Medicare Part D coverage · bepotastine besilate · RxCUI 863038
bepotastine besilate 15 MG/ML Ophthalmic Solution
Per the CMS 2026 Part D formulary file, bepotastine besilate 15 MG/ML Ophthalmic Solution is covered by 878 Medicare Part D plans (17.4% of enrollable products), averaging Tier 2.8, with prior authorization required on 0% of covering formularies.
- 17.4%
- Plan coverage
- 878
- Plans covering
- T2.8
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for bepotastine besilate 15 MG/ML Ophthalmic Solution
Per the CMS 2026 Part D formulary file, bepotastine besilate 15 MG/ML Ophthalmic Solution (RxNorm concept RXCUI 863038, generic name bepotastine besilate) appears on 23 distinct formulary files spanning 878 Medicare Part D plan offerings - 17.4% 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 2.8.
Real-world access to bepotastine besilate 15 MG/ML Ophthalmic Solution depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 30.4% require step therapy. 13% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 19,677 Part D beneficiaries filled bepotastine besilate 15 MG/ML Ophthalmic Solution in 2023, with total plan-and-beneficiary spending of $14,858,515 and an average per-beneficiary annual cost of $755.12. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry bepotastine besilate 15 MG/ML Ophthalmic Solution today.
Coverage Details
- Formularies covering
- 23
- Plans covering
- 878
- Coverage rate
- 17.4%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 30.4% of formularies
- Quantity limits
- 13% of formularies
2023 Medicare Spending
- Beneficiaries
- 19,677
- Total spending
- $14,858,515
- Avg per beneficiary
- $755.12
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering bepotastine besilate 15 MG/ML Ophthalmic Solution
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T4 | No | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T4 | No | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering bepotastine besilate 15 MG/ML Ophthalmic Solution
98 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| PHP (HMO C-snp) | Aids Healthcare Foundation | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | No | $0 | NY |
| 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 |
| Leon MediExtra (HMO) | Leon Health, Inc. | T1 | No | $0 | FL |
| Leon MediDual (HMO D-SNP) | Leon Health, Inc. | T1 | No | $0 | FL |
| Leon MediMore (HMO) | Leon Health, Inc. | T1 | No | $0 | FL |
| Leon MediMax (HMO D-SNP) | Leon Health, Inc. | T1 | No | $0 | FL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | No | $4.80 | FL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | No | $17.00 | AZ |
| VNS Health EasyCare Plus (HMO D-SNP) | VNS Choice | T1 | No | $51.60 | NY |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T2 | No | $0 | MS |
| Gold Heart & Diabetes (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T2 | No | $0 | FL |
| Gold Heart & Diabetes Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T2 | No | $0 | FL |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T2 | No | $0 | FL |
| Gold Health (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T2 | No | $0 | FL |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T2 | No | $0 | FL |
| Gold Heart & Diabetes (HMO-POS C-SNP) | Gold Kidney OF Arizona | T2 | No | $0 | AZ |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | Gold Kidney OF Arizona | T2 | No | $0 | AZ |
| Gold Heart & Diabetes (HMO-POS C-SNP) | Gold Kidney OF Arizona | T2 | No | $0 | AZ |
Show the next 30 plans
| Gold Dialysis & Kidney (HMO-POS C-SNP) | Gold Kidney OF Arizona | T2 | No | $0 | AZ |
| MMM Supremo (HMO C-SNP) | MMM Healthcare, LLC | T2 | No | $0 | PR |
| MMM Diamante Platino (HMO D-SNP) | MMM Healthcare, LLC | T2 | No | $0 | PR |
