Medicare Part D coverage · bromfenac · RxCUI 578018
bromfenac 0.9 MG/ML Ophthalmic Solution
Per the CMS 2026 Part D formulary file, bromfenac 0.9 MG/ML Ophthalmic Solution is covered by 1,934 Medicare Part D plans (38.3% of enrollable products), averaging Tier 2.8, with prior authorization required on 0% of covering formularies.
- 38.3%
- Plan coverage
- 1,934
- Plans covering
- T2.8
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for bromfenac 0.9 MG/ML Ophthalmic Solution
Per the CMS 2026 Part D formulary file, bromfenac 0.9 MG/ML Ophthalmic Solution (RxNorm concept RXCUI 578018, generic name bromfenac) appears on 103 distinct formulary files spanning 1,934 Medicare Part D plan offerings - 38.3% 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 2.8.
Real-world access to bromfenac 0.9 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% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 144,112 Part D beneficiaries filled bromfenac 0.9 MG/ML Ophthalmic Solution in 2023, with total plan-and-beneficiary spending of $94,508,695 and an average per-beneficiary annual cost of $655.80. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry bromfenac 0.9 MG/ML Ophthalmic Solution today.
Coverage Details
- Formularies covering
- 103
- Plans covering
- 1,934
- Coverage rate
- 38.3%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 144,112
- Total spending
- $94,508,695
- Avg per beneficiary
- $655.80
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering bromfenac 0.9 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 |
| 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 |
| 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 |
| 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 |
| PHP (HMO C-snp) | Aids Healthcare Foundation | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | No | $0 | NY |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | No | $0 | CA |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
Show the next 30 plans
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Leon MediExtra (HMO) | Leon Health, Inc. | T1 | No | $0 | FL |
| Leon MediDual (HMO D-SNP) | Leon Health, Inc. | T1 | No | $0 | FL |
| Leon MediMore (HMO) | Leon Health, Inc. | T1 | No | $0 | FL |
| Leon MediMax (HMO D-SNP) | Leon Health, Inc. | T1 | No | $0 | FL |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | No | $4.80 | FL |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Hcsc Insurance Services Company | T1 | No | $4.80 | TX |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | No | $4.80 | FL |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS Insurance Company | T1 | No | $5.00 | OK |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Michigan, Inc. | T1 | No | $8.80 | MI |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Illinois, Inc. | T1 | No | $15.20 | IL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | No | $17.00 | AZ |
| WellSense Added Value (HMO) | Boston Medical Center Health Plan, Inc. | T1 | No | $21.70 | NH |
| Hamaspik Medicare Select (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $34.50 | NY |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Colorado, Inc. | T1 | No | $35.20 | CO |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF North Carolina, Inc. | T1 | No | $36.20 | NC |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | No | $40.00 | NJ |
| VNS Health EasyCare Plus (HMO D-SNP) | VNS Choice | T1 | No | $51.60 | NY |
| ElderServe Star (HMO I-SNP) | Elderserve Health, Inc. | T1 | No | $58.80 | NY |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF NEW York, Inc. | T1 | No | $58.80 | NY |
| Medicare BlueEssential (PPO) | Excellus Health Plan, Inc. | T2 | No | $0 | NY |
| Medicare BlueActive (PPO) | Excellus Health Plan, Inc. | T2 | No | $0 | NY |
| Medicare BlueVital (PPO) | Excellus Health Plan, Inc. | T2 | No | $0 | NY |
| Univera SeniorChoice Basic (HMO) | Excellus Health Plan, Inc. | T2 | No | $0 | NY |
| Univera SeniorChoice Extra (HMO) | Excellus Health Plan, Inc. | T2 | No | $0 | NY |
| Medicare Blue Choice Core (HMO) | Excellus Health Plan, Inc. | T2 | No | $0 | NY |
| Univera Medicare Dual (HMO D-SNP) | Excellus Health Plan Community Care LLC | T2 | No | $0 | NY |
| Medicare Blue Dual (HMO D-SNP) | Excellus Health Plan Community Care LLC | T2 | No | $0 | NY |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is bromfenac 0.9 MG/ML Ophthalmic Solution covered by Medicare Part D?
Yes, bromfenac 0.9 MG/ML Ophthalmic Solution is covered by 1,934 Medicare Part D plans (38.3% of all Part D formularies).
What tier is bromfenac 0.9 MG/ML Ophthalmic Solution on Medicare Part D plans?
bromfenac 0.9 MG/ML Ophthalmic Solution averages Tier 2.8 across Part D plans, ranging from Tier 1 to Tier 4.
Does bromfenac 0.9 MG/ML Ophthalmic Solution require prior authorization?
0% of Part D formularies require prior authorization for bromfenac 0.9 MG/ML Ophthalmic Solution. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on bromfenac 0.9 MG/ML Ophthalmic Solution?
In 2023, total Medicare Part D spending on bromfenac 0.9 MG/ML Ophthalmic Solution was $94,508,695, covering 144,112 beneficiaries. The average spend per beneficiary was $655.80.
Read our methodology - how this data is sourced, computed, and verified.
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.
Closest average formulary tier
- bromocriptine 2.5 MG Oral Tablet T2.8
- cyclosporine 25 MG Oral Capsule T2.8
- emtricitabine 200 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet T2.8
- ampicillin 1000 MG Injection T2.8
- estradiol 0.01 MG Vaginal Insert T2.8
- acetaminophen 21.7 MG/ML / hydrocodone bitartrate 0.5 MG/ML Oral Solution T2.8
Similar prior-authorization rate
- metronidazole 10 MG/ML Topical Cream [Noritate] 0% PA
- 24 HR minocycline 40 MG Extended Release Oral Capsule [Emrosi] 0% PA
- buspirone hydrochloride 10 MG Oral Capsule [Bucapsol] 0% PA
- diflunisal 375 MG Oral Tablet [Dolobid] 0% PA
- hydrocortisone 1 MG/ML Oral Solution [Khindivi] 0% PA
- indomethacin 50 MG Rectal Suppository [Indocin] 0% PA