Medicare Part D coverage · dexamethasone · RxCUI 205669
dexamethasone 1 MG/ML Ophthalmic Suspension [Maxidex]
Per the CMS 2026 Part D formulary file, dexamethasone 1 MG/ML Ophthalmic Suspension [Maxidex] is covered by 36 Medicare Part D plans (0.7% of enrollable products), averaging Tier 3, with prior authorization required on 0% of covering formularies.
- 0.7%
- Plan coverage
- 36
- Plans covering
- T3
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for dexamethasone 1 MG/ML Ophthalmic Suspension [Maxidex]
Per the CMS 2026 Part D formulary file, dexamethasone 1 MG/ML Ophthalmic Suspension [Maxidex] (RxNorm concept RXCUI 205669, generic name dexamethasone) appears on 6 distinct formulary files spanning 36 Medicare Part D plan offerings - 0.7% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.
Real-world access to dexamethasone 1 MG/ML Ophthalmic Suspension [Maxidex] depends on utilization management as much as tier placement: 0% 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 850,184 Part D beneficiaries filled dexamethasone 1 MG/ML Ophthalmic Suspension [Maxidex] in 2023, with total plan-and-beneficiary spending of $19,991,137 and an average per-beneficiary annual cost of $23.51. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry dexamethasone 1 MG/ML Ophthalmic Suspension [Maxidex] today.
Coverage Details
- Formularies covering
- 6
- Plans covering
- 36
- Coverage rate
- 0.7%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 850,184
- Total spending
- $19,991,137
- Avg per beneficiary
- $23.51
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering dexamethasone 1 MG/ML Ophthalmic Suspension [Maxidex]
36 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $13.10 | PA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $17.60 | PA |
| Highmark Health Options Duals Select (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $31.20 | DE |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T2 | No | $0 | CA |
| HAP Medicare Explore (PPO) | Alliance Health AND Life Insurance Company | T3 | No | $0 | MI |
| HAP Medicare Prime (PPO) | Alliance Health AND Life Insurance Company | T3 | No | $0 | MI |
| HAP Medicare Connect (HMO) | Health Alliance Plan OF Michigan | T3 | No | $0 | MI |
| HAP Medicare Complete Duals (HMO D-SNP) | Health Alliance Plan OF Michigan | T3 | No | $0 | MI |
| HAP Medicare Superior (HMO) | Health Alliance Plan OF Michigan | T3 | No | $0 | MI |
| Henry Ford Select (HMO) | Health Alliance Plan OF Michigan | T3 | No | $0 | MI |
| HAP Member Assist (PPO) | Alliance Health AND Life Insurance Company | T3 | No | $8.80 | MI |
| HAP Medicare Complete Assist (PPO D-SNP) | Alliance Health AND Life Insurance Company | T3 | No | $8.80 | MI |
| HAP Medicare Diabetes and Heart (HMO C-SNP) | Health Alliance Plan OF Michigan | T3 | No | $8.80 | MI |
| HAP Senior Plus Henry Ford Tiered Access (HMO) | Health Alliance Plan OF Michigan | T3 | No | $11.30 | MI |
| HAP Senior Plus (HMO-POS) | Health Alliance Plan OF Michigan | T3 | No | $13.50 | MI |
| HAP Senior Plus (PPO) | Alliance Health AND Life Insurance Company | T3 | No | $42.60 | MI |
Show the next 16 plans
Frequently Asked Questions
Is dexamethasone 1 MG/ML Ophthalmic Suspension [Maxidex] covered by Medicare Part D?
Yes, dexamethasone 1 MG/ML Ophthalmic Suspension [Maxidex] is covered by 36 Medicare Part D plans (0.7% of all Part D formularies).
What tier is dexamethasone 1 MG/ML Ophthalmic Suspension [Maxidex] on Medicare Part D plans?
dexamethasone 1 MG/ML Ophthalmic Suspension [Maxidex] averages Tier 3 across Part D plans, ranging from Tier 1 to Tier 4.
Does dexamethasone 1 MG/ML Ophthalmic Suspension [Maxidex] require prior authorization?
0% of Part D formularies require prior authorization for dexamethasone 1 MG/ML Ophthalmic Suspension [Maxidex]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on dexamethasone 1 MG/ML Ophthalmic Suspension [Maxidex]?
In 2023, total Medicare Part D spending on dexamethasone 1 MG/ML Ophthalmic Suspension [Maxidex] was $19,991,137, covering 850,184 beneficiaries. The average spend per beneficiary was $23.51.
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
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