dexamethasone 0.5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Tobradex]

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dexamethasone

RxCUI: 1011080

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.
20.4%
Plan Coverage
1,033
Plans Covering
T3.4
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for dexamethasone 0.5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Tobradex]

Per the CMS 2026 Part D formulary file, dexamethasone 0.5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Tobradex] (RxNorm concept RXCUI 1011080, generic name dexamethasone) appears on 44 distinct formulary files spanning 1,033 Medicare Part D plan offerings - 20.4% 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 3.4.

Real-world access to dexamethasone 0.5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Tobradex] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 2.3% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 850,184 Part D beneficiaries filled dexamethasone 0.5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Tobradex] in 2023, with total plan-and-beneficiary spending of $20,009,734 and an average per-beneficiary annual cost of $23.54. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry dexamethasone 0.5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Tobradex] today.

Coverage Details

Formularies covering
44
Plans covering
1,033
Coverage rate
20.4%
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
2.3% of formularies

2023 Medicare Spending

Beneficiaries
850,184
Total spending
$20,009,734
Avg per beneficiary
$23.54

Tier Distribution Across Plans

24 plans
Tier 1, Preferred Generic
76 plans
Tier 3, Preferred Brand

Medicare Advantage Plans (MA-PD) Covering dexamethasone 0.5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Tobradex]

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
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 Maryland Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN, INC. T1 No $0 MD
Provider Partners Missouri Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. T1 No $0 MO
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
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
Provider Partners Texas Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC. T1 No $4.80 TX
Provider Partners Illinois Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS T1 No $15.20 IL
Provider Partners Maryland Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN, INC. T1 No $31.20 MD
Provider Partners Maryland Essential Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN, INC. T1 No $31.20 MD
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
Provider Partners Indiana Essential Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF INDIANA T1 No $38.40 IN
Provider Partners Kentucky Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY T1 No $38.40 KY
Provider Partners Missouri Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. T1 No $43.00 MO
Provider Partners Missouri Essential Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. T1 No $43.00 MO
Aetna Medicare Signature (HMO) AETNA HEALTH OF CALIFORNIA INC. T3 No $0 CA
Aetna Medicare Signature (HMO) AETNA HEALTH OF CALIFORNIA INC. T3 No $0 CA
Aetna Medicare Signature Extra (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T3 No $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T3 No $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T3 No $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T3 No $0 CA
Aetna Medicare Signature Extra (HMO) AETNA HEALTH OF CALIFORNIA INC. T3 No $0 CA
Aetna Medicare Prime (HMO-POS) AETNA HEALTH OF CALIFORNIA INC. T3 No $0 CA
Aetna Medicare Signature Extra (HMO) AETNA HEALTH OF CALIFORNIA INC. T3 No $0 CA
Aetna Medicare Signature Extra (HMO) AETNA HEALTH OF CALIFORNIA INC. T3 No $0 CA
Aetna Medicare Signature Extra (HMO) AETNA HEALTH OF CALIFORNIA INC. T3 No $0 CA
Aetna Medicare Signature Care (HMO-POS) AETNA HEALTH OF OHIO INC. T3 No $0 OH
Aetna Medicare Signature Extra (HMO-POS) AETNA HEALTH OF OHIO INC. T3 No $0 OH
Aetna Medicare Signature Care (HMO-POS) AETNA HEALTH OF OHIO INC. T3 No $0 OH
Aetna Medicare Signature Extra (HMO-POS) AETNA HEALTH OF OHIO INC. T3 No $0 KY
Aetna Medicare Signature (HMO-POS) AETNA HEALTH OF OHIO INC. T3 No $0 KY
Aetna Medicare Signature (HMO-POS) AETNA HEALTH OF OHIO INC. T3 No $0 KY
Aetna Medicare HIDE (HMO D-SNP) AETNA HEALTH OF OHIO INC. T3 No $0 KY
Aetna Medicare Dual Care (HMO D-SNP) AETNA HEALTH OF OHIO INC. T3 No $0 OH
Aetna Medicare Signature Care (HMO-POS) AETNA HEALTH OF OHIO INC. T3 No $0 OH
Aetna Medicare Signature (HMO-POS) AETNA HEALTH OF OHIO INC. T3 No $0 OH
Aetna Medicare Signature (HMO-POS) AETNA HEALTH OF OHIO INC. T3 No $0 KY
Aetna Medicare Partial Dual (HMO D-SNP) AETNA HEALTH OF OHIO INC. T3 No $0 KY
Aetna Medicare Partial Dual (HMO D-SNP) AETNA HEALTH OF OHIO INC. T3 No $0 OH
Aetna Medicare Signature (HMO) AETNA HEALTH INC.(GA) T3 No $0 GA
Aetna Medicare Signature (HMO-POS) COVENTRY HEALTH CARE OF ILLINOIS, INC. T3 No $0 WI

Frequently Asked Questions

Is dexamethasone 0.5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Tobradex] covered by Medicare Part D?

Yes, dexamethasone 0.5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Tobradex] is covered by 1,033 Medicare Part D plans (20.4% of all Part D formularies).

What tier is dexamethasone 0.5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Tobradex] on Medicare Part D plans?

dexamethasone 0.5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Tobradex] averages Tier 3.4 across Part D plans, ranging from Tier 1 to Tier 4.

Does dexamethasone 0.5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Tobradex] require prior authorization?

0% of Part D formularies require prior authorization for dexamethasone 0.5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Tobradex]. Step therapy: 0%. Quantity limits: 2.3%.

How much does Medicare spend on dexamethasone 0.5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Tobradex]?

In 2023, total Medicare Part D spending on dexamethasone 0.5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Tobradex] was $20,009,734, covering 850,184 beneficiaries. The average spend per beneficiary was $23.54.

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