Medicare Part D coverage · brimonidine tartrate · RxCUI 861204

brimonidine tartrate 1 MG/ML Ophthalmic Solution

Per the CMS 2026 Part D formulary file, brimonidine tartrate 1 MG/ML Ophthalmic Solution is covered by 2,204 Medicare Part D plans (43.6% of enrollable products), averaging Tier 2.4, with prior authorization required on 0% of covering formularies.

43.6%
Plan coverage
2,204
Plans covering
T2.4
Avg tier
0%
Prior auth required

Verify with CMS →

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.

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 211 distinct formulary files spanning 2,204 Medicare Part D plan offerings - 43.6% 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 2.4.

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
211
Plans covering
2,204
Coverage rate
43.6%
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
Show the next 30 plans
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 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
Platino Blindao (HMO D-SNP) Triple S Advantage, Inc. T1 No $0 PR

Showing top 50 of 100 plans.

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 2,204 Medicare Part D plans (43.6% 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 2.4 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.

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.

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