Medicare Part D coverage · cyclosporine · RxCUI 402092

cyclosporine 0.5 MG/ML Ophthalmic Suspension [Restasis]

Per the CMS 2026 Part D formulary file, cyclosporine 0.5 MG/ML Ophthalmic Suspension [Restasis] is covered by 2,685 Medicare Part D plans (53.1% of enrollable products), averaging Tier 2.7, with prior authorization required on 0% of covering formularies.

53.1%
Plan coverage
2,685
Plans covering
T2.7
Avg tier
0%
Prior auth required

Verify with CMS →

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.

What the CMS Formulary Data Shows for cyclosporine 0.5 MG/ML Ophthalmic Suspension [Restasis]

Per the CMS 2026 Part D formulary file, cyclosporine 0.5 MG/ML Ophthalmic Suspension [Restasis] (RxNorm concept RXCUI 402092, generic name cyclosporine) appears on 123 distinct formulary files spanning 2,685 Medicare Part D plan offerings - 53.1% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 3, with a cross-plan average of Tier 2.7.

Real-world access to cyclosporine 0.5 MG/ML Ophthalmic Suspension [Restasis] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 34.1% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 492,479 Part D beneficiaries filled cyclosporine 0.5 MG/ML Ophthalmic Suspension [Restasis] in 2023, with total plan-and-beneficiary spending of $1,501,664,198 and an average per-beneficiary annual cost of $3,049.19. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry cyclosporine 0.5 MG/ML Ophthalmic Suspension [Restasis] today.

Coverage Details

Formularies covering
123
Plans covering
2,685
Coverage rate
53.1%
Tier range
Tier 1 – Tier 3
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
0% of formularies
Step therapy required
0% of formularies
Quantity limits
34.1% of formularies

2023 Medicare Spending

Beneficiaries
492,479
Total spending
$1,501,664,198
Avg per beneficiary
$3,049.19

Tier Distribution Across Plans

56 plans
Tier 1, Preferred Generic
3 plans
Tier 2, Generic
41 plans
Tier 3, Preferred Brand

Standalone Drug Plans (PDP) Covering cyclosporine 0.5 MG/ML Ophthalmic Suspension [Restasis]

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 T3 No No $0 -
AARP Medicare Rx Preferred from UHC (PDP) Unitedhealthcare INS. Co. & UHC INS. Co. OF NY T3 No No $0 -
AARP Medicare Rx Saver from UHC (PDP) Unitedhealthcare INS. Co. & UHC INS. Co. OF NY T3 No No $0 -
AARP Medicare Rx Saver from UHC (PDP) Unitedhealthcare INS. Co. & UHC INS. Co. OF NY T3 No No $0 -
AARP Medicare Rx Saver from UHC (PDP) Unitedhealthcare INS. Co. & UHC INS. Co. OF NY T3 No No $0 -

Medicare Advantage Plans (MA-PD) Covering cyclosporine 0.5 MG/ML Ophthalmic Suspension [Restasis]

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
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
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
NaviCare (HMO D-SNP) Fallon Community Health Plan T1 No $0 MA
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
Show the next 30 plans
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 No $0 PR
Platino Enlace (HMO D-SNP) Triple S Advantage, Inc. T1 No $0 PR
Platino Advance (HMO D-snp) Triple S Advantage, Inc. T1 No $0 PR
Platino Plus (HMO D-snp) Triple S Advantage, Inc. T1 No $0 PR
Mass General Brigham SCO (HMO D-SNP) Mass General Brigham Health Plan, Inc T1 No $0 MA
Mass General Brigham One Care (HMO D-SNP) Mass General Brigham Health Plan, Inc T1 No $0 MA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) Gateway Health Plan, Inc. T1 No $0 PA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) Gateway Health Plan, Inc. T1 No $0 PA
Highmark Health Options Duals (HMO D-SNP) Highmark Health Options West Virginia Inc. T1 No $0 WV
Highmark Health Options Duals (HMO D-SNP) Highmark Bcbsd, Inc. T1 No $0 DE
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
Provider Partners Texas Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF Texas, Inc. T1 No $4.80 TX
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) Gateway Health Plan, Inc. T1 No $13.10 PA
Provider Partners Illinois Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF Illinois T1 No $15.20 IL
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) Gateway Health Plan, Inc. T1 No $17.60 PA
Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) Elderplan, Inc. T1 No $22.70 NY
VIVA Medicare Extra Value (HMO D-SNP) Viva Health, Inc. T1 No $27.70 AL
VIVA Medicare Extra Care (HMO D-SNP) Viva Health, Inc. T1 No $27.70 AL
Highmark Health Options Duals Select (HMO D-SNP) Highmark Bcbsd, Inc. T1 No $31.20 DE
Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF Pennsylvania, Inc T1 No $32.70 PA
Provider Partners Pennsylvania Essential Plan (HMO I-SNP) Provider Partners Health Plan OF Pennsylvania, Inc T1 No $32.70 PA
Provider Partners North Carolina Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF North Carolina T1 No $36.20 NC
Provider Partners North Carolina Essential Plan (HMO I-SNP) Provider Partners Health Plan OF North Carolina T1 No $36.20 NC
Provider Partners Indiana Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF Indiana T1 No $38.40 IN

Showing top 50 of 95 plans.

Frequently Asked Questions

Is cyclosporine 0.5 MG/ML Ophthalmic Suspension [Restasis] covered by Medicare Part D?

Yes, cyclosporine 0.5 MG/ML Ophthalmic Suspension [Restasis] is covered by 2,685 Medicare Part D plans (53.1% of all Part D formularies).

What tier is cyclosporine 0.5 MG/ML Ophthalmic Suspension [Restasis] on Medicare Part D plans?

cyclosporine 0.5 MG/ML Ophthalmic Suspension [Restasis] averages Tier 2.7 across Part D plans, ranging from Tier 1 to Tier 3.

Does cyclosporine 0.5 MG/ML Ophthalmic Suspension [Restasis] require prior authorization?

0% of Part D formularies require prior authorization for cyclosporine 0.5 MG/ML Ophthalmic Suspension [Restasis]. Step therapy: 0%. Quantity limits: 34.1%.

How much does Medicare spend on cyclosporine 0.5 MG/ML Ophthalmic Suspension [Restasis]?

In 2023, total Medicare Part D spending on cyclosporine 0.5 MG/ML Ophthalmic Suspension [Restasis] was $1,501,664,198, covering 492,479 beneficiaries. The average spend per beneficiary was $3,049.19.

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.

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