Medicare Part D coverage · C1 · RxCUI 1926823
C1 esterase inhibitor (human) 2000 UNT Injection [Haegarda]
Per the CMS 2026 Part D formulary file, C1 esterase inhibitor (human) 2000 UNT Injection [Haegarda] is covered by 4,594 Medicare Part D plans (90.9% of enrollable products), averaging Tier 4.3, with prior authorization required on 99.3% of covering formularies.
- 90.9%
- Plan coverage
- 4,594
- Plans covering
- T4.3
- Avg tier
- 99.3%
- Prior auth required
What the CMS Formulary Data Shows for C1 esterase inhibitor (human) 2000 UNT Injection [Haegarda]
Per the CMS 2026 Part D formulary file, C1 esterase inhibitor (human) 2000 UNT Injection [Haegarda] (RxNorm concept RXCUI 1926823, generic name C1) appears on 270 distinct formulary files spanning 4,594 Medicare Part D plan offerings - 90.9% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.3.
Real-world access to C1 esterase inhibitor (human) 2000 UNT Injection [Haegarda] depends on utilization management as much as tier placement: 99.3% of covering formularies require prior authorization. 0% require step therapy. 80.4% 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) 2000 UNT Injection [Haegarda] 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) 2000 UNT Injection [Haegarda] today.
Coverage Details
- Formularies covering
- 270
- Plans covering
- 4,594
- Coverage rate
- 90.9%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 99.3% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 80.4% 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) 2000 UNT Injection [Haegarda]
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 | Yes | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | Yes | $0 | VA |
| 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 |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | Yes | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | Yes | $0 | AL |
| 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 |
Show the next 30 plans
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare OF NEW Jersey, Inc. | T1 | Yes | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | Yes | $0 | MN |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | Yes | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | Yes | $0 | CA |
| 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 |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | Yes | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | Yes | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | Yes | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | Yes | $0 | NY |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | Yes | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | Yes | $0 | AR |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | Yes | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | Yes | $0 | DE |
| 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 |
| 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 |
| Senior Care (HMO I-SNP) | Align Senior Care Florida, Inc. | T1 | Yes | $4.80 | FL |
| ProCare Advantage (HMO-POS I-SNP) | Procare Advantage, LLC | T1 | Yes | $4.80 | TX |
| ProCare Advantage - Kidney Care (HMO-POS C-SNP) | Procare Advantage, LLC | T1 | Yes | $4.80 | TX |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is C1 esterase inhibitor (human) 2000 UNT Injection [Haegarda] covered by Medicare Part D?
Yes, C1 esterase inhibitor (human) 2000 UNT Injection [Haegarda] is covered by 4,594 Medicare Part D plans (90.9% of all Part D formularies).
What tier is C1 esterase inhibitor (human) 2000 UNT Injection [Haegarda] on Medicare Part D plans?
C1 esterase inhibitor (human) 2000 UNT Injection [Haegarda] averages Tier 4.3 across Part D plans, ranging from Tier 1 to Tier 5.
Does C1 esterase inhibitor (human) 2000 UNT Injection [Haegarda] require prior authorization?
99.3% of Part D formularies require prior authorization for C1 esterase inhibitor (human) 2000 UNT Injection [Haegarda]. Step therapy: 0%. Quantity limits: 80.4%.
How much does Medicare spend on C1 esterase inhibitor (human) 2000 UNT Injection [Haegarda]?
In 2023, total Medicare Part D spending on C1 esterase inhibitor (human) 2000 UNT Injection [Haegarda] 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
- sapropterin dihydrochloride 100 MG Powder for Oral Solution T4.3
- tolvaptan 15 MG Oral Tablet T4.3
- perampanel 0.5 MG/ML Oral Suspension [FYCOMPA] T4.3
- pirfenidone 534 MG Oral Tablet T4.3
- 0.5 ML ustekinumab 90 MG/ML Prefilled Syringe [Stelara] T4.3
- 1 ML ustekinumab 90 MG/ML Prefilled Syringe [Stelara] T4.3
Similar prior-authorization rate
- levalbuterol 0.21 MG/ML Inhalation Solution 99.3% PA
- sofosbuvir 400 MG / velpatasvir 100 MG Oral Tablet 99.3% PA
- bosentan 125 MG Oral Tablet 99.3% PA
- bosentan 62.5 MG Oral Tablet 99.3% PA
- sapropterin dihydrochloride 100 MG Oral Tablet [Javygtor] 99.3% PA
- 1 ML guselkumab 100 MG/ML Prefilled Syringe [Tremfya] 99.3% PA