budesonide 0.2 MG/ML Oral Suspension [Eohilia]

Verify with CMS →

budesonide

RxCUI: 2675286

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.
2%
Plan Coverage
99
Plans Covering
T4.2
Avg Tier
100%
Prior Auth Required

What the CMS Formulary Data Shows for budesonide 0.2 MG/ML Oral Suspension [Eohilia]

Per the CMS 2026 Part D formulary file, budesonide 0.2 MG/ML Oral Suspension [Eohilia] (RxNorm concept RXCUI 2675286, generic name budesonide) appears on 15 distinct formulary files spanning 99 Medicare Part D plan offerings - 2% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.2.

Real-world access to budesonide 0.2 MG/ML Oral Suspension [Eohilia] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 73.3% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 61,841 Part D beneficiaries filled budesonide 0.2 MG/ML Oral Suspension [Eohilia] in 2023, with total plan-and-beneficiary spending of $33,914,751 and an average per-beneficiary annual cost of $548.42. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry budesonide 0.2 MG/ML Oral Suspension [Eohilia] today.

Coverage Details

Formularies covering
15
Plans covering
99
Coverage rate
2%
Tier range
Tier 1 – Tier 5
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
100% of formularies
Step therapy required
0% of formularies
Quantity limits
73.3% of formularies

2023 Medicare Spending

Beneficiaries
61,841
Total spending
$33,914,751
Avg per beneficiary
$548.42

Tier Distribution Across Plans

9 plans
Tier 1, Preferred Generic
90 plans
Tier 5, Specialty

Standalone Drug Plans (PDP) Covering budesonide 0.2 MG/ML Oral Suspension [Eohilia]

2 standalone prescription drug plans include this drug.

Plan Insurer Tier PA ST Premium States
Blue Rx PDP Complete (PDP) HM HEALTH INSURANCE COMPANY T5 Yes No $164.80 -
Blue Rx PDP Plus (PDP) HM HEALTH INSURANCE COMPANY T5 Yes No $193.20 -

Medicare Advantage Plans (MA-PD) Covering budesonide 0.2 MG/ML Oral Suspension [Eohilia]