| MMM Unico (HMO-POS) | MMM Healthcare, LLC | T2 | No | $0 | PR |
| MMM Elite (HMO-POS) | MMM Healthcare, LLC | T2 | No | $0 | PR |
| MMM Deluxe (HMO-POS) | MMM Healthcare, LLC | T2 | No | $0 | PR |
| MMM Dorado Platino (HMO D-SNP) | MMM Healthcare, LLC | T2 | No | $0 | PR |
| PMC Premier Platino (HMO D-SNP) | MMM Healthcare, LLC | T2 | No | $0 | PR |
| PMC Max (HMO-POS) | MMM Healthcare, LLC | T2 | No | $0 | PR |
| MMM Plenitud (HMO-POS) | MMM Healthcare, LLC | T2 | No | $0 | PR |
| MMM Valioso (HMO-POS) | MMM Healthcare, LLC | T2 | No | $0 | PR |
| MMM Combo Platino (HMO D-SNP) | MMM Healthcare, LLC | T2 | No | $0 | PR |
| MMM Flexi Platino (HMO D-SNP) | MMM Healthcare, LLC | T2 | No | $0 | PR |
| MMM Grandioso (HMO-POS) | MMM Healthcare, LLC | T2 | No | $0 | PR |
| MMM Mega Flex (HMO-POS) | MMM Healthcare, LLC | T2 | No | $0 | PR |
| MMM Relax Platino (HMO D-SNP) | MMM Healthcare, LLC | T2 | No | $0 | PR |
| MMM Balance (HMO-POS) | MMM Healthcare, LLC | T2 | No | $0 | PR |
| PacificSource Medicare Essentials Rx 27 (HMO) | Pacificsource Community Health Plans | T2 | No | $0 | OR |
| PacificSource Medicare MyCare Choice Rx 29 (HMO-POS) | Pacificsource Community Health Plans | T2 | No | $0 | MT |
| PacificSource Medicare Essentials Choice Rx 36 (HMO-POS) | Pacificsource Community Health Plans | T2 | No | $0 | OR |
| PacificSource Medicare MyCare Rx 40 (HMO) | Pacificsource Community Health Plans | T2 | No | $0 | OR |
| PacificSource Dual Care (HMO D-SNP) | Pacificsource Community Health Plans | T2 | No | $0 | OR |
| PacificSource Medicare MyCare Choice Rx 34 (HMO-POS) | Pacificsource Community Health Plans | T2 | No | $19.00 | ID |
| PacificSource Medicare Essentials Choice Rx 14 (HMO-POS) | Pacificsource Community Health Plans | T2 | No | $29.10 | OR |
| PacificSource Medicare MyCare Choice Rx 24 (HMO-POS) | Pacificsource Community Health Plans | T2 | No | $52.00 | ID |
| PacificSource Medicare Essentials Rx 41 (HMO) | Pacificsource Community Health Plans | T2 | No | $69.30 | OR |
| PacificSource Medicare Explorer Rx 4 (PPO) | Pacificsource Community Health Plans | T2 | No | $88.70 | OR |
| PacificSource Medicare Essentials Rx 6 (HMO) | Pacificsource Community Health Plans | T2 | No | $105.90 | OR |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T3 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T3 | No | $0 | NV |
Showing top 50 of 98 plans.
Frequently Asked Questions
Is bepotastine besilate 15 MG/ML Ophthalmic Solution covered by Medicare Part D?
Yes, bepotastine besilate 15 MG/ML Ophthalmic Solution is covered by 878 Medicare Part D plans (17.4% of all Part D formularies).
What tier is bepotastine besilate 15 MG/ML Ophthalmic Solution on Medicare Part D plans?
bepotastine besilate 15 MG/ML Ophthalmic Solution averages Tier 2.8 across Part D plans, ranging from Tier 1 to Tier 4.
Does bepotastine besilate 15 MG/ML Ophthalmic Solution require prior authorization?
0% of Part D formularies require prior authorization for bepotastine besilate 15 MG/ML Ophthalmic Solution. Step therapy: 30.4%. Quantity limits: 13%.
How much does Medicare spend on bepotastine besilate 15 MG/ML Ophthalmic Solution?
In 2023, total Medicare Part D spending on bepotastine besilate 15 MG/ML Ophthalmic Solution was $14,858,515, covering 19,677 beneficiaries. The average spend per beneficiary was $755.12.
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
Similar prior-authorization rate
- metronidazole 10 MG/ML Topical Cream [Noritate] 0% PA
- 24 HR minocycline 40 MG Extended Release Oral Capsule [Emrosi] 0% PA
- buspirone hydrochloride 10 MG Oral Capsule [Bucapsol] 0% PA
- diflunisal 375 MG Oral Tablet [Dolobid] 0% PA
- hydrocortisone 1 MG/ML Oral Solution [Khindivi] 0% PA
- indomethacin 50 MG Rectal Suppository [Indocin] 0% PA