Medicare Part D coverage · betamethasone dipropionate · RxCUI 1716099
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] is covered by 786 Medicare Part D plans (15.6% of enrollable products), averaging Tier 4.2, with prior authorization required on 93.3% of covering formularies.
- 15.6%
- 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 - 15.6% 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
- 15.6%
- 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
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 |
Show the next 30 plans
| 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 |
Showing top 50 of 98 plans.
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 (15.6% 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.
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
- amikacin liposomal 70.3 MG/ML Inhalation Suspension [Arikayce] T4.2
- cannabidiol 100 MG/ML Oral Solution [Epidiolex] T4.2
- fecal microbiota spores, live-brpk 30000000 UNT Oral Capsule [Vowst] T4.2
- fenfluramine 2.2 MG/ML Oral Solution [Fintepla] T4.2
- ganaxolone 50 MG/ML Oral Suspension [Ztalmy] T4.2
- ibrutinib 140 MG Oral Capsule [Imbruvica] T4.2
Similar prior-authorization rate
- vonoprazan 10 MG Oral Tablet [Voquezna] 93.3% PA
- {4 (ozanimod 0.23 MG Oral Capsule [Zeposia]) / 3 (ozanimod 0.46 MG Oral Capsule [Zeposia]) } Pack [Zeposia 7-Day Starter Pack] 93.3% PA
- ozanimod 0.92 MG Oral Capsule [Zeposia] 93.3% PA
- 1 ML tbo-filgrastim 0.3 MG/ML Injection [Granix] 93.3% PA
- {84 (amoxicillin 500 MG Oral Capsule) / 28 (vonoprazan 20 MG Oral Tablet) } Pack [Voquezna 14 Day DualPak 20;500] 93.5% PA
- 2 ML lanadelumab-flyo 150 MG/ML Injection [Takhzyro] 93.5% PA