buprenorphine 0.75 MG Buccal Film [Belbuca]

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buprenorphine

RxCUI: 1716083

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.
6.6%
Plan Coverage
332
Plans Covering
T2.7
Avg Tier
82.5%
Prior Auth Required

What the CMS Formulary Data Shows for buprenorphine 0.75 MG Buccal Film [Belbuca]

Per the CMS 2026 Part D formulary file, buprenorphine 0.75 MG Buccal Film [Belbuca] (RxNorm concept RXCUI 1716083, generic name buprenorphine) appears on 40 distinct formulary files spanning 332 Medicare Part D plan offerings - 6.6% 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 2.7.

Real-world access to buprenorphine 0.75 MG Buccal Film [Belbuca] depends on utilization management as much as tier placement: 82.5% of covering formularies require prior authorization. 0% require step therapy. 90% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 74,893 Part D beneficiaries filled buprenorphine 0.75 MG Buccal Film [Belbuca] in 2023, with total plan-and-beneficiary spending of $119,900,450 and an average per-beneficiary annual cost of $1,600.96. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry buprenorphine 0.75 MG Buccal Film [Belbuca] today.

Coverage Details

Formularies covering
40
Plans covering
332
Coverage rate
6.6%
Tier range
Tier 1 – Tier 5
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
82.5% of formularies
Step therapy required
0% of formularies
Quantity limits
90% of formularies

2023 Medicare Spending

Beneficiaries
74,893
Total spending
$119,900,450
Avg per beneficiary
$1,600.96

Tier Distribution Across Plans

23 plans
Tier 1, Preferred Generic
77 plans
Tier 3, Preferred Brand

Medicare Advantage Plans (MA-PD) Covering buprenorphine 0.75 MG Buccal Film [Belbuca]

