Medicare Part D coverage · C1 · RxCUI 867381
C1 esterase inhibitor (human) 500 UNT Injection [Berinert]
Per the CMS 2026 Part D formulary file, C1 esterase inhibitor (human) 500 UNT Injection [Berinert] is covered by 1,452 Medicare Part D plans (28.7% of enrollable products), averaging Tier 4.3, with prior authorization required on 97.4% of covering formularies.
- 28.7%
- Plan coverage
- 1,452
- Plans covering
- T4.3
- Avg tier
- 97.4%
- Prior auth required
What the CMS Formulary Data Shows for C1 esterase inhibitor (human) 500 UNT Injection [Berinert]
Per the CMS 2026 Part D formulary file, C1 esterase inhibitor (human) 500 UNT Injection [Berinert] (RxNorm concept RXCUI 867381, generic name C1) appears on 77 distinct formulary files spanning 1,452 Medicare Part D plan offerings - 28.7% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 4.3.
Real-world access to C1 esterase inhibitor (human) 500 UNT Injection [Berinert] depends on utilization management as much as tier placement: 97.4% of covering formularies require prior authorization. 0% require step therapy. 76.6% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 191 Part D beneficiaries filled C1 esterase inhibitor (human) 500 UNT Injection [Berinert] in 2023, with total plan-and-beneficiary spending of $78,929,250 and an average per-beneficiary annual cost of $413,242.15. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry C1 esterase inhibitor (human) 500 UNT Injection [Berinert] today.
Coverage Details
- Formularies covering
- 77
- Plans covering
- 1,452
- Coverage rate
- 28.7%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 97.4% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 76.6% of formularies
2023 Medicare Spending
- Beneficiaries
- 191
- Total spending
- $78,929,250
- Avg per beneficiary
- $413,242.15
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering C1 esterase inhibitor (human) 500 UNT Injection [Berinert]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $0 | FL |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | Yes | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | Yes | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | Yes | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | Yes | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | Yes | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | Yes | $0 | NY |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | Yes | $0 | MA |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | Yes | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | Yes | $0 | MA |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | Yes | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | Yes | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | Yes | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | Yes | $0 | MA |
Show the next 30 plans
| Florida Complete Care (HMO I-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Florida Complete Care- In The Community (HMO-POS I-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) | Elderplan, Inc. | T1 | Yes | $22.70 | NY |
| VIVA Medicare Extra Value (HMO D-SNP) | Viva Health, Inc. | T1 | Yes | $27.70 | AL |
| VIVA Medicare Extra Care (HMO D-SNP) | Viva Health, Inc. | T1 | Yes | $27.70 | AL |
| Elderplan Advantage For Nursing Home Residents (HMO-POS I-SNP) | Elderplan, Inc. | T1 | Yes | $44.80 | NY |
| MetroPlus Platinum Plan (HMO) | Metroplus Health Plan, Inc. | T1 | Yes | $58.80 | NY |
| Aetna Medicare Signature (HMO) | Aetna Health OF California Inc. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature (HMO) | Aetna Health OF California Inc. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF California Inc. | T5 | Yes | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T5 | Yes | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T5 | Yes | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T5 | Yes | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T5 | Yes | $0 | CA |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | KY |
| Aetna Medicare HIDE (HMO D-SNP) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | KY |
| Aetna Medicare Dual Care (HMO D-SNP) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | OH |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | OH |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | KY |
| Aetna Medicare Partial Dual (HMO D-SNP) | Aetna Health OF Ohio Inc. | T5 | Yes | $0 | KY |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is C1 esterase inhibitor (human) 500 UNT Injection [Berinert] covered by Medicare Part D?
Yes, C1 esterase inhibitor (human) 500 UNT Injection [Berinert] is covered by 1,452 Medicare Part D plans (28.7% of all Part D formularies).
What tier is C1 esterase inhibitor (human) 500 UNT Injection [Berinert] on Medicare Part D plans?
C1 esterase inhibitor (human) 500 UNT Injection [Berinert] averages Tier 4.3 across Part D plans, ranging from Tier 1 to Tier 6.
Does C1 esterase inhibitor (human) 500 UNT Injection [Berinert] require prior authorization?
97.4% of Part D formularies require prior authorization for C1 esterase inhibitor (human) 500 UNT Injection [Berinert]. Step therapy: 0%. Quantity limits: 76.6%.
How much does Medicare spend on C1 esterase inhibitor (human) 500 UNT Injection [Berinert]?
In 2023, total Medicare Part D spending on C1 esterase inhibitor (human) 500 UNT Injection [Berinert] was $78,929,250, covering 191 beneficiaries. The average spend per beneficiary was $413,242.15.
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
- nitisinone 2 MG Oral Capsule T4.3
- Pediatric 1.5 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron] T4.3
- nafarelin 0.2 MG/ACTUAT Metered Dose Nasal Spray [Synarel] T4.3
- 10 ML immunoglobulin G, human 100 MG/ML Injection [Gammaked] T4.3
- 0.6 ML risperidone 150 MG/ML Prefilled Syringe [Perseris] T4.3
- 0.8 ML risperidone 150 MG/ML Prefilled Syringe [Perseris] T4.3
Similar prior-authorization rate
- 0.5 ML ustekinumab-aekn 90 MG/ML Injection [Selarsdi] 97.4% PA
- alanine 21.7 MG/ML / arginine 14.7 MG/ML / aspartate 4.34 MG/ML / glutamate 7.49 MG/ML / glycine 10.4 MG/ML / histidine 8.94 MG/ML / isoleucine 7.49 MG/ML / leucine 10.4 MG/ML / lysine 11.8 MG/ML / methionine 7.49 MG/ML / phenylalanine 10.4 MG/ML / proline 8.94 MG/ML / serine 5.92 MG/ML / threonine 7.49 MG/ML / tryptophan 2.5 MG/ML / tyrosine 0.39 MG/ML / valine 9.6 MG/ML Injectable Solution [Clinisol 15] 97.4% PA
- leuprolide acetate 22.5 MG Injection [Lutrate] 97.5% PA
- alanine 5.4 MG/ML / arginine 12 MG/ML / aspartate 3.2 MG/ML / cysteine 0.16 MG/ML / glutamate 5 MG/ML / glycine 3.6 MG/ML / histidine 4.8 MG/ML / isoleucine 8.2 MG/ML / leucine 14 MG/ML / lysine 8.2 MG/ML / methionine 3.4 MG/ML / phenylalanine 4.8 MG/ML / proline 6.8 MG/ML / serine 3.8 MG/ML / taurine 0.25 MG/ML / threonine 4.2 MG/ML / tryptophan 2 MG/ML / tyrosine 2.4 MG/ML / valine 7.8 MG/ML Injectable Solution [PremaSol] 97.5% PA
- rilonacept 220 MG Injection [Arcalyst] 97.3% PA
- {28 (alpelisib 200 MG Oral Tablet [Vijoice]) / 28 (alpelisib 50 MG Oral Tablet [Vijoice]) } Pack [Vijoice 250 MG 28 Day] 97.3% PA