carglumic acid 200 MG Tablet for Oral Suspension [Carbaglu]

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carglumic acid

RxCUI: 905394

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.
0.2%
Plan Coverage
12
Plans Covering
T2.3
Avg Tier
100%
Prior Auth Required

What the CMS Formulary Data Shows for carglumic acid 200 MG Tablet for Oral Suspension [Carbaglu]

Per the CMS 2026 Part D formulary file, carglumic acid 200 MG Tablet for Oral Suspension [Carbaglu] (RxNorm concept RXCUI 905394, generic name carglumic acid) appears on 3 distinct formulary files spanning 12 Medicare Part D plan offerings - 0.2% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 2.3.

Real-world access to carglumic acid 200 MG Tablet for Oral Suspension [Carbaglu] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.

Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry carglumic acid 200 MG Tablet for Oral Suspension [Carbaglu] today.

Coverage Details

Formularies covering
3
Plans covering
12
Coverage rate
0.2%
Tier range
Tier 1 – Tier 5
Average tier
Tier 2, Generic

Restrictions

Prior authorization required
100% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

Tier Distribution Across Plans

6 plans
Tier 1, Preferred Generic
6 plans
Tier 5, Specialty

Medicare Advantage Plans (MA-PD) Covering carglumic acid 200 MG Tablet for Oral Suspension [Carbaglu]

12 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 Yes $0 NY
Platino Blindao (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
Platino Enlace (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
PLATINO ADVANCE (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
PLATINO PLUS (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
Hamaspik Medicare Select (HMO D-SNP) HAMASPIK, INC. T1 Yes $34.50 NY
Óptimo Plus (PPO) TRIPLE S ADVANTAGE, INC. T5 Yes $0 PR
Contigo Plus (HMO C-SNP) TRIPLE S ADVANTAGE, INC. T5 Yes $0 PR
Brillante (HMO-POS) TRIPLE S ADVANTAGE, INC. T5 Yes $0 PR
Enlace Plus (HMO) TRIPLE S ADVANTAGE, INC. T5 Yes $0 PR
ContigoEnMente (HMO C-SNP) TRIPLE S ADVANTAGE, INC. T5 Yes $0 PR
Ahorro Plus (HMO) TRIPLE S ADVANTAGE, INC. T5 Yes $0 PR

Frequently Asked Questions

Is carglumic acid 200 MG Tablet for Oral Suspension [Carbaglu] covered by Medicare Part D?

Yes, carglumic acid 200 MG Tablet for Oral Suspension [Carbaglu] is covered by 12 Medicare Part D plans (0.2% of all Part D formularies).

What tier is carglumic acid 200 MG Tablet for Oral Suspension [Carbaglu] on Medicare Part D plans?

carglumic acid 200 MG Tablet for Oral Suspension [Carbaglu] averages Tier 2.3 across Part D plans, ranging from Tier 1 to Tier 5.

Does carglumic acid 200 MG Tablet for Oral Suspension [Carbaglu] require prior authorization?

100% of Part D formularies require prior authorization for carglumic acid 200 MG Tablet for Oral Suspension [Carbaglu]. Step therapy: 0%. Quantity limits: 0%.

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