Medicare Part D coverage · corticotropin · RxCUI 2584475
corticotropin 80 UNT/ML Injectable Solution [Cortrophin]
Per the CMS 2026 Part D formulary file, corticotropin 80 UNT/ML Injectable Solution [Cortrophin] is covered by 347 Medicare Part D plans (6.9% of enrollable products), averaging Tier 4.1, with prior authorization required on 100% of covering formularies.
- 6.9%
- Plan coverage
- 347
- Plans covering
- T4.1
- Avg tier
- 100%
- Prior auth required
What the CMS Formulary Data Shows for corticotropin 80 UNT/ML Injectable Solution [Cortrophin]
Per the CMS 2026 Part D formulary file, corticotropin 80 UNT/ML Injectable Solution [Cortrophin] (RxNorm concept RXCUI 2584475, generic name corticotropin) appears on 79 distinct formulary files spanning 347 Medicare Part D plan offerings - 6.9% 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 4.1.
Real-world access to corticotropin 80 UNT/ML Injectable Solution [Cortrophin] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 68.4% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 942 Part D beneficiaries filled corticotropin 80 UNT/ML Injectable Solution [Cortrophin] in 2023, with total plan-and-beneficiary spending of $377,839,859 and an average per-beneficiary annual cost of $401,103.88. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry corticotropin 80 UNT/ML Injectable Solution [Cortrophin] today.
Coverage Details
- Formularies covering
- 79
- Plans covering
- 347
- Coverage rate
- 6.9%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 68.4% of formularies
2023 Medicare Spending
- Beneficiaries
- 942
- Total spending
- $377,839,859
- Avg per beneficiary
- $401,103.88
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering corticotropin 80 UNT/ML Injectable Solution [Cortrophin]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 |
| 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 |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| 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 |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | Yes | $4.80 | FL |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | Yes | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | Yes | $4.80 | TX |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | Yes | $10.50 | OR |
Show the next 30 plans
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | Yes | $10.50 | OR |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $13.10 | PA |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | Yes | $17.00 | AZ |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $17.60 | PA |
| Alterwood Advantage Dual Value (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | Yes | $31.20 | MD |
| Highmark Health Options Duals Select (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | Yes | $31.20 | DE |
| Valor Health Plan (HMO I-SNP) | TSG Guard, Inc. | T1 | Yes | $31.40 | OH |
| WV Senior Advantage (HMO I-SNP) | West Virginia Senior Advantage, Inc. | T1 | Yes | $32.70 | WV |
| Abilis Health (HMO I-SNP) | Signature Advantage, LLC | T1 | Yes | $35.90 | KY, TN |
| CommuniCare Advantage ISNP (HMO I-SNP) | OH CHS SNP Inc. | T1 | Yes | $38.40 | IN, MD, OH |
| Nascentia Skilled Nursing Facility (HMO I-SNP) | Visiting Nurse Association OF Central NEW York | T1 | Yes | $58.80 | NY |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T2 | Yes | $0 | CA |
| PHP (HMO C-snp) | Aids Healthcare Foundation | T4 | Yes | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T4 | Yes | $0 | NY |
| Leon MediExtra (HMO) | Leon Health, Inc. | T4 | Yes | $0 | FL |
| Leon MediDual (HMO D-SNP) | Leon Health, Inc. | T4 | Yes | $0 | FL |
| Leon MediMore (HMO) | Leon Health, Inc. | T4 | Yes | $0 | FL |
| Leon MediMax (HMO D-SNP) | Leon Health, Inc. | T4 | Yes | $0 | FL |
| VNS Health EasyCare Plus (HMO D-SNP) | VNS Choice | T4 | Yes | $51.60 | NY |
| Medicare BlueEssential (PPO) | Excellus Health Plan, Inc. | T5 | Yes | $0 | NY |
| Medicare BlueActive (PPO) | Excellus Health Plan, Inc. | T5 | Yes | $0 | NY |
| Medicare BlueVital (PPO) | Excellus Health Plan, Inc. | T5 | Yes | $0 | NY |
| Univera SeniorChoice Basic (HMO) | Excellus Health Plan, Inc. | T5 | Yes | $0 | NY |
| Univera SeniorChoice Extra (HMO) | Excellus Health Plan, Inc. | T5 | Yes | $0 | NY |
| Medicare Blue Choice Core (HMO) | Excellus Health Plan, Inc. | T5 | Yes | $0 | NY |
| Univera Medicare Dual (HMO D-SNP) | Excellus Health Plan Community Care LLC | T5 | Yes | $0 | NY |
| Medicare Blue Dual (HMO D-SNP) | Excellus Health Plan Community Care LLC | T5 | Yes | $0 | NY |
| Troy Medicare (HMO) | Troy Health, Inc. | T5 | Yes | $0 | NC |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | Troy Health, Inc. | T5 | Yes | $0 | NC |
| Contra Costa Health Care Plus (HMO D-SNP) | Contra Costa County Medical Service DBA Contra Costa Health | T5 | Yes | $0 | CA |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is corticotropin 80 UNT/ML Injectable Solution [Cortrophin] covered by Medicare Part D?
Yes, corticotropin 80 UNT/ML Injectable Solution [Cortrophin] is covered by 347 Medicare Part D plans (6.9% of all Part D formularies).
What tier is corticotropin 80 UNT/ML Injectable Solution [Cortrophin] on Medicare Part D plans?
corticotropin 80 UNT/ML Injectable Solution [Cortrophin] averages Tier 4.1 across Part D plans, ranging from Tier 1 to Tier 5.
Does corticotropin 80 UNT/ML Injectable Solution [Cortrophin] require prior authorization?
100% of Part D formularies require prior authorization for corticotropin 80 UNT/ML Injectable Solution [Cortrophin]. Step therapy: 0%. Quantity limits: 68.4%.
How much does Medicare spend on corticotropin 80 UNT/ML Injectable Solution [Cortrophin]?
In 2023, total Medicare Part D spending on corticotropin 80 UNT/ML Injectable Solution [Cortrophin] was $377,839,859, covering 942 beneficiaries. The average spend per beneficiary was $401,103.88.
Read our methodology - how this data is sourced, computed, and verified.
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