Medicare Part D coverage · budesonide · RxCUI 616817
budesonide 0.25 MG/ML Inhalation Suspension [Pulmicort]
Per the CMS 2026 Part D formulary file, budesonide 0.25 MG/ML Inhalation Suspension [Pulmicort] is covered by 235 Medicare Part D plans (4.7% of enrollable products), averaging Tier 4, with prior authorization required on 100% of covering formularies.
- 4.7%
- Plan coverage
- 235
- Plans covering
- T4
- Avg tier
- 100%
- Prior auth required
What the CMS Formulary Data Shows for budesonide 0.25 MG/ML Inhalation Suspension [Pulmicort]
Per the CMS 2026 Part D formulary file, budesonide 0.25 MG/ML Inhalation Suspension [Pulmicort] (RxNorm concept RXCUI 616817, generic name budesonide) appears on 5 distinct formulary files spanning 235 Medicare Part D plan offerings - 4.7% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 4 to Tier 4, with a cross-plan average of Tier 4.
Real-world access to budesonide 0.25 MG/ML Inhalation Suspension [Pulmicort] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 80% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 61,841 Part D beneficiaries filled budesonide 0.25 MG/ML Inhalation Suspension [Pulmicort] 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 0.25 MG/ML Inhalation Suspension [Pulmicort] today.
Coverage Details
- Formularies covering
- 5
- Plans covering
- 235
- Coverage rate
- 4.7%
- Tier range
- Tier 4, Non-Preferred
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 80% of formularies
2023 Medicare Spending
- Beneficiaries
- 61,841
- Total spending
- $33,914,751
- Avg per beneficiary
- $548.42
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering budesonide 0.25 MG/ML Inhalation Suspension [Pulmicort]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| HealthSpring Preferred (HMO) | Bravo Health Pennsylvania, Inc. | T4 | Yes | $0 | AZ |
| HealthSpring Alliance (HMO) | Bravo Health Pennsylvania, Inc. | T4 | Yes | $0 | AZ |
| HealthSpring Preferred Savings (HMO) | Bravo Health Pennsylvania, Inc. | T4 | Yes | $0 | AZ |
| HealthSpring Preferred Full Savings (HMO) | Bravo Health Pennsylvania, Inc. | T4 | Yes | $0 | AZ |
| HealthSpring Preferred GA (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | GA |
| HealthSpring Preferred Savings (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | GA |
| HealthSpring Preferred Savings (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | GA |
| HealthSpring Preferred Savings (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | GA |
| HealthSpring Preferred Savings (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | MO |
| HealthSpring Preferred Savings (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | MO |
| HealthSpring Premier (HMO-POS) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | UT |
| HealthSpring Preferred (HMO) | Healthspring Healthcare OF Colorado, Inc. | T4 | Yes | $0 | NM |
| HealthSpring Preferred (HMO) | Healthspring Healthcare OF Colorado, Inc. | T4 | Yes | $0 | OH |
Show the next 30 plans
| HealthSpring Preferred (HMO) | Healthspring Healthcare OF Colorado, Inc. | T4 | Yes | $0 | KY, OH |
| HealthSpring Preferred Savings (HMO) | Healthspring Healthcare OF Colorado, Inc. | T4 | Yes | $0 | OH |
| HealthSpring Preferred Savings (HMO) | Healthspring Healthcare OF Colorado, Inc. | T4 | Yes | $0 | KY, OH |
| HealthSpring Preferred (HMO) | Healthspring Healthcare OF Colorado, Inc. | T4 | Yes | $0 | CO |
| HealthSpring Preferred (HMO) | Bravo Health Mid-atlantic, Inc. | T4 | Yes | $0 | DC, DE |
| HealthSpring Preferred PA (HMO) | Bravo Health Pennsylvania, Inc. | T4 | Yes | $0 | PA |
| HealthSpring Preferred (HMO) | Bravo Health Pennsylvania, Inc. | T4 | Yes | $0 | PA |
| HealthSpring Preferred (HMO) | Bravo Health Pennsylvania, Inc. | T4 | Yes | $0 | PA |
| HealthSpring Preferred (HMO) | Bravo Health Pennsylvania, Inc. | T4 | Yes | $0 | PA |
| HealthSpring Preferred (HMO) | Bravo Health Pennsylvania, Inc. | T4 | Yes | $0 | PA |
| HealthSpring Preferred (HMO) | Bravo Health Pennsylvania, Inc. | T4 | Yes | $0 | PA |
| HealthSpring Preferred Savings (HMO) | Bravo Health Pennsylvania, Inc. | T4 | Yes | $0 | PA |
| HealthSpring Preferred (HMO) | Bravo Health Pennsylvania, Inc. | T4 | Yes | $0 | NJ |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | MS |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | WA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | OR, WA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | TX |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | TN |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | AR |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | MS, TN |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | AR |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | AR |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | TX |
| HealthSpring Alliance (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | TX |
| HealthSpring Preferred Savings (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | GA, TN |
| HealthSpring Preferred Savings (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | OK |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | TX |
| HealthSpring Preferred Savings (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | TX |
| HealthSpring Premier (HMO-POS) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | IL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is budesonide 0.25 MG/ML Inhalation Suspension [Pulmicort] covered by Medicare Part D?
Yes, budesonide 0.25 MG/ML Inhalation Suspension [Pulmicort] is covered by 235 Medicare Part D plans (4.7% of all Part D formularies).
What tier is budesonide 0.25 MG/ML Inhalation Suspension [Pulmicort] on Medicare Part D plans?
budesonide 0.25 MG/ML Inhalation Suspension [Pulmicort] averages Tier 4 across Part D plans, ranging from Tier 4 to Tier 4.
Does budesonide 0.25 MG/ML Inhalation Suspension [Pulmicort] require prior authorization?
100% of Part D formularies require prior authorization for budesonide 0.25 MG/ML Inhalation Suspension [Pulmicort]. Step therapy: 0%. Quantity limits: 80%.
How much does Medicare spend on budesonide 0.25 MG/ML Inhalation Suspension [Pulmicort]?
In 2023, total Medicare Part D spending on budesonide 0.25 MG/ML Inhalation Suspension [Pulmicort] was $33,914,751, covering 61,841 beneficiaries. The average spend per beneficiary was $548.42.
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
- dihydroergotamine mesylate 0.5 MG/ACTUAT Metered Dose Nasal Spray T4
- 0.5 ML darbepoetin alfa 0.2 MG/ML Prefilled Syringe [Aranesp] T4
- amoxicillin 250 MG / omeprazole 10 MG / rifabutin 12.5 MG Delayed Release Oral Capsule [Talicia] T4
- timolol hemihydrate 5 MG/ML Ophthalmic Solution [Betimol] T4
- deflazacort 18 MG Oral Tablet [Jaythari] T4
- bepotastine besilate 15 MG/ML Ophthalmic Solution [Bepreve] T4
Similar prior-authorization rate
- azathioprine 50 MG Oral Tablet 100% PA
- 0.5 ML hepatitis B surface antigen vaccine 0.04 MG/ML Prefilled Syringe [Heplisav-B] 100% PA
- 0.5 ML hepatitis B surface antigen vaccine 0.02 MG/ML Prefilled Syringe [Engerix-B] 100% PA
- 1 ML hepatitis B surface antigen vaccine 0.02 MG/ML Prefilled Syringe [Engerix-B] 100% PA
- sotagliflozin 200 MG Oral Tablet [Inpefa] 100% PA
- mycophenolate mofetil 250 MG Oral Capsule 100% PA