brimonidine tartrate 1 MG/ML Ophthalmic Solution [Alphagan]

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brimonidine tartrate

RxCUI: 861206

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.
25.1%
Plan Coverage
1,273
Plans Covering
T2.9
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for brimonidine tartrate 1 MG/ML Ophthalmic Solution [Alphagan]

Per the CMS 2026 Part D formulary file, brimonidine tartrate 1 MG/ML Ophthalmic Solution [Alphagan] (RxNorm concept RXCUI 861206, generic name brimonidine tartrate) appears on 30 distinct formulary files spanning 1,273 Medicare Part D plan offerings - 25.1% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 3, with a cross-plan average of Tier 2.9.

Real-world access to brimonidine tartrate 1 MG/ML Ophthalmic Solution [Alphagan] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 6.7% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 573,214 Part D beneficiaries filled brimonidine tartrate 1 MG/ML Ophthalmic Solution [Alphagan] in 2023, with total plan-and-beneficiary spending of $88,900,177 and an average per-beneficiary annual cost of $155.09. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry brimonidine tartrate 1 MG/ML Ophthalmic Solution [Alphagan] today.

Coverage Details

Formularies covering
30
Plans covering
1,273
Coverage rate
25.1%
Tier range
Tier 1 – Tier 3
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
0% of formularies
Step therapy required
0% of formularies
Quantity limits
6.7% of formularies

2023 Medicare Spending

Beneficiaries
573,214
Total spending
$88,900,177
Avg per beneficiary
$155.09

Tier Distribution Across Plans

4 plans
Tier 1, Preferred Generic
96 plans
Tier 3, Preferred Brand

Standalone Drug Plans (PDP) Covering brimonidine tartrate 1 MG/ML Ophthalmic Solution [Alphagan]

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 T3 No No $0 -
AARP Medicare Rx Preferred from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T3 No No $0 -

Medicare Advantage Plans (MA-PD) Covering brimonidine tartrate 1 MG/ML Ophthalmic Solution [Alphagan]