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

Plan Insurer Tier PA Premium States
Mass General Brigham SCO (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 Yes $0 MA
Mass General Brigham One Care (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 Yes $0 MA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $0 PA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $0 PA
Highmark Health Options Duals (HMO D-SNP) HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. T1 Yes $0 WV
Highmark Health Options Duals (HMO D-SNP) HIGHMARK BCBSD, INC. T1 Yes $0 DE
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $13.10 PA
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $17.60 PA
Highmark Health Options Duals Select (HMO D-SNP) HIGHMARK BCBSD, INC. T1 Yes $31.20 DE
Community Blue Medicare HMO Signature (HMO) Highmark Western and Northeastern New York Inc. T5 Yes $0 NY
Community Blue Medicare HMO Merit (HMO) Highmark Western and Northeastern New York Inc. T5 Yes $0 NY
Community Blue Medicare PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Complete Blue PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Community Blue Medicare Plus PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Complete Blue PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Complete Blue PPO Merit (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Complete Blue PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Complete Blue PPO Distinct (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Community Blue Medicare Plus PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Complete Blue Plus PPO Merit (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Community Blue Medicare PPO Signature (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Complete Blue PPO Merit (PPO) HIGHMARK SENIOR HEALTH COMPANY T5 Yes $0 PA
Community Blue Medicare HMO Signature (HMO) HIGHMARK CHOICE COMPANY T5 Yes $0 PA
Security Blue HMO-POS ValueRx (HMO-POS) HIGHMARK CHOICE COMPANY T5 Yes $0 PA
Community Blue Medicare HMO Signature (HMO) HIGHMARK CHOICE COMPANY T5 Yes $0 PA
Together Blue Medicare HMO Signature (HMO) HIGHMARK CHOICE COMPANY T5 Yes $0 PA
Community Blue Medicare HMO Distinct (HMO) HIGHMARK CHOICE COMPANY T5 Yes $0 PA
Complete Blue HMO Distinct (HMO) HIGHMARK CHOICE COMPANY T5 Yes $0 PA
Complete Blue PPO Distinct (PPO) HIGHMARK SENIOR SOLUTIONS COMPANY T5 Yes $0 WV
Complete Blue PPO Signature (PPO) HIGHMARK SENIOR SOLUTIONS COMPANY T5 Yes $0 WV
Complete Blue PPO Signature (PPO) HIGHMARK SENIOR SOLUTIONS COMPANY T5 Yes $0 WV
Complete Blue PPO Merit (PPO) HIGHMARK SENIOR SOLUTIONS COMPANY T5 Yes $0 WV
Complete Blue PPO Signature (PPO) HIGHMARK BCBSD INC. T5 Yes $0 DE
UPMC for Life HMO Premier Rx (HMO) UPMC HEALTH PLAN, INC. T5 Yes $0 PA
UPMC for Life Complete Care (HMO D-SNP) UPMC FOR YOU, INC T5 Yes $0 PA
UPMC for Life Complete Care (HMO D-SNP) UPMC FOR YOU, INC T5 Yes $0 PA
UPMC for Life PPO Premier Rx (PPO) UPMC HEALTH NETWORK, INC. T5 Yes $0 PA
UPMC for Life PPO Premier Rx (PPO) UPMC HEALTH NETWORK, INC. T5 Yes $0 PA
UPMC for Life PPO Essential Care Rx (PPO) UPMC HEALTH NETWORK, INC. T5 Yes $0 PA
UPMC for Life Complete Care (HMO D-SNP) UPMC HEALTH COVERAGE, INC. T5 Yes $0 PA
PriorityMedicare Key (HMO-POS) PRIORITY HEALTH T5 Yes $0 MI
PriorityMedicare Smart Savings (HMO-POS) PRIORITY HEALTH T5 Yes $0 MI
PriorityMedicare Edge (PPO) PRIORITY HEALTH T5 Yes $0 MI
PriorityMedicare Vital (PPO) PRIORITY HEALTH T5 Yes $0 MI
PriorityMedicare Thrive (PPO) PRIORITY HEALTH T5 Yes $0 MI
PriorityMedicare D-SNP (HMO D-SNP) PRIORITY HEALTH CHOICE, INC. T5 Yes $0 MI
PriorityMedicare Dual Premier (HMO D-SNP) PRIORITY HEALTH CHOICE, INC. T5 Yes $0 MI
Mass General Brigham Advantage (PPO) Mass General Brigham Health Plan, Inc. T5 Yes $0 MA
CareOregon Advantage Plus (HMO D-SNP) HEALTH PLAN OF CAREOREGON, INC. T5 Yes $0 OR
Senior Blue 652 (HMO) Highmark Western and Northeastern New York Inc. T5 Yes $0.40 NY

Frequently Asked Questions

Is budesonide 0.2 MG/ML Oral Suspension [Eohilia] covered by Medicare Part D?

Yes, budesonide 0.2 MG/ML Oral Suspension [Eohilia] is covered by 99 Medicare Part D plans (2% of all Part D formularies).

What tier is budesonide 0.2 MG/ML Oral Suspension [Eohilia] on Medicare Part D plans?

budesonide 0.2 MG/ML Oral Suspension [Eohilia] averages Tier 4.2 across Part D plans, ranging from Tier 1 to Tier 5.

Does budesonide 0.2 MG/ML Oral Suspension [Eohilia] require prior authorization?

100% of Part D formularies require prior authorization for budesonide 0.2 MG/ML Oral Suspension [Eohilia]. Step therapy: 0%. Quantity limits: 73.3%.

How much does Medicare spend on budesonide 0.2 MG/ML Oral Suspension [Eohilia]?

In 2023, total Medicare Part D spending on budesonide 0.2 MG/ML Oral Suspension [Eohilia] was $33,914,751, covering 61,841 beneficiaries. The average spend per beneficiary was $548.42.

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