Medicare Part D coverage · buprenorphine · RxCUI 1010603
buprenorphine 2 MG / naloxone 0.5 MG Sublingual Film [Suboxone]
Per the CMS 2026 Part D formulary file, buprenorphine 2 MG / naloxone 0.5 MG Sublingual Film [Suboxone] is covered by 843 Medicare Part D plans (16.7% of enrollable products), averaging Tier 3.3, with prior authorization required on 0% of covering formularies.
- 16.7%
- Plan coverage
- 843
- Plans covering
- T3.3
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for buprenorphine 2 MG / naloxone 0.5 MG Sublingual Film [Suboxone]
Per the CMS 2026 Part D formulary file, buprenorphine 2 MG / naloxone 0.5 MG Sublingual Film [Suboxone] (RxNorm concept RXCUI 1010603, generic name buprenorphine) appears on 8 distinct formulary files spanning 843 Medicare Part D plan offerings - 16.7% 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 3.3.
Real-world access to buprenorphine 2 MG / naloxone 0.5 MG Sublingual Film [Suboxone] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 25% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 74,893 Part D beneficiaries filled buprenorphine 2 MG / naloxone 0.5 MG Sublingual Film [Suboxone] 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 2 MG / naloxone 0.5 MG Sublingual Film [Suboxone] today.
Coverage Details
- Formularies covering
- 8
- Plans covering
- 843
- Coverage rate
- 16.7%
- 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
- 25% of formularies
2023 Medicare Spending
- Beneficiaries
- 74,893
- Total spending
- $119,710,207
- Avg per beneficiary
- $1,598.42
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering buprenorphine 2 MG / naloxone 0.5 MG Sublingual Film [Suboxone]
5 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T4 | No | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T4 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T4 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T4 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T4 | No | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering buprenorphine 2 MG / naloxone 0.5 MG Sublingual Film [Suboxone]
95 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | No | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $0 | DE |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $13.10 | PA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $17.60 | PA |
| Highmark Health Options Duals Select (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $31.20 | DE |
| Hamaspik Medicare Select (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $34.50 | NY |
| UHC Dual Complete IA-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | No | $0 | IA |
| UHC Dual Complete MO-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | No | $0 | MO |
| UHC Dual Complete NE-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | No | $0 | NE |
| UHC Dual Complete KS-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | No | $0 | KS |
| UHC Dual Complete MO-S3 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | No | $0 | MO |
| UHC Dual Complete KS-Q1 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | No | $0 | KS |
| UHC Dual Complete TN-S001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T4 | No | $0 | TN |
| UHC Dual Complete TN-Y001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T4 | No | $0 | TN |
| UHC Dual Complete TN-Y2 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T4 | No | $0 | TN |
| AARP Medicare Advantage from UHC MI-0001 (PPO) | Unitedhealthcare Insurance Company | T4 | No | $0 | MI |
| UHC Dual Complete NM-Y1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T4 | No | $0 | NM |
Show the next 30 plans
Showing top 50 of 95 plans.
Frequently Asked Questions
Is buprenorphine 2 MG / naloxone 0.5 MG Sublingual Film [Suboxone] covered by Medicare Part D?
Yes, buprenorphine 2 MG / naloxone 0.5 MG Sublingual Film [Suboxone] is covered by 843 Medicare Part D plans (16.7% of all Part D formularies).
What tier is buprenorphine 2 MG / naloxone 0.5 MG Sublingual Film [Suboxone] on Medicare Part D plans?
buprenorphine 2 MG / naloxone 0.5 MG Sublingual Film [Suboxone] averages Tier 3.3 across Part D plans, ranging from Tier 1 to Tier 4.
Does buprenorphine 2 MG / naloxone 0.5 MG Sublingual Film [Suboxone] require prior authorization?
0% of Part D formularies require prior authorization for buprenorphine 2 MG / naloxone 0.5 MG Sublingual Film [Suboxone]. Step therapy: 0%. Quantity limits: 25%.
How much does Medicare spend on buprenorphine 2 MG / naloxone 0.5 MG Sublingual Film [Suboxone]?
In 2023, total Medicare Part D spending on buprenorphine 2 MG / naloxone 0.5 MG Sublingual Film [Suboxone] 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.
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