98 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 No $0 VA
Sentara Community Complete (HMO D-SNP) SENTARA HEALTH PLANS T1 No $0 VA
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 No $0 NY
Hamaspik Medicare Select (HMO D-SNP) HAMASPIK, INC. T1 No $34.50 NY
UHC Dual Complete IA-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T3 No $0 IA
UHC Dual Complete MO-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T3 No $0 MO
UHC Dual Complete NE-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T3 No $0 NE
UHC Dual Complete KS-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T3 No $0 KS
UHC Dual Complete MO-S3 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T3 No $0 MO
UHC Dual Complete KS-Q1 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T3 No $0 KS
UHC Dual Complete TN-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. T3 No $0 TN
UHC Dual Complete TN-Y001 (HMO-POS D-SNP) UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. T3 No $0 TN
UHC Dual Complete TN-Y2 (HMO-POS D-SNP) UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. T3 No $0 TN
AARP Medicare Advantage from UHC MI-0001 (PPO) UNITEDHEALTHCARE INSURANCE COMPANY T3 No $0 MI
UHC Dual Complete NM-Y1 (PPO D-SNP) UNITEDHEALTHCARE INSURANCE COMPANY T3 No $0 NM
UHC Dual Complete NM-S1 (PPO D-SNP) UNITEDHEALTHCARE INSURANCE COMPANY T3 No $0 NM
UHC Dual Complete NM-V1 (PPO D-SNP) UNITEDHEALTHCARE INSURANCE COMPANY T3 No $0 NM
UHC Dual Complete AZ-S001 (HMO-POS D-SNP) ARIZONA PHYSICIANS IPA, INC. T3 No $0 AZ
UHC Dual Complete AZ-Y001 (HMO-POS D-SNP) ARIZONA PHYSICIANS IPA, INC. T3 No $0 AZ
UHC Dual Complete VA-Y4 (PPO D-SNP) CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. T3 No $0 VA
AARP Medicare Advantage from UHC AL-0001 (HMO-POS) UNITEDHEALTHCARE OF THE MIDLANDS, INC. T3 No $0 AL
AARP Medicare Advantage from UHC CA-0002 (HMO-POS) UHC OF CALIFORNIA T3 No $0 CA
UHC Sharp Medicare Advantage CA-001P (HMO-POS) UHC OF CALIFORNIA T3 No $0 CA
AARP Medicare Advantage from UHC CA-003P (HMO-POS) UHC OF CALIFORNIA T3 No $0 CA
AARP Medicare Advantage from UHC CA-0012 (HMO-POS) UHC OF CALIFORNIA T3 No $0 CA
AARP Medicare Advantage from UHC CA-004P (HMO-POS) UHC OF CALIFORNIA T3 No $0 CA
AARP Medicare Advantage from UHC CA-005P (HMO-POS) UHC OF CALIFORNIA T3 No $0 CA
AARP Medicare Advantage from UHC CA-006P (HMO-POS) UHC OF CALIFORNIA T3 No $0 CA
AARP Medicare Advantage from UHC CA-10 (HMO-POS) UHC OF CALIFORNIA T3 No $0 CA
UHC Sharp Medicare Advantage ValueRx CA-12P (HMO-POS) UHC OF CALIFORNIA T3 No $0 CA
AARP Medicare Advantage from UHC CA-021P (HMO-POS) UHC OF CALIFORNIA T3 No $0 CA
AARP Medicare Advantage from UHC CA-022P (HMO-POS) UHC OF CALIFORNIA T3 No $0 CA
AARP Medicare Advantage from UHC CA-023P (HMO-POS) UHC OF CALIFORNIA T3 No $0 CA
AARP Medicare Advantage from UHC CA-026P (HMO-POS) UHC OF CALIFORNIA T3 No $0 CA
AARP Medicare Advantage Giveback from UHC CA-19 (HMO-POS) UHC OF CALIFORNIA T3 No $0 CA
AARP Medicare Advantage Giveback from UHC CA-20 (HMO-POS) UHC OF CALIFORNIA T3 No $0 CA
AARP Medicare Advantage Giveback from UHC CA-21 (HMO-POS) UHC OF CALIFORNIA T3 No $0 CA
AARP Medicare Advantage Essentials from UHC CO-2 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T3 No $0 CO
AARP Medicare Advantage Essentials from UHC AZ-1 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T3 No $0 AZ
AARP Medicare Advantage Essentials from UHC AZ-2 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T3 No $0 AZ
AARP Medicare Advantage from UHC AZ-002P (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T3 No $0 AZ
AARP Medicare Advantage from UHC NV-0001 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T3 No $0 NV
AARP Medicare Advantage from UHC NV-0002 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T3 No $0 NV
UHC Medicare Advantage NV-001P (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T3 No $0 NV
AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T3 No $0 CO
AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T3 No $0 NV
AARP Medicare Advantage from UHC NV-0006 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T3 No $0 NV
AARP Medicare Advantage Extras from UHC AZ-4 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T3 No $0 AZ
AARP Medicare Advantage Extras from UHC AZ-5 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T3 No $0 AZ
AARP Medicare Advantage Extras from UHC CO-5 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T3 No $0 CO

Frequently Asked Questions

Is brimonidine tartrate 1 MG/ML Ophthalmic Solution [Alphagan] covered by Medicare Part D?

Yes, brimonidine tartrate 1 MG/ML Ophthalmic Solution [Alphagan] is covered by 1,273 Medicare Part D plans (25.1% of all Part D formularies).

What tier is brimonidine tartrate 1 MG/ML Ophthalmic Solution [Alphagan] on Medicare Part D plans?

brimonidine tartrate 1 MG/ML Ophthalmic Solution [Alphagan] averages Tier 2.9 across Part D plans, ranging from Tier 1 to Tier 3.

Does brimonidine tartrate 1 MG/ML Ophthalmic Solution [Alphagan] require prior authorization?

0% of Part D formularies require prior authorization for brimonidine tartrate 1 MG/ML Ophthalmic Solution [Alphagan]. Step therapy: 0%. Quantity limits: 6.7%.

How much does Medicare spend on brimonidine tartrate 1 MG/ML Ophthalmic Solution [Alphagan]?

In 2023, total Medicare Part D spending on brimonidine tartrate 1 MG/ML Ophthalmic Solution [Alphagan] was $88,900,177, covering 573,214 beneficiaries. The average spend per beneficiary was $155.09.

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