betaxolol 2.5 MG/ML Ophthalmic Suspension [Betoptic S]

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betaxolol

RxCUI: 213729

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.
8.1%
Plan Coverage
410
Plans Covering
T3.2
Avg Tier
2.8%
Prior Auth Required

What the CMS Formulary Data Shows for betaxolol 2.5 MG/ML Ophthalmic Suspension [Betoptic S]

Per the CMS 2026 Part D formulary file, betaxolol 2.5 MG/ML Ophthalmic Suspension [Betoptic S] (RxNorm concept RXCUI 213729, generic name betaxolol) appears on 36 distinct formulary files spanning 410 Medicare Part D plan offerings - 8.1% 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 3.2.

Real-world access to betaxolol 2.5 MG/ML Ophthalmic Suspension [Betoptic S] depends on utilization management as much as tier placement: 2.8% of covering formularies require prior authorization. 2.8% require step therapy. 0% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 7,458 Part D beneficiaries filled betaxolol 2.5 MG/ML Ophthalmic Suspension [Betoptic S] in 2023, with total plan-and-beneficiary spending of $2,066,789 and an average per-beneficiary annual cost of $277.12. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry betaxolol 2.5 MG/ML Ophthalmic Suspension [Betoptic S] today.

Coverage Details

Formularies covering
36
Plans covering
410
Coverage rate
8.1%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
2.8% of formularies
Step therapy required
2.8% of formularies
Quantity limits
0% of formularies

2023 Medicare Spending

Beneficiaries
7,458
Total spending
$2,066,789
Avg per beneficiary
$277.12

Tier Distribution Across Plans

17 plans
Tier 1, Preferred Generic
2 plans
Tier 2, Generic
9 plans
Tier 3, Preferred Brand
72 plans
Tier 4, Non-Preferred

Standalone Drug Plans (PDP) Covering betaxolol 2.5 MG/ML Ophthalmic Suspension [Betoptic S]

2 standalone prescription drug plans include this drug.

Plan Insurer Tier PA ST Premium States
Anthem Full Dual Advantage (PPO D-SNP) ANTHEM HEALTH PLANS, INC. T4 No No $0 CT
Anthem Dual Advantage (PPO D-SNP) ANTHEM HEALTH PLANS, INC. T4 No No $0 CT

Medicare Advantage Plans (MA-PD) Covering betaxolol 2.5 MG/ML Ophthalmic Suspension [Betoptic S]

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

Plan Insurer Tier PA Premium States
Gold Coast Health Plan Total Care Advantage (HMO D-SNP) Ventura County Medi-Cal Managed Care Commission T1 No $0 CA
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) Health Care Service Corporation T1 No $0 NM
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) Health Care Service Corporation T1 No $0 NM
SecureBlue (HMO D-SNP) HMO Minnesota T1 No $0 MN
NaviCare (HMO D-SNP) FALLON COMMUNITY HEALTH PLAN T1 No $0 MA
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 No $0 NY
Community Care's Partnership Program (HMO D-SNP) COMMUNITY CARE HEALTH PLAN, INC. T1 No $0 WI
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 No $0 PA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 No $0 PA
Highmark Health Options Duals (HMO D-SNP) HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. T1 No $0 WV
Highmark Health Options Duals (HMO D-SNP) HIGHMARK BCBSD, INC. T1 No $0 DE
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) HCSC INSURANCE SERVICES COMPANY T1 No $4.80 TX
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) GHS INSURANCE COMPANY T1 No $5.00 OK
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 No $13.10 PA
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 No $17.60 PA
Highmark Health Options Duals Select (HMO D-SNP) HIGHMARK BCBSD, INC. T1 No $31.20 DE
Hamaspik Medicare Select (HMO D-SNP) HAMASPIK, INC. T1 No $34.50 NY
CareAdvantage (HMO D-SNP) SAN MATEO HEALTH COMMISSION T2 No $0 CA
CalOptima Health OneCare Complete (HMO D-SNP) ORANGE COUNTY HEALTH AUTHORITY T2 No $0 CA
Fallon Medicare Plus Orange (HMO) FALLON COMMUNITY HEALTH PLAN T3 No $0 MA
Presbyterian Senior Care Plan 2 with Rx (HMO) PRESBYTERIAN HEALTH PLAN T3 No $0 NM
Presbyterian Dual Plus (HMO D-SNP) PRESBYTERIAN HEALTH PLAN T3 No $0 NM
Presbyterian Senior Care Extra Health Plan with Rx (HMO) PRESBYTERIAN HEALTH PLAN T3 No $0 NM
FHCP Medicare Classic (HMO) FLORIDA BLUE MEDICARE, INC. T3 No $0 FL
FHCP Medicare Rx Plus (HMO-POS) FLORIDA BLUE MEDICARE, INC. T3 No $49.00 FL
Fallon Medicare Plus Green (HMO) FALLON COMMUNITY HEALTH PLAN T3 No $56.40 MA
Presbyterian Senior Care Plan 3 with Rx (HMO) PRESBYTERIAN HEALTH PLAN T3 No $65.80 NM
Fallon Medicare Plus Blue (HMO) FALLON COMMUNITY HEALTH PLAN T3 No $72.10 MA
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 NV
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T4 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 UT
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T4 No $0 NV
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T4 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare Flex (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare Active (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T4 No $0 NV
Select Health Medicare Wellness (HMO) SELECTHEALTH, INC. T4 No $0 NV
Wellpoint Medicare Advantage (HMO-POS) WELLPOINT WEST VIRGINIA , INC. T4 No $0 WV
Anthem Medicare Advantage 3 (HMO-POS) HealthKeepers, Inc. T4 No $0 VA
Anthem Medicare Advantage 3 (HMO-POS) HealthKeepers, Inc. T4 No $0 VA
Anthem Medicare Advantage 3 (HMO-POS) HealthKeepers, Inc. T4 No $0 VA
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TENNESSEE, INC. T4 No $0 TN
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TENNESSEE, INC. T4 No $0 TN
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TENNESSEE, INC. T4 No $0 TN
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TENNESSEE, INC. T4 No $0 TN

Frequently Asked Questions

Is betaxolol 2.5 MG/ML Ophthalmic Suspension [Betoptic S] covered by Medicare Part D?

Yes, betaxolol 2.5 MG/ML Ophthalmic Suspension [Betoptic S] is covered by 410 Medicare Part D plans (8.1% of all Part D formularies).

What tier is betaxolol 2.5 MG/ML Ophthalmic Suspension [Betoptic S] on Medicare Part D plans?

betaxolol 2.5 MG/ML Ophthalmic Suspension [Betoptic S] averages Tier 3.2 across Part D plans, ranging from Tier 1 to Tier 4.

Does betaxolol 2.5 MG/ML Ophthalmic Suspension [Betoptic S] require prior authorization?

2.8% of Part D formularies require prior authorization for betaxolol 2.5 MG/ML Ophthalmic Suspension [Betoptic S]. Step therapy: 2.8%. Quantity limits: 0%.

How much does Medicare spend on betaxolol 2.5 MG/ML Ophthalmic Suspension [Betoptic S]?

In 2023, total Medicare Part D spending on betaxolol 2.5 MG/ML Ophthalmic Suspension [Betoptic S] was $2,066,789, covering 7,458 beneficiaries. The average spend per beneficiary was $277.12.

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