brimonidine tartrate 1 MG/ML Ophthalmic Solution

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brimonidine tartrate

RxCUI: 861204

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.
43.8%
Plan Coverage
2,219
Plans Covering
T2.5
Avg Tier
0%
Prior Auth Required

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

Per the CMS 2026 Part D formulary file, brimonidine tartrate 1 MG/ML Ophthalmic Solution (RxNorm concept RXCUI 861204, generic name brimonidine tartrate) appears on 213 distinct formulary files spanning 2,219 Medicare Part D plan offerings - 43.8% 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 2.5.

Real-world access to brimonidine tartrate 1 MG/ML Ophthalmic Solution depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0.9% 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 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 today.

Coverage Details

Formularies covering
213
Plans covering
2,219
Coverage rate
43.8%
Tier range
Tier 1 – Tier 4
Average tier
Tier 2, Generic

Restrictions

Prior authorization required
0% of formularies
Step therapy required
0% of formularies
Quantity limits
0.9% of formularies

2023 Medicare Spending

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

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

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

100 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
Wellpoint Medicare Advantage (HMO-POS) WELLPOINT WEST VIRGINIA , INC. T1 No $0 WV
Anthem Medicare Advantage 3 (HMO-POS) HealthKeepers, Inc. T1 No $0 VA
Anthem Medicare Advantage 3 (HMO-POS) HealthKeepers, Inc. T1 No $0 VA
Anthem Medicare Advantage 3 (HMO-POS) HealthKeepers, Inc. T1 No $0 VA
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TENNESSEE, INC. T1 No $0 TN
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TENNESSEE, INC. T1 No $0 TN
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TENNESSEE, INC. T1 No $0 TN
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TENNESSEE, INC. T1 No $0 TN
ElderServe MAP (HMO D-SNP) ELDERSERVE HEALTH, INC. T1 No $0 NY
Cooperative Advantage (HMO D-SNP) GROUP HEALTH COOPERATIVE OF EAU CLAIRE T1 No $0 WI
HAP Medicare Explore (PPO) ALLIANCE HEALTH AND LIFE INSURANCE COMPANY T1 No $0 MI
HAP Medicare Prime (PPO) ALLIANCE HEALTH AND LIFE INSURANCE COMPANY T1 No $0 MI
HAP Medicare Connect (HMO) HEALTH ALLIANCE PLAN OF MICHIGAN T1 No $0 MI
HAP Medicare Complete Duals (HMO D-SNP) HEALTH ALLIANCE PLAN OF MICHIGAN T1 No $0 MI
HAP Medicare Superior (HMO) HEALTH ALLIANCE PLAN OF MICHIGAN T1 No $0 MI
Henry Ford Select (HMO) HEALTH ALLIANCE PLAN OF MICHIGAN T1 No $0 MI
Longevity Health Plan (PPO I-SNP) LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP T1 No $0 NJ
Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) UPPER PENINSULA HEALTH PLAN, LLC T1 No $0 MI
CareSource Dual Advantage (HMO D-SNP) CARESOURCE GEORGIA CO. T1 No $0 GA
HAP CareSource MI Coordinated Health (HMO D-SNP) HAP CARESOURCE T1 No $0 MI
PruittHealth Premier D-SNP (HMO D-SNP) PRUITTHEALTH PREMIER, INC. T1 No $0 GA
Simpra Advantage Dual Care (PPO D-SNP) SIMPRA ADVANTAGE, INC. T1 No $0 AL
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
SeniorCare Complete (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 No $0 MN
AbilityCare (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 No $0 MN
Alameda Alliance Wellness (HMO D-SNP) ALAMEDA ALLIANCE FOR HEALTH T1 No $0 CA
PHP (HMO C-SNP) AIDS HEALTHCARE FOUNDATION T1 No $0 CA
Elevate Medicare Choice (HMO D-SNP) DENVER HEALTH MEDICAL PLAN, INC. T1 No $0 CO
AllCare Advantage Redwood Rx (HMO D-SNP) ALLCARE HEALTH PLAN, INC. T1 No $0 OR
PrimeWest Senior Health Complete (HMO D-SNP) PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE T1 No $0 MN
Prime Health Complete (HMO D-SNP) PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE T1 No $0 MN
DualConnect (HMO D-SNP) SANTA CLARA COUNTY HEALTH AUTHORITY T1 No $0 CA
VNS Health Total (HMO D-SNP) VNS CHOICE T1 No $0 NY
Alterwood Advantage Dual Secure (HMO D-SNP) ALTERWOOD ADVANTAGE, INC. T1 No $0 MD
Nascentia Dual Advantage (HMO D-SNP) VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK T1 No $0 NY
Provider Partners Pennsylvania Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC T1 No $0 PA
Provider Partners North Carolina Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA T1 No $0 NC
Provider Partners Indiana Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF INDIANA T1 No $0 IN
Provider Partners Maryland Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN, INC. T1 No $0 MD
Provider Partners Missouri Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. T1 No $0 MO
Abilis Health Community (HMO I-SNP) SIGNATURE ADVANTAGE, LLC T1 No $0 KY, TN
Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) ARKANSAS SUPERIOR SELECT, INC. T1 No $0 AR
Community Care's Partnership Program (HMO D-SNP) COMMUNITY CARE HEALTH PLAN, INC. T1 No $0 WI

Frequently Asked Questions

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

Yes, brimonidine tartrate 1 MG/ML Ophthalmic Solution is covered by 2,219 Medicare Part D plans (43.8% of all Part D formularies).

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

brimonidine tartrate 1 MG/ML Ophthalmic Solution averages Tier 2.5 across Part D plans, ranging from Tier 1 to Tier 4.

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

0% of Part D formularies require prior authorization for brimonidine tartrate 1 MG/ML Ophthalmic Solution. Step therapy: 0%. Quantity limits: 0.9%.

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

In 2023, total Medicare Part D spending on brimonidine tartrate 1 MG/ML Ophthalmic Solution 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