Medicare Part D coverage · dexamethasone · RxCUI 1011080
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] is covered by 1,020 Medicare Part D plans (20.2% of enrollable products), averaging Tier 3.4, with prior authorization required on 0% of covering formularies.
- 20.2%
- Plan coverage
- 1,020
- 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 43 distinct formulary files spanning 1,020 Medicare Part D plan offerings - 20.2% 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 $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 0.5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Tobradex] today.
Coverage Details
- Formularies covering
- 43
- Plans covering
- 1,020
- Coverage rate
- 20.2%
- 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
- $19,991,137
- Avg per beneficiary
- $23.51
Tier Distribution Across Plans
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 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 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 |
Show the next 30 plans
| 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 |
| Aetna Medicare Signature (HMO-POS) | Coventry Health Care OF Illinois, Inc. | T3 | No | $0 | IL |
| Aetna Medicare Prime Chronic Care (HMO C-SNP) | Coventry Health Care OF Illinois, Inc. | T3 | No | $0 | IL |
| Aetna Medicare Signature Extra (HMO-POS) | Coventry Health Care OF Illinois, Inc. | T3 | No | $0 | IL |
Showing top 50 of 100 plans.
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 1,020 Medicare Part D plans (20.2% 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 $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
- tacrolimus 0.2 MG Granules for Oral Suspension [Prograf] T3.4
- nafcillin 100 MG/ML Injectable Solution T3.4
- hydroxyurea 100 MG Oral Tablet [Siklos] T3.4
- {14 (cenobamate 12.5 MG Oral Tablet [Xcopri]) / 14 (cenobamate 25 MG Oral Tablet [Xcopri]) } Pack [Xcopri Titration Pack - 12.5 MG (14), 25 MG (14) 28 Count] T3.4
- {2 (iloperidone 1 MG Oral Tablet [Fanapt]) / 2 (iloperidone 2 MG Oral Tablet [Fanapt]) / 2 (iloperidone 4 MG Oral Tablet [Fanapt]) / 2 (iloperidone 6 MG Oral Tablet [Fanapt]) } Pack [Fanapt Titration Pack] T3.4
- Sprinkle duloxetine 20 MG Delayed Release Oral Capsule [Drizalma] T3.4