Medicare Part D coverage · canagliflozin · RxCUI 1545159
canagliflozin 150 MG / metformin hydrochloride 500 MG Oral Tablet [Invokamet]
Per the CMS 2026 Part D formulary file, canagliflozin 150 MG / metformin hydrochloride 500 MG Oral Tablet [Invokamet] is covered by 699 Medicare Part D plans (13.8% of enrollable products), averaging Tier 3.5, with prior authorization required on 0% of covering formularies.
- 13.8%
- Plan coverage
- 699
- Plans covering
- T3.5
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for canagliflozin 150 MG / metformin hydrochloride 500 MG Oral Tablet [Invokamet]
Per the CMS 2026 Part D formulary file, canagliflozin 150 MG / metformin hydrochloride 500 MG Oral Tablet [Invokamet] (RxNorm concept RXCUI 1545159, generic name canagliflozin) appears on 20 distinct formulary files spanning 699 Medicare Part D plan offerings - 13.8% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 2 to Tier 4, with a cross-plan average of Tier 3.5.
Real-world access to canagliflozin 150 MG / metformin hydrochloride 500 MG Oral Tablet [Invokamet] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 95% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 69,576 Part D beneficiaries filled canagliflozin 150 MG / metformin hydrochloride 500 MG Oral Tablet [Invokamet] in 2023, with total plan-and-beneficiary spending of $357,419,494 and an average per-beneficiary annual cost of $5,137.11. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry canagliflozin 150 MG / metformin hydrochloride 500 MG Oral Tablet [Invokamet] today.
Coverage Details
- Formularies covering
- 20
- Plans covering
- 699
- Coverage rate
- 13.8%
- Tier range
- Tier 2 – Tier 4
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 95% of formularies
2023 Medicare Spending
- Beneficiaries
- 69,576
- Total spending
- $357,419,494
- Avg per beneficiary
- $5,137.11
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering canagliflozin 150 MG / metformin hydrochloride 500 MG Oral Tablet [Invokamet]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T2 | No | $0 | CA |
| Freedom VIP Care (HMO C-SNP) | Freedom Health, Inc. | T3 | No | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | Freedom Health, Inc. | T3 | No | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | Freedom Health, Inc. | T3 | No | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | Freedom Health, Inc. | T3 | No | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | Freedom Health, Inc. | T3 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | Optimum Healthcare, Inc. | T3 | No | $0 | FL |
| Optimum Diamond Savings (HMO C-SNP) | Optimum Healthcare, Inc. | T3 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | Optimum Healthcare, Inc. | T3 | No | $0 | FL |
| Optimum Diamond (HMO C-SNP) | Optimum Healthcare, Inc. | T3 | No | $0 | FL |
| Freedom Medi-Medi Partial (HMO D-SNP) | Freedom Health, Inc. | T3 | No | $0 | FL |
| Freedom Medi-Medi Full (HMO D-SNP) | Freedom Health, Inc. | T3 | No | $0 | FL |
| Optimum Emerald Partial (HMO D-SNP) | Optimum Healthcare, Inc. | T3 | No | $0 | FL |
| Optimum Emerald Full (HMO D-SNP) | Optimum Healthcare, Inc. | T3 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | Freedom Health, Inc. | T3 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | Freedom Health, Inc. | T3 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | Freedom Health, Inc. | T3 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | Freedom Health, Inc. | T3 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T3 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T3 | No | $0 | FL |
Show the next 30 plans
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T3 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T3 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T3 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T3 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T3 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T3 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T3 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T3 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T3 | No | $0 | FL |
| Freedom Máximo (HMO-POS) | Freedom Health, Inc. | T3 | No | $0 | FL |
| Freedom Máximo (HMO-POS) | Freedom Health, Inc. | T3 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T3 | No | $0 | FL |
| Optimum Platinum Plan (HMO) | Optimum Healthcare, Inc. | T3 | No | $0 | FL |
| Optimum Gold Plan (HMO) | Optimum Healthcare, Inc. | T3 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T3 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T3 | No | $0 | FL |
| Optimum Diamond Rewards COPD (HMO C-SNP) | Optimum Healthcare, Inc. | T3 | No | $0 | FL |
| Optimum Diamond Savings COPD (HMO C-SNP) | Optimum Healthcare, Inc. | T3 | No | $0 | FL |
| Optimum Gold Plus Plan (HMO) | Optimum Healthcare, Inc. | T3 | No | $0 | FL |
| Optimum Diamond Rewards COPD (HMO C-SNP) | Optimum Healthcare, Inc. | T3 | No | $0 | FL |
| Network Health Select (PPO) | Network Health Insurance Corporation | T3 | No | $0 | WI |
| Network Health Go (PPO) | Network Health Insurance Corporation | T3 | No | $0 | WI |
| Network Health Anywhere (PPO) | Network Health Insurance Corporation | T3 | No | $0 | WI |
| Network Health Choice (PPO) | Network Health Insurance Corporation | T3 | No | $0 | WI |
| Network Health Zero (PPO) | Network Health Insurance Corporation | T3 | No | $0 | WI |
| Alignment Health the ONE + Walgreens (HMO) | Alignment Health Plan OF Arizona, Inc. | T3 | No | $0 | AZ |
| Alignment Health the ONE + Walgreens (HMO) | Alignment Health Plan OF Arizona, Inc. | T3 | No | $0 | AZ |
| Alignment Health Heart & Diabetes (HMO C-SNP) | Alignment Health Plan OF Arizona, Inc. | T3 | No | $0 | AZ |
| Alignment Health smartHMO (HMO) | Alignment Health Plan OF Arizona, Inc. | T3 | No | $0 | AZ |
| Alignment Health My Choice (HMO) | Alignment Health Plan | T3 | No | $0 | CA |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is canagliflozin 150 MG / metformin hydrochloride 500 MG Oral Tablet [Invokamet] covered by Medicare Part D?
Yes, canagliflozin 150 MG / metformin hydrochloride 500 MG Oral Tablet [Invokamet] is covered by 699 Medicare Part D plans (13.8% of all Part D formularies).
What tier is canagliflozin 150 MG / metformin hydrochloride 500 MG Oral Tablet [Invokamet] on Medicare Part D plans?
canagliflozin 150 MG / metformin hydrochloride 500 MG Oral Tablet [Invokamet] averages Tier 3.5 across Part D plans, ranging from Tier 2 to Tier 4.
Does canagliflozin 150 MG / metformin hydrochloride 500 MG Oral Tablet [Invokamet] require prior authorization?
0% of Part D formularies require prior authorization for canagliflozin 150 MG / metformin hydrochloride 500 MG Oral Tablet [Invokamet]. Step therapy: 0%. Quantity limits: 95%.
How much does Medicare spend on canagliflozin 150 MG / metformin hydrochloride 500 MG Oral Tablet [Invokamet]?
In 2023, total Medicare Part D spending on canagliflozin 150 MG / metformin hydrochloride 500 MG Oral Tablet [Invokamet] was $357,419,494, covering 69,576 beneficiaries. The average spend per beneficiary was $5,137.11.
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
- lomustine 40 MG Oral Capsule T3.5
- 1 ML denosumab 60 MG/ML Prefilled Syringe [Prolia] T3.5
- tretinoin 0.001 MG/MG Topical Gel T3.5
- ethacrynic acid 25 MG Oral Tablet T3.5
- daridorexant 25 MG Oral Tablet [Quviviq] T3.5
- 24 HR canagliflozin 150 MG / metformin hydrochloride 1000 MG Extended Release Oral Tablet [Invokamet] T3.5