Medicare Part D coverage · carglumic acid · RxCUI 905394
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] is covered by 12 Medicare Part D plans (0.2% of enrollable products), averaging Tier 2.3, with prior authorization required on 100% of covering formularies.
- 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
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%.
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
- 0.25 ML tick-borne encephalitis purified antigen 0.0048 MG/ML Prefilled Syringe [Ticovac] T2.3
- 0.5 ML acellular pertussis vaccine, inactivated 0.116 MG/ML / diphtheria toxoid vaccine, inactivated 50 UNT/ML / hepatitis B surface antigen vaccine 0.02 MG/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 80 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 16 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 64 UNT/ML / tetanus toxoid vaccine, inactivated 20 UNT/ML Prefilled Syringe [PEDIARIX] T2.3
- acetaminophen 325 MG / oxycodone hydrochloride 5 MG Oral Tablet T2.3
- sodium polystyrene sulfonate 15000 MG Powder for Oral Suspension T2.3
- oxycodone hydrochloride 30 MG Oral Tablet T2.3
- fosinopril sodium 10 MG Oral Tablet T2.3
Similar prior-authorization rate
- sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane] 100% PA
- formoterol fumarate 0.01 MG/ML Inhalation Solution [Perforomist] 100% PA
- lusutrombopag 3 MG Oral Tablet [Mulpleta] 100% PA
- 12 HR tapentadol 100 MG Extended Release Oral Tablet [Nucynta] 100% PA
- {14 (24 HR lamotrigine 100 MG Extended Release Oral Tablet [Lamictal]) / 7 (24 HR lamotrigine 200 MG Extended Release Oral Tablet [Lamictal]) / 14 (24 HR lamotrigine 50 MG Extended Release Oral Tablet [Lamictal]) } Pack [Lamictal XR Green Patient Titration Kit (for Patients Taking Carbamazepine, Phenytoin, Phenobarbital, or Primidone, and Not Taking Valproate)] 100% PA
- eltrombopag 25 MG Oral Tablet [Promacta] 100% PA