Medicare Part D coverage · crinecerfont · RxCUI 2701397
crinecerfont 100 MG Oral Capsule [Crenessity]
Per the CMS 2026 Part D formulary file, crinecerfont 100 MG Oral Capsule [Crenessity] is covered by 175 Medicare Part D plans (3.5% of enrollable products), averaging Tier 4.1, with prior authorization required on 87.5% of covering formularies.
- 3.5%
- Plan coverage
- 175
- Plans covering
- T4.1
- Avg tier
- 87.5%
- Prior auth required
What the CMS Formulary Data Shows for crinecerfont 100 MG Oral Capsule [Crenessity]
Per the CMS 2026 Part D formulary file, crinecerfont 100 MG Oral Capsule [Crenessity] (RxNorm concept RXCUI 2701397, generic name crinecerfont) appears on 16 distinct formulary files spanning 175 Medicare Part D plan offerings - 3.5% 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 crinecerfont 100 MG Oral Capsule [Crenessity] depends on utilization management as much as tier placement: 87.5% of covering formularies require prior authorization. 0% require step therapy. 62.5% 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 crinecerfont 100 MG Oral Capsule [Crenessity] today.
Coverage Details
- Formularies covering
- 16
- Plans covering
- 175
- Coverage rate
- 3.5%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 87.5% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 62.5% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering crinecerfont 100 MG Oral Capsule [Crenessity]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | Yes | $0 | MA |
| 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 |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T2 | Yes | $0 | CA |
| Personal Choice 65 Achieve Rx (PPO) | QCC Insurance Company | T5 | Yes | $0 | PA |
| Keystone 65 Focus Rx (HMO-POS) | Keystone Health Plan East, Inc. | T5 | Yes | $0 | PA |
| Keystone 65 Focus Rx (HMO-POS) | Keystone Health Plan East, Inc. | T5 | Yes | $0 | PA |
| Keystone 65 Basic Rx (HMO) | Keystone Health Plan East, Inc. | T5 | Yes | $0 | PA |
| AmeriHealth Medicare Core (PPO) | Amerihealth Insurance Company OF NEW Jersey | T5 | Yes | $0 | NJ |
| AmeriHealth Medicare Ultimate (PPO) | Amerihealth Insurance Company OF NEW Jersey | T5 | Yes | $0 | NJ |
| Geisinger Gold Preferred Complete Rx (PPO) | Geisinger Indemnity Insurance Company | T5 | Yes | $0 | PA |
| Geisinger Gold Secure Rx (HMO D-SNP) | Geisinger Health Plan | T5 | Yes | $0 | PA |
| Geisinger Gold Classic 360 Rx (HMO) | Geisinger Health Plan | T5 | Yes | $0 | PA |
| Geisinger Gold Classic Essential Rx (HMO) | Geisinger Health Plan | T5 | Yes | $0 | PA |
| Fallon Medicare Plus Orange (HMO) | Fallon Community Health Plan | T5 | Yes | $0 | MA |
| UPMC for Life HMO Premier Rx (HMO) | Upmc Health Plan, Inc. | T5 | Yes | $0 | PA |
| UPMC for Life Complete Care (HMO D-SNP) | Upmc FOR YOU, Inc | T5 | Yes | $0 | PA |
| UPMC for Life Complete Care (HMO D-SNP) | Upmc FOR YOU, Inc | T5 | Yes | $0 | PA |
| UPMC for Life PPO Premier Rx (PPO) | Upmc Health Network, Inc. | T5 | Yes | $0 | PA |
| UPMC for Life PPO Premier Rx (PPO) | Upmc Health Network, Inc. | T5 | Yes | $0 | PA |
Show the next 30 plans
Showing top 50 of 100 plans.
Frequently Asked Questions
Is crinecerfont 100 MG Oral Capsule [Crenessity] covered by Medicare Part D?
Yes, crinecerfont 100 MG Oral Capsule [Crenessity] is covered by 175 Medicare Part D plans (3.5% of all Part D formularies).
What tier is crinecerfont 100 MG Oral Capsule [Crenessity] on Medicare Part D plans?
crinecerfont 100 MG Oral Capsule [Crenessity] averages Tier 4.1 across Part D plans, ranging from Tier 1 to Tier 5.
Does crinecerfont 100 MG Oral Capsule [Crenessity] require prior authorization?
87.5% of Part D formularies require prior authorization for crinecerfont 100 MG Oral Capsule [Crenessity]. Step therapy: 0%. Quantity limits: 62.5%.
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
Similar prior-authorization rate
- Once-Daily gabapentin 300 MG Oral Tablet 87.5% PA
- 1 ML ustekinumab-ttwe 90 MG/ML Prefilled Syringe 87.5% PA
- 0.5 ML ustekinumab-ttwe 90 MG/ML Prefilled Syringe 87.5% PA
- 1.7 ML denosumab-bmwo 70 MG/ML Injection [Osenvelt] 87.3% PA
- tetrabenazine 12.5 MG Oral Tablet 87.8% PA
- thalidomide 50 MG Oral Capsule [Thalomid] 87.2% PA