butorphanol tartrate 1 MG/ACTUAT Metered Dose Nasal Spray

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butorphanol tartrate

RxCUI: 886634

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.
44.5%
Plan Coverage
2,254
Plans Covering
T3
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for butorphanol tartrate 1 MG/ACTUAT Metered Dose Nasal Spray

Per the CMS 2026 Part D formulary file, butorphanol tartrate 1 MG/ACTUAT Metered Dose Nasal Spray (RxNorm concept RXCUI 886634, generic name butorphanol tartrate) appears on 128 distinct formulary files spanning 2,254 Medicare Part D plan offerings - 44.5% 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.

Real-world access to butorphanol tartrate 1 MG/ACTUAT Metered Dose Nasal Spray depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 93% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 2,753 Part D beneficiaries filled butorphanol tartrate 1 MG/ACTUAT Metered Dose Nasal Spray in 2023, with total plan-and-beneficiary spending of $2,463,385 and an average per-beneficiary annual cost of $894.80. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry butorphanol tartrate 1 MG/ACTUAT Metered Dose Nasal Spray today.

Coverage Details

Formularies covering
128
Plans covering
2,254
Coverage rate
44.5%
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
93% of formularies

2023 Medicare Spending

Beneficiaries
2,753
Total spending
$2,463,385
Avg per beneficiary
$894.80

Tier Distribution Across Plans

50 plans
Tier 1, Preferred Generic
50 plans
Tier 2, Generic

Standalone Drug Plans (PDP) Covering butorphanol tartrate 1 MG/ACTUAT Metered Dose Nasal Spray

2 standalone prescription drug plans include this drug.

Plan Insurer Tier PA ST Premium States
Wellcare Simple (HMO-POS) WELLCARE OF CONNECTICUT, INC. T2 No No $0 CT
Wellcare Giveback (HMO-POS) WELLCARE OF CONNECTICUT, INC. T2 No No $0 CT

Medicare Advantage Plans (MA-PD) Covering butorphanol tartrate 1 MG/ACTUAT Metered Dose Nasal Spray

98 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
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
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
HAP CareSource MI Coordinated Health (HMO D-SNP) HAP CARESOURCE T1 No $0 MI
Gold Coast Health Plan Total Care Advantage (HMO D-SNP) Ventura County Medi-Cal Managed Care Commission T1 No $0 CA
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) Health Care Service Corporation T1 No $0 NM
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) Health Care Service Corporation T1 No $0 NM
SecureBlue (HMO D-SNP) HMO Minnesota T1 No $0 MN
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 No $0 NY
SeniorCare Complete (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 No $0 MN
AbilityCare (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 No $0 MN
Alameda Alliance Wellness (HMO D-SNP) ALAMEDA ALLIANCE FOR HEALTH T1 No $0 CA
PHP (HMO C-SNP) AIDS HEALTHCARE FOUNDATION T1 No $0 CA
VNS Health Total (HMO D-SNP) VNS CHOICE T1 No $0 NY
Mass General Brigham SCO (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 No $0 MA
Mass General Brigham One Care (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 No $0 MA
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
Tufts Health One Care (HMO D-SNP) TUFTS HEALTH PUBLIC PLANS, INC. T1 No $0 MA
Tufts Health One Care CW (HMO D-SNP) TUFTS HEALTH PUBLIC PLANS, INC. T1 No $0 MA
Tufts Health Plan Senior Care Options (HMO D-SNP) TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION T1 No $0 MA
Tufts Health Plan Senior Care Options CW (HMO D-SNP) TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION T1 No $0 MA
Leon MediExtra (HMO) LEON HEALTH, INC. T1 No $0 FL
Leon MediDual (HMO D-SNP) LEON HEALTH, INC. T1 No $0 FL
Leon MediMore (HMO) LEON HEALTH, INC. T1 No $0 FL
Leon MediMax (HMO D-SNP) LEON HEALTH, INC. T1 No $0 FL
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF FLORIDA, INC. T1 No $4.80 FL
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) HCSC INSURANCE SERVICES COMPANY T1 No $4.80 TX
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T1 No $4.80 FL
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) GHS INSURANCE COMPANY T1 No $5.00 OK
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF MICHIGAN, INC. T1 No $8.80 MI
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 No $13.10 PA
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF ILLINOIS, INC. T1 No $15.20 IL
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF ARIZONA T1 No $17.00 AZ
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 No $17.60 PA
WellSense Added Value (HMO) BOSTON MEDICAL CENTER HEALTH PLAN, INC. T1 No $21.70 NH
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
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF COLORADO, INC. T1 No $35.20 CO
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC. T1 No $36.20 NC
Longevity Health Plan (PPO I-SNP) LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP T1 No $40.00 NJ
VNS Health EasyCare Plus (HMO D-SNP) VNS CHOICE T1 No $51.60 NY
ElderServe Star (HMO I-SNP) ELDERSERVE HEALTH, INC. T1 No $58.80 NY
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF NEW YORK, INC. T1 No $58.80 NY

Frequently Asked Questions

Is butorphanol tartrate 1 MG/ACTUAT Metered Dose Nasal Spray covered by Medicare Part D?

Yes, butorphanol tartrate 1 MG/ACTUAT Metered Dose Nasal Spray is covered by 2,254 Medicare Part D plans (44.5% of all Part D formularies).

What tier is butorphanol tartrate 1 MG/ACTUAT Metered Dose Nasal Spray on Medicare Part D plans?

butorphanol tartrate 1 MG/ACTUAT Metered Dose Nasal Spray averages Tier 3 across Part D plans, ranging from Tier 1 to Tier 4.

Does butorphanol tartrate 1 MG/ACTUAT Metered Dose Nasal Spray require prior authorization?

0% of Part D formularies require prior authorization for butorphanol tartrate 1 MG/ACTUAT Metered Dose Nasal Spray. Step therapy: 0%. Quantity limits: 93%.

How much does Medicare spend on butorphanol tartrate 1 MG/ACTUAT Metered Dose Nasal Spray?

In 2023, total Medicare Part D spending on butorphanol tartrate 1 MG/ACTUAT Metered Dose Nasal Spray was $2,463,385, covering 2,753 beneficiaries. The average spend per beneficiary was $894.80.

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