / ezetimibe 10 MG Oral Tablet [Nexlizet]
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 | No | $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 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | No | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | No | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | No | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | No | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | No | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | No | $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 | No | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $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 |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | Yes | $0 | MA |
| 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 | No | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | No | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | No | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | No | $0 | NY |
| 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 |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | No | $0 | AR |
| 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 |
| 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 |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | Yes | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | Yes | $0 | MA |
| Florida Complete Care (HMO I-SNP) | Hpmp OF Florida, Inc. | T1 | No | $4.80 | FL |
| Florida Complete Care- In The Community (HMO-POS I-SNP) | Hpmp OF Florida, Inc. | T1 | No | $4.80 | FL |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | Yes | $4.80 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is bempedoic acid 180 MG / ezetimibe 10 MG Oral Tablet [Nexlizet] covered by Medicare Part D?
Yes, bempedoic acid 180 MG / ezetimibe 10 MG Oral Tablet [Nexlizet] is covered by 4,265 Medicare Part D plans (84.4% of all Part D formularies).
What tier is bempedoic acid 180 MG / ezetimibe 10 MG Oral Tablet [Nexlizet] on Medicare Part D plans?
bempedoic acid 180 MG / ezetimibe 10 MG Oral Tablet [Nexlizet] averages Tier 2.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does bempedoic acid 180 MG / ezetimibe 10 MG Oral Tablet [Nexlizet] require prior authorization?
56% of Part D formularies require prior authorization for bempedoic acid 180 MG / ezetimibe 10 MG Oral Tablet [Nexlizet]. Step therapy: 20.6%. Quantity limits: 86.8%.
How much does Medicare spend on bempedoic acid 180 MG / ezetimibe 10 MG Oral Tablet [Nexlizet]?
In 2023, total Medicare Part D spending on bempedoic acid 180 MG / ezetimibe 10 MG Oral Tablet [Nexlizet] was $45,523,814, covering 18,619 beneficiaries. The average spend per beneficiary was $2,445.02.
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
- 3 ML insulin aspart, human 100 UNT/ML Cartridge [NovoLog] T2.7
- aliskiren 150 MG Oral Tablet T2.7
- cyclosporine, modified 100 MG Oral Capsule T2.7
- Niacinamide insulin aspart, human 100 UNT/ML Injectable Solution [Fiasp] T2.7
- tazarotene 1 MG/ML Topical Cream T2.7
- tenofovir disoproxil fumarate 300 MG Oral Tablet T2.7
Similar prior-authorization rate
- methyltestosterone 10 MG Oral Capsule 56.1% PA
- eluxadoline 75 MG Oral Tablet [Viberzi] 55.9% PA
- lidocaine 25 MG/ML / prilocaine 25 MG/ML Topical Cream 56.4% PA
- promethazine hydrochloride 1.25 MG/ML Oral Solution 56.4% PA
- {21 (memantine hydrochloride 10 MG Oral Tablet) / 28 (memantine hydrochloride 5 MG Oral Tablet) } Pack 56.5% PA
- hydroxyzine hydrochloride 25 MG Oral Tablet 56.7% PA