Medicare Part D coverage · ceftaroline fosamil · RxCUI 1040016
ceftaroline fosamil 600 MG Injection [Teflaro]
Per the CMS 2026 Part D formulary file, ceftaroline fosamil 600 MG Injection [Teflaro] is covered by 4,293 Medicare Part D plans (85% of enrollable products), averaging Tier 4.4, with prior authorization required on 14.1% of covering formularies.
- 85%
- Plan coverage
- 4,293
- Plans covering
- T4.4
- Avg tier
- 14.1%
- Prior auth required
What the CMS Formulary Data Shows for ceftaroline fosamil 600 MG Injection [Teflaro]
Per the CMS 2026 Part D formulary file, ceftaroline fosamil 600 MG Injection [Teflaro] (RxNorm concept RXCUI 1040016, generic name ceftaroline fosamil) appears on 199 distinct formulary files spanning 4,293 Medicare Part D plan offerings - 85% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.4.
Real-world access to ceftaroline fosamil 600 MG Injection [Teflaro] depends on utilization management as much as tier placement: 14.1% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 887 Part D beneficiaries filled ceftaroline fosamil 600 MG Injection [Teflaro] in 2023, with total plan-and-beneficiary spending of $11,267,093 and an average per-beneficiary annual cost of $12,702.47. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry ceftaroline fosamil 600 MG Injection [Teflaro] today.
Coverage Details
- Formularies covering
- 199
- Plans covering
- 4,293
- Coverage rate
- 85%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 14.1% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 887
- Total spending
- $11,267,093
- Avg per beneficiary
- $12,702.47
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering ceftaroline fosamil 600 MG Injection [Teflaro]
5 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | No | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | No | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering ceftaroline fosamil 600 MG Injection [Teflaro]
95 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 | No | $0 | FL |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | Yes | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | Yes | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | Yes | $0 | NJ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | No | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | No | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | No | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | No | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | No | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | No | $0 | NY |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | Yes | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | Yes | $0 | GA |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | Yes | $0 | MI |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | No | $0 | CA |
Show the next 30 plans
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare OF NEW Jersey, Inc. | T1 | No | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | No | $0 | CA |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $0 | MO |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| 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 |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Florida Complete Care (HMO I-SNP) | Hpmp OF Florida, Inc. | T1 | No | $4.80 | FL |
| Florida Complete Care- In The Community (HMO-POS I-SNP) | Hpmp OF Florida, Inc. | T1 | No | $4.80 | FL |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Hcsc Insurance Services Company | T1 | No | $4.80 | TX |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Texas, Inc. | T1 | No | $4.80 | TX |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS Insurance Company | T1 | No | $5.00 | OK |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Michigan, Inc. | T1 | Yes | $8.80 | MI |
Showing top 50 of 95 plans.
Frequently Asked Questions
Is ceftaroline fosamil 600 MG Injection [Teflaro] covered by Medicare Part D?
Yes, ceftaroline fosamil 600 MG Injection [Teflaro] is covered by 4,293 Medicare Part D plans (85% of all Part D formularies).
What tier is ceftaroline fosamil 600 MG Injection [Teflaro] on Medicare Part D plans?
ceftaroline fosamil 600 MG Injection [Teflaro] averages Tier 4.4 across Part D plans, ranging from Tier 1 to Tier 5.
Does ceftaroline fosamil 600 MG Injection [Teflaro] require prior authorization?
14.1% of Part D formularies require prior authorization for ceftaroline fosamil 600 MG Injection [Teflaro]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on ceftaroline fosamil 600 MG Injection [Teflaro]?
In 2023, total Medicare Part D spending on ceftaroline fosamil 600 MG Injection [Teflaro] was $11,267,093, covering 887 beneficiaries. The average spend per beneficiary was $12,702.47.
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
- cysteamine 4.4 MG/ML Ophthalmic Solution [Cystaran] T4.4
- sapropterin dihydrochloride 500 MG Powder for Oral Solution [Zelvysia] T4.4
- eliglustat 84 MG Oral Capsule [Cerdelga] T4.4
- {28 (alpelisib 50 MG Oral Granules [Vijoice]) } Pack [Vijoice 50 MG Granules 28 Day] T4.4
- sofosbuvir 200 MG Oral Tablet [Sovaldi] T4.4
- sinecatechins 0.15 MG/MG Topical Ointment [Veregen] T4.4
Similar prior-authorization rate
- omega-3 acid ethyl esters (USP) 1000 MG Oral Capsule 14.1% PA
- tenofovir alafenamide 25 MG Oral Tablet [Vemlidy] 14.1% PA
- haloperidol 5 MG/ML Injectable Solution 14% PA
- 1 ML haloperidol decanoate 100 MG/ML Injection 14.2% PA
- haloperidol decanoate 50 MG/ML Injectable Solution 14.2% PA
- tigecycline 50 MG Injection 14% PA