Medicare Part D coverage · buprenorphine · RxCUI 1307061
buprenorphine 12 MG / naloxone 3 MG Sublingual Film
Per the CMS 2026 Part D formulary file, buprenorphine 12 MG / naloxone 3 MG Sublingual Film is covered by 4,057 Medicare Part D plans (80.3% of enrollable products), averaging Tier 2.6, with prior authorization required on 0% of covering formularies.
- 80.3%
- Plan coverage
- 4,057
- Plans covering
- T2.6
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for buprenorphine 12 MG / naloxone 3 MG Sublingual Film
Per the CMS 2026 Part D formulary file, buprenorphine 12 MG / naloxone 3 MG Sublingual Film (RxNorm concept RXCUI 1307061, generic name buprenorphine) appears on 317 distinct formulary files spanning 4,057 Medicare Part D plan offerings - 80.3% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 2.6.
Real-world access to buprenorphine 12 MG / naloxone 3 MG Sublingual Film depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 42% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 74,893 Part D beneficiaries filled buprenorphine 12 MG / naloxone 3 MG Sublingual Film in 2023, with total plan-and-beneficiary spending of $119,710,207 and an average per-beneficiary annual cost of $1,598.42. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry buprenorphine 12 MG / naloxone 3 MG Sublingual Film today.
Coverage Details
- Formularies covering
- 317
- Plans covering
- 4,057
- Coverage rate
- 80.3%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 42% of formularies
2023 Medicare Spending
- Beneficiaries
- 74,893
- Total spending
- $119,710,207
- Avg per beneficiary
- $1,598.42
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering buprenorphine 12 MG / naloxone 3 MG Sublingual Film
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 |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | No | $0 | FL |
| 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 |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | No | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | No | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | No | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | No | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | No | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | No | $0 | NY |
| 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 |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
Show the next 30 plans
| 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 |
| KeyCare Advantage Plus (HMO C-SNP) | Isnp Ventures, LLC | T1 | No | $0 | MD |
| Premier Care (HMO-POS I-SNP) | Lifeworks Advantage, LLC | T1 | No | $0 | VA |
| Premier Care (HMO I-SNP) | Align Senior Care California Inc. | T1 | No | $0 | CA |
| Advantage Care (HMO) | Align Senior Care California Inc. | T1 | No | $0 | CA |
| Premier Care (HMO-POS I-SNP) | Align Senior Care MI, LLC | T1 | No | $0 | MI |
| Premier Care (HMO I-SNP) | Align Senior Care Florida, Inc. | T1 | No | $0 | FL |
| Perennial Advantage Freedom (HMO-POS) | Perennial Advantage OF Colorado, Inc. | T1 | No | $0 | CO |
| Perennial Advantage Premier (HMO-POS I-SNP) | Perennial Advantage OF Colorado, Inc. | T1 | No | $0 | CO |
| Perennial Advantage Freedom (HMO) | Perennial Advantage OF Colorado, Inc. | T1 | No | $0 | PA |
| Perennial Advantage Premier (HMO I-SNP) | Perennial Advantage OF Colorado, Inc. | T1 | No | $0 | PA |
| Perennial Advantage Freedom (HMO-POS) | Perennial Advantage OF Ohio, Inc. | T1 | No | $0 | OH |
| Perennial Advantage Premier (HMO-POS I-SNP) | Perennial Advantage OF Ohio, Inc. | T1 | No | $0 | OH |
| ProCare Advantage - Diabetes Care Management (HMO-POS C-SNP) | Procare Advantage, LLC | T1 | No | $0 | TX |
| PruittHealth Premier Advantage (HMO I-SNP) | Pruitthealth Premier, Inc. | T1 | No | $0 | GA |
| Senior Health Plan Silver Plus (HMO) | Communitycare Government Programs, Inc. | T1 | No | $0 | OK |
| Senior Health Plan Oklahoma Dual Complete (HMO D-SNP) | Communitycare Government Programs, Inc. | T1 | No | $0 | OK |
| Community First Medicare Advantage Alamo Plan (HMO) | Community First Health Plans, Inc. | T1 | No | $0 | TX |
| Community First Medicare Advantage D-SNP (HMO D-SNP) | Community First Health Plans, Inc. | T1 | No | $0 | TX |
| Community DualCare Aligned (HMO D-SNP) | Community Health Choice Texas, Inc. | T1 | No | $0 | TX |
| Community DualCare Access (HMO D-SNP) | Community Health Choice Texas, Inc. | T1 | No | $0 | TX |
| El Paso Health Medicare Advantage Dual (HMO D-SNP) | EL Paso First Health Plans, Inc. | T1 | No | $0 | TX |
| El Paso Health Total (HMO) | EL Paso First Health Plans, Inc. | T1 | No | $0 | TX |
| El Paso Health Giveback (HMO) | EL Paso First Health Plans, Inc. | T1 | No | $0 | TX |
| Liberty Medicare Advantage (HMO C-SNP) | Liberty Advantage, LLC | T1 | No | $0 | NC |
| Peak Advantage Vista (PPO) | Peak Health Insurance Corporation | T1 | No | $0 | PA, WV |
| SECUR Edge (HMO I-SNP) | Secur Inc | T1 | No | $0 | FL |
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | No | $0 | AL |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is buprenorphine 12 MG / naloxone 3 MG Sublingual Film covered by Medicare Part D?
Yes, buprenorphine 12 MG / naloxone 3 MG Sublingual Film is covered by 4,057 Medicare Part D plans (80.3% of all Part D formularies).
What tier is buprenorphine 12 MG / naloxone 3 MG Sublingual Film on Medicare Part D plans?
buprenorphine 12 MG / naloxone 3 MG Sublingual Film averages Tier 2.6 across Part D plans, ranging from Tier 1 to Tier 6.
Does buprenorphine 12 MG / naloxone 3 MG Sublingual Film require prior authorization?
0% of Part D formularies require prior authorization for buprenorphine 12 MG / naloxone 3 MG Sublingual Film. Step therapy: 0%. Quantity limits: 42%.
How much does Medicare spend on buprenorphine 12 MG / naloxone 3 MG Sublingual Film?
In 2023, total Medicare Part D spending on buprenorphine 12 MG / naloxone 3 MG Sublingual Film was $119,710,207, covering 74,893 beneficiaries. The average spend per beneficiary was $1,598.42.
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
- carbamazepine 20 MG/ML Oral Suspension T2.6
- morphine sulfate 15 MG Oral Tablet T2.6
- {2 (480 ML) (magnesium sulfate 0.0277 MEQ/ML / potassium sulfate 0.0374 MEQ/ML / sodium sulfate 0.257 MEQ/ML Oral Solution) } Pack T2.6
- 6 ML clindamycin 150 MG/ML Injection T2.6
- travoprost 0.04 MG/ML Ophthalmic Solution T2.6
- 24 HR linagliptin 2.5 MG / metformin hydrochloride 1000 MG Extended Release Oral Tablet [Jentadueto] T2.6
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