Medicare Part D coverage · emtricitabine · RxCUI 1147337
emtricitabine 200 MG / rilpivirine 25 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Complera]
Per the CMS 2026 Part D formulary file, emtricitabine 200 MG / rilpivirine 25 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Complera] is covered by 1,174 Medicare Part D plans (23.2% of enrollable products), averaging Tier 4.8, with prior authorization required on 0% of covering formularies.
- 23.2%
- Plan coverage
- 1,174
- Plans covering
- T4.8
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for emtricitabine 200 MG / rilpivirine 25 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Complera]
Per the CMS 2026 Part D formulary file, emtricitabine 200 MG / rilpivirine 25 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Complera] (RxNorm concept RXCUI 1147337, generic name emtricitabine) appears on 21 distinct formulary files spanning 1,174 Medicare Part D plan offerings - 23.2% 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 4.8.
Real-world access to emtricitabine 200 MG / rilpivirine 25 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Complera] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 71.4% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 997 Part D beneficiaries filled emtricitabine 200 MG / rilpivirine 25 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Complera] in 2023, with total plan-and-beneficiary spending of $2,662,092 and an average per-beneficiary annual cost of $2,670.10. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry emtricitabine 200 MG / rilpivirine 25 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Complera] today.
Coverage Details
- Formularies covering
- 21
- Plans covering
- 1,174
- Coverage rate
- 23.2%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 5, Specialty
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 71.4% of formularies
2023 Medicare Spending
- Beneficiaries
- 997
- Total spending
- $2,662,092
- Avg per beneficiary
- $2,670.10
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering emtricitabine 200 MG / rilpivirine 25 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Complera]
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 | T5 | No | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | No | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering emtricitabine 200 MG / rilpivirine 25 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Complera]
95 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| Hamaspik Medicare Select (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $34.50 | NY |
| UHC Dual Complete IA-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T5 | No | $0 | IA |
| UHC Dual Complete MO-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T5 | No | $0 | MO |
| UHC Dual Complete NE-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T5 | No | $0 | NE |
| UHC Dual Complete KS-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T5 | No | $0 | KS |
| UHC Dual Complete MO-S3 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T5 | No | $0 | MO |
| UHC Dual Complete KS-Q1 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T5 | No | $0 | KS |
| UHC Dual Complete TN-S001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T5 | No | $0 | TN |
| UHC Dual Complete TN-Y001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T5 | No | $0 | TN |
| UHC Dual Complete TN-Y2 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T5 | No | $0 | TN |
| AARP Medicare Advantage from UHC MI-0001 (PPO) | Unitedhealthcare Insurance Company | T5 | No | $0 | MI |
| UHC Dual Complete NM-Y1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T5 | No | $0 | NM |
| UHC Dual Complete NM-S1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T5 | No | $0 | NM |
| UHC Dual Complete NM-V1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T5 | No | $0 | NM |
| UHC Dual Complete AZ-S001 (HMO-POS D-SNP) | Arizona Physicians IPA, Inc. | T5 | No | $0 | AZ |
| UHC Dual Complete AZ-Y001 (HMO-POS D-SNP) | Arizona Physicians IPA, Inc. | T5 | No | $0 | AZ |
| UHC Dual Complete VA-Y4 (PPO D-SNP) | Care Improvement Plus South Central Insurance Co. | T5 | No | $0 | VA |
| AARP Medicare Advantage from UHC AL-0001 (HMO-POS) | Unitedhealthcare OF THE Midlands, Inc. | T5 | No | $0 | AL |
| AARP Medicare Advantage from UHC CA-0002 (HMO-POS) | UHC OF California | T5 | No | $0 | CA |
Show the next 30 plans
Showing top 50 of 95 plans.
Frequently Asked Questions
Is emtricitabine 200 MG / rilpivirine 25 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Complera] covered by Medicare Part D?
Yes, emtricitabine 200 MG / rilpivirine 25 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Complera] is covered by 1,174 Medicare Part D plans (23.2% of all Part D formularies).
What tier is emtricitabine 200 MG / rilpivirine 25 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Complera] on Medicare Part D plans?
emtricitabine 200 MG / rilpivirine 25 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Complera] averages Tier 4.8 across Part D plans, ranging from Tier 1 to Tier 5.
Does emtricitabine 200 MG / rilpivirine 25 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Complera] require prior authorization?
0% of Part D formularies require prior authorization for emtricitabine 200 MG / rilpivirine 25 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Complera]. Step therapy: 0%. Quantity limits: 71.4%.
How much does Medicare spend on emtricitabine 200 MG / rilpivirine 25 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Complera]?
In 2023, total Medicare Part D spending on emtricitabine 200 MG / rilpivirine 25 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Complera] was $2,662,092, covering 997 beneficiaries. The average spend per beneficiary was $2,670.10.
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
- 0.4 ML adalimumab-adbm 100 MG/ML Prefilled Syringe T4.8
- selegiline hydrochloride 1.25 MG Disintegrating Oral Tablet [Zelapar] T4.8
- eltrombopag 25 MG Oral Tablet [Promacta] T4.8
- mercaptopurine 20 MG/ML Oral Suspension [Purixan] T4.8
- prednisone 1 MG Delayed Release Oral Tablet T4.8
- eltrombopag 25 MG Powder for Oral Suspension [Promacta] T4.8