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

Plan Insurer Tier PA Premium States
ElderServe MAP (HMO D-SNP) ELDERSERVE HEALTH, INC. T1 Yes $0 NY
Cooperative Advantage (HMO D-SNP) GROUP HEALTH COOPERATIVE OF EAU CLAIRE T1 Yes $0 WI
Longevity Health Plan (PPO I-SNP) LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP T1 Yes $0 NJ
Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) UPPER PENINSULA HEALTH PLAN, LLC T1 Yes $0 MI
CareSource Dual Advantage (HMO D-SNP) CARESOURCE GEORGIA CO. T1 Yes $0 GA
HAP CareSource MI Coordinated Health (HMO D-SNP) HAP CARESOURCE T1 Yes $0 MI
Gold Coast Health Plan Total Care Advantage (HMO D-SNP) Ventura County Medi-Cal Managed Care Commission T1 Yes $0 CA
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) Health Care Service Corporation T1 Yes $0 NM
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) Health Care Service Corporation T1 Yes $0 NM
SecureBlue (HMO D-SNP) HMO Minnesota T1 Yes $0 MN
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 Yes $0 NY
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF FLORIDA, INC. T1 Yes $4.80 FL
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) HCSC INSURANCE SERVICES COMPANY T1 Yes $4.80 TX
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) GHS INSURANCE COMPANY T1 Yes $5.00 OK
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF MICHIGAN, INC. T1 Yes $8.80 MI
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF ILLINOIS, INC. T1 Yes $15.20 IL
WellSense Added Value (HMO) BOSTON MEDICAL CENTER HEALTH PLAN, INC. T1 Yes $21.70 NH
Hamaspik Medicare Select (HMO D-SNP) HAMASPIK, INC. T1 Yes $34.50 NY
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF COLORADO, INC. T1 Yes $35.20 CO
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC. T1 Yes $36.20 NC
Longevity Health Plan (PPO I-SNP) LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP T1 Yes $40.00 NJ
ElderServe Star (HMO I-SNP) ELDERSERVE HEALTH, INC. T1 Yes $58.80 NY
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF NEW YORK, INC. T1 Yes $58.80 NY
The Health Plan SecureCare - Option II (HMO) THE HEALTH PLAN OF WEST VIRGINIA, INC. T3 Yes $0 OH
The Health Plan SecureCare - Option II (HMO) THE HEALTH PLAN OF WEST VIRGINIA, INC. T3 Yes $0 OH, WV
The Health Plan SecureCare Capitol Plan (HMO) THE HEALTH PLAN OF WEST VIRGINIA, INC. T3 Yes $0 WV
The Health Plan SecureChoice Optimum (PPO) THP INSURANCE COMPANY T3 Yes $0 OH, WV
WellSense Signature (HMO) BOSTON MEDICAL CENTER HEALTH PLAN, INC. T3 Yes $0 NH
WellSense Signature Access (PPO) BOSTON MEDICAL CENTER HEALTH PLAN, INC. T3 Yes $0 NH
Essence Advantage (HMO) ESSENCE HEALTHCARE, INC. T3 Yes $0 IL, MO
Essence Advantage (HMO) ESSENCE HEALTHCARE, INC. T3 Yes $0 AR, MO
Essence Advantage Select (HMO) ESSENCE HEALTHCARE, INC. T3 Yes $0 IL, MO
Essence Advantage (HMO) ESSENCE HEALTHCARE, INC. T3 Yes $0 IN, KY
Essence Advantage Select (HMO) ESSENCE HEALTHCARE, INC. T3 Yes $0 IL
Essence Advantage Choice (PPO) ESSENCE HEALTHCARE PPO, INC. T3 Yes $0 IL, MO
Essence Advantage Choice (PPO) ESSENCE HEALTHCARE PPO, INC. T3 Yes $0 AR, MO
Essence Advantage Choice (PPO) ESSENCE HEALTHCARE PPO, INC. T3 Yes $0 IL
CareSource Dual Advantage Plus (HMO D-SNP) CARESOURCE GEORGIA CO. T3 Yes $0 GA
CareSource MyCare Ohio (HMO D-SNP) CARESOURCE OHIO, INC. T3 Yes $0 OH
Blue adVantage Liberty (PPO) LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY T3 Yes $0 LA
Blue adVantage Thrive (PPO) LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY T3 Yes $0 LA
Blue adVantage Classic (HMO-POS) HMO LOUISIANA, INC. T3 Yes $0 LA
Blue adVantage Giveback (HMO-POS) HMO LOUISIANA, INC. T3 Yes $0 LA
Blue Medicare Essential Plus (HMO-POS) BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA T3 Yes $0 NC
Blue Medicare Choice (HMO) BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA T3 Yes $0 NC
Blue Medicare Essential (HMO) BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA T3 Yes $0 NC
Experience Health Medicare Advantage (HMO) BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA T3 Yes $0 NC
Healthy Blue + Medicare (HMO-POS D-SNP) BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH T3 Yes $0 NC
Blue Advantage Complete (PPO) BLUE CROSS AND BLUE SHIELD OF ALABAMA T3 Yes $0 AL
BSW SeniorCare Advantage (PPO) Baylor Scott & White Insurance Company T3 Yes $0 TX

Frequently Asked Questions

Is buprenorphine 0.75 MG Buccal Film [Belbuca] covered by Medicare Part D?

Yes, buprenorphine 0.75 MG Buccal Film [Belbuca] is covered by 332 Medicare Part D plans (6.6% of all Part D formularies).

What tier is buprenorphine 0.75 MG Buccal Film [Belbuca] on Medicare Part D plans?

buprenorphine 0.75 MG Buccal Film [Belbuca] averages Tier 2.7 across Part D plans, ranging from Tier 1 to Tier 5.

Does buprenorphine 0.75 MG Buccal Film [Belbuca] require prior authorization?

82.5% of Part D formularies require prior authorization for buprenorphine 0.75 MG Buccal Film [Belbuca]. Step therapy: 0%. Quantity limits: 90%.

How much does Medicare spend on buprenorphine 0.75 MG Buccal Film [Belbuca]?

In 2023, total Medicare Part D spending on buprenorphine 0.75 MG Buccal Film [Belbuca] was $119,900,450, covering 74,893 beneficiaries. The average spend per beneficiary was $1,600.96.

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