betamethasone dipropionate 0.643 MG/ML / calcipotriene 0.05 MG/ML Topical Foam [Enstilar]

Verify with CMS →

betamethasone dipropionate

RxCUI: 1716099

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.
15.5%
Plan Coverage
786
Plans Covering
T4.2
Avg Tier
93.3%
Prior Auth Required

What the CMS Formulary Data Shows for betamethasone dipropionate 0.643 MG/ML / calcipotriene 0.05 MG/ML Topical Foam [Enstilar]

Per the CMS 2026 Part D formulary file, betamethasone dipropionate 0.643 MG/ML / calcipotriene 0.05 MG/ML Topical Foam [Enstilar] (RxNorm concept RXCUI 1716099, generic name betamethasone dipropionate) appears on 60 distinct formulary files spanning 786 Medicare Part D plan offerings - 15.5% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.2.

Real-world access to betamethasone dipropionate 0.643 MG/ML / calcipotriene 0.05 MG/ML Topical Foam [Enstilar] depends on utilization management as much as tier placement: 93.3% of covering formularies require prior authorization. 0% require step therapy. 88.3% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 407,711 Part D beneficiaries filled betamethasone dipropionate 0.643 MG/ML / calcipotriene 0.05 MG/ML Topical Foam [Enstilar] in 2023, with total plan-and-beneficiary spending of $42,156,509 and an average per-beneficiary annual cost of $103.40. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry betamethasone dipropionate 0.643 MG/ML / calcipotriene 0.05 MG/ML Topical Foam [Enstilar] today.

Coverage Details

Formularies covering
60
Plans covering
786
Coverage rate
15.5%
Tier range
Tier 1 – Tier 5
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
93.3% of formularies
Step therapy required
0% of formularies
Quantity limits
88.3% of formularies

2023 Medicare Spending

Beneficiaries
407,711
Total spending
$42,156,509
Avg per beneficiary
$103.40

Tier Distribution Across Plans

22 plans
Tier 1, Preferred Generic
2 plans
Tier 4, Non-Preferred
76 plans
Tier 5, Specialty

Standalone Drug Plans (PDP) Covering betamethasone dipropionate 0.643 MG/ML / calcipotriene 0.05 MG/ML Topical Foam [Enstilar]

2 standalone prescription drug plans include this drug.

Plan Insurer Tier PA ST Premium States
Blue MedicareRx Value Plus (PDP) ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT T4 Yes No $20.70 -
BlueMedicare Value Rx (PDP) USABLE MUTUAL INSURANCE COMPANY T4 Yes No $52.50 -

Medicare Advantage Plans (MA-PD) Covering betamethasone dipropionate 0.643 MG/ML / calcipotriene 0.05 MG/ML Topical Foam [Enstilar]

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

Plan Insurer Tier PA Premium States
Florida Complete Care-Duals VIP (HMO-POS D-SNP) HPMP OF FLORIDA, INC. T1 Yes $0 FL
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
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
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
Florida Complete Care (HMO I-SNP) HPMP OF FLORIDA, INC. T1 Yes $4.80 FL
Florida Complete Care- In The Community (HMO-POS I-SNP) HPMP OF FLORIDA, INC. T1 Yes $4.80 FL
Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) ELDERPLAN, INC. T1 Yes $22.70 NY
VIVA Medicare Extra Value (HMO D-SNP) VIVA HEALTH, INC. T1 Yes $27.70 AL
VIVA Medicare Extra Care (HMO D-SNP) VIVA HEALTH, INC. T1 Yes $27.70 AL
Elderplan Advantage For Nursing Home Residents (HMO-POS I-SNP) ELDERPLAN, INC. T1 Yes $44.80 NY
MetroPlus Platinum Plan (HMO) METROPLUS HEALTH PLAN, INC. T1 Yes $58.80 NY
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T5 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T5 No $0 NV
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T5 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T5 No $0 UT
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T5 No $0 NV
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T5 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T5 No $0 CO
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T5 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T5 No $0 CO
Select Health Medicare Flex (HMO) SELECTHEALTH, INC. T5 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T5 No $0 CO
Select Health Medicare Active (HMO) SELECTHEALTH, INC. T5 No $0 CO
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T5 No $0 NV
Select Health Medicare Wellness (HMO) SELECTHEALTH, INC. T5 No $0 NV
Medicare BlueEssential (PPO) EXCELLUS HEALTH PLAN, INC. T5 Yes $0 NY
Medicare BlueActive (PPO) EXCELLUS HEALTH PLAN, INC. T5 Yes $0 NY
Medicare BlueVital (PPO) EXCELLUS HEALTH PLAN, INC. T5 Yes $0 NY
Univera SeniorChoice Basic (HMO) EXCELLUS HEALTH PLAN, INC. T5 Yes $0 NY
Univera SeniorChoice Extra (HMO) EXCELLUS HEALTH PLAN, INC. T5 Yes $0 NY
Medicare Blue Choice Core (HMO) EXCELLUS HEALTH PLAN, INC. T5 Yes $0 NY
Univera Medicare Dual (HMO D-SNP) EXCELLUS HEALTH PLAN COMMUNITY CARE LLC T5 Yes $0 NY
Medicare Blue Dual (HMO D-SNP) EXCELLUS HEALTH PLAN COMMUNITY CARE LLC T5 Yes $0 NY
Sharp Direct Advantage Gold (HMO) SHARP HEALTH PLAN T5 Yes $0 CA
Sharp Direct Advantage VIP (HMO) SHARP HEALTH PLAN T5 Yes $0 CA
Sharp Direct Advantage VIP Plus (HMO) SHARP HEALTH PLAN T5 Yes $0 CA
Blue Medicare Advantage PPO (PPO) WELLMARK ADVANTAGE HEALTH PLAN, INC. T5 Yes $0 IA
BlueMedicare Premier (HMO) USABLE HMO, INC. T5 Yes $0 AR
BlueMedicare Classic Plus (HMO) USABLE HMO, INC. T5 Yes $0 AR

Frequently Asked Questions

Is betamethasone dipropionate 0.643 MG/ML / calcipotriene 0.05 MG/ML Topical Foam [Enstilar] covered by Medicare Part D?

Yes, betamethasone dipropionate 0.643 MG/ML / calcipotriene 0.05 MG/ML Topical Foam [Enstilar] is covered by 786 Medicare Part D plans (15.5% of all Part D formularies).

What tier is betamethasone dipropionate 0.643 MG/ML / calcipotriene 0.05 MG/ML Topical Foam [Enstilar] on Medicare Part D plans?

betamethasone dipropionate 0.643 MG/ML / calcipotriene 0.05 MG/ML Topical Foam [Enstilar] averages Tier 4.2 across Part D plans, ranging from Tier 1 to Tier 5.

Does betamethasone dipropionate 0.643 MG/ML / calcipotriene 0.05 MG/ML Topical Foam [Enstilar] require prior authorization?

93.3% of Part D formularies require prior authorization for betamethasone dipropionate 0.643 MG/ML / calcipotriene 0.05 MG/ML Topical Foam [Enstilar]. Step therapy: 0%. Quantity limits: 88.3%.

How much does Medicare spend on betamethasone dipropionate 0.643 MG/ML / calcipotriene 0.05 MG/ML Topical Foam [Enstilar]?

In 2023, total Medicare Part D spending on betamethasone dipropionate 0.643 MG/ML / calcipotriene 0.05 MG/ML Topical Foam [Enstilar] was $42,156,509, covering 407,711 beneficiaries. The average spend per beneficiary was $103.40.

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