brimonidine 0.0033 MG/MG Topical Gel

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brimonidine

RxCUI: 1437707

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.
0.7%
Plan Coverage
36
Plans Covering
T3.5
Avg Tier
50%
Prior Auth Required

What the CMS Formulary Data Shows for brimonidine 0.0033 MG/MG Topical Gel

Per the CMS 2026 Part D formulary file, brimonidine 0.0033 MG/MG Topical Gel (RxNorm concept RXCUI 1437707, generic name brimonidine) appears on 6 distinct formulary files spanning 36 Medicare Part D plan offerings - 0.7% 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 3.5.

Real-world access to brimonidine 0.0033 MG/MG Topical Gel depends on utilization management as much as tier placement: 50% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 573,214 Part D beneficiaries filled brimonidine 0.0033 MG/MG Topical Gel 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 0.0033 MG/MG Topical Gel today.

Coverage Details

Formularies covering
6
Plans covering
36
Coverage rate
0.7%
Tier range
Tier 1 – Tier 4
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
50% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

2023 Medicare Spending

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

Tier Distribution Across Plans

12 plans
Tier 1, Preferred Generic
24 plans
Tier 4, Non-Preferred

Medicare Advantage Plans (MA-PD) Covering brimonidine 0.0033 MG/MG Topical Gel

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

Plan Insurer Tier PA Premium States
HAP Medicare Explore (PPO) ALLIANCE HEALTH AND LIFE INSURANCE COMPANY T1 Yes $0 MI
HAP Medicare Prime (PPO) ALLIANCE HEALTH AND LIFE INSURANCE COMPANY T1 Yes $0 MI
HAP Medicare Connect (HMO) HEALTH ALLIANCE PLAN OF MICHIGAN T1 Yes $0 MI
HAP Medicare Complete Duals (HMO D-SNP) HEALTH ALLIANCE PLAN OF MICHIGAN T1 Yes $0 MI
HAP Medicare Superior (HMO) HEALTH ALLIANCE PLAN OF MICHIGAN T1 Yes $0 MI
Henry Ford Select (HMO) HEALTH ALLIANCE PLAN OF MICHIGAN T1 Yes $0 MI
HAP Member Assist (PPO) ALLIANCE HEALTH AND LIFE INSURANCE COMPANY T1 Yes $8.80 MI
HAP Medicare Complete Assist (PPO D-SNP) ALLIANCE HEALTH AND LIFE INSURANCE COMPANY T1 Yes $8.80 MI
HAP Medicare Diabetes and Heart (HMO C-SNP) HEALTH ALLIANCE PLAN OF MICHIGAN T1 Yes $8.80 MI
HAP Senior Plus Henry Ford Tiered Access (HMO) HEALTH ALLIANCE PLAN OF MICHIGAN T1 Yes $11.30 MI
HAP Senior Plus (HMO-POS) HEALTH ALLIANCE PLAN OF MICHIGAN T1 Yes $13.50 MI
HAP Senior Plus (PPO) ALLIANCE HEALTH AND LIFE INSURANCE COMPANY T1 Yes $42.60 MI
Network Health Select (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 Yes $0 WI
Network Health Go (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 Yes $0 WI
Network Health Anywhere (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 Yes $0 WI
Network Health Choice (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 Yes $0 WI
Network Health Zero (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 Yes $0 WI
PacificSource Medicare Essentials Rx 27 (HMO) PACIFICSOURCE COMMUNITY HEALTH PLANS T4 No $0 OR
PacificSource Medicare MyCare Choice Rx 29 (HMO-POS) PACIFICSOURCE COMMUNITY HEALTH PLANS T4 No $0 MT
PacificSource Medicare Essentials Choice Rx 36 (HMO-POS) PACIFICSOURCE COMMUNITY HEALTH PLANS T4 No $0 OR
PacificSource Medicare MyCare Rx 40 (HMO) PACIFICSOURCE COMMUNITY HEALTH PLANS T4 No $0 OR
PacificSource Dual Care (HMO D-SNP) PACIFICSOURCE COMMUNITY HEALTH PLANS T4 No $0 OR
PacificSource Dual Care Alliance (HMO D-SNP) PACIFICSOURCE COMMUNITY HEALTH PLANS T4 No $0 OR
Samaritan Dual Advantage (HMO D-SNP) SAMARITAN HEALTH PLANS, INC. T4 Yes $10.50 OR
PacificSource Medicare MyCare Choice Rx 34 (HMO-POS) PACIFICSOURCE COMMUNITY HEALTH PLANS T4 No $19.00 ID
Network Health Cares (PPO D-SNP) NETWORK HEALTH INSURANCE CORPORATION T4 Yes $21.10 WI
PacificSource Medicare Essentials Choice Rx 14 (HMO-POS) PACIFICSOURCE COMMUNITY HEALTH PLANS T4 No $29.10 OR
Network Health PlusRx (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 Yes $38.60 WI
Independent Health's Assure Advantage (HMO C-SNP) INDEPENDENT HEALTH ASSOCIATION, INC. T4 No $46.50 NY
PacificSource Medicare MyCare Choice Rx 24 (HMO-POS) PACIFICSOURCE COMMUNITY HEALTH PLANS T4 No $52.00 ID
Independent Health's Medicare Family Choice (HMO I-SNP) INDEPENDENT HEALTH ASSOCIATION, INC. T4 No $58.80 NY
PacificSource Medicare Essentials Rx 41 (HMO) PACIFICSOURCE COMMUNITY HEALTH PLANS T4 No $69.30 OR
PacificSource Medicare Explorer Rx 4 (PPO) PACIFICSOURCE COMMUNITY HEALTH PLANS T4 No $88.70 OR
Network Health PremierRx (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 Yes $92.80 WI
PacificSource Medicare Essentials Rx 6 (HMO) PACIFICSOURCE COMMUNITY HEALTH PLANS T4 No $105.90 OR
Independent Health's Encompass 65 RED 043 (HMO) INDEPENDENT HEALTH ASSOCIATION, INC. T4 No $190.00 NY

Frequently Asked Questions

Is brimonidine 0.0033 MG/MG Topical Gel covered by Medicare Part D?

Yes, brimonidine 0.0033 MG/MG Topical Gel is covered by 36 Medicare Part D plans (0.7% of all Part D formularies).

What tier is brimonidine 0.0033 MG/MG Topical Gel on Medicare Part D plans?

brimonidine 0.0033 MG/MG Topical Gel averages Tier 3.5 across Part D plans, ranging from Tier 1 to Tier 4.

Does brimonidine 0.0033 MG/MG Topical Gel require prior authorization?

50% of Part D formularies require prior authorization for brimonidine 0.0033 MG/MG Topical Gel. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on brimonidine 0.0033 MG/MG Topical Gel?

In 2023, total Medicare Part D spending on brimonidine 0.0033 MG/MG Topical Gel 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