emtricitabine 200 MG / rilpivirine 25 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Complera]

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emtricitabine

RxCUI: 1147337

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.
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

2 plans
Tier 1, Preferred Generic
98 plans
Tier 5, Specialty

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
UHC Sharp Medicare Advantage CA-001P (HMO-POS) UHC OF CALIFORNIA T5 No $0 CA
AARP Medicare Advantage from UHC CA-003P (HMO-POS) UHC OF CALIFORNIA T5 No $0 CA
AARP Medicare Advantage from UHC CA-0012 (HMO-POS) UHC OF CALIFORNIA T5 No $0 CA
AARP Medicare Advantage from UHC CA-004P (HMO-POS) UHC OF CALIFORNIA T5 No $0 CA
AARP Medicare Advantage from UHC CA-005P (HMO-POS) UHC OF CALIFORNIA T5 No $0 CA
AARP Medicare Advantage from UHC CA-006P (HMO-POS) UHC OF CALIFORNIA T5 No $0 CA
AARP Medicare Advantage from UHC CA-10 (HMO-POS) UHC OF CALIFORNIA T5 No $0 CA
UHC Sharp Medicare Advantage ValueRx CA-12P (HMO-POS) UHC OF CALIFORNIA T5 No $0 CA
AARP Medicare Advantage from UHC CA-021P (HMO-POS) UHC OF CALIFORNIA T5 No $0 CA
AARP Medicare Advantage from UHC CA-022P (HMO-POS) UHC OF CALIFORNIA T5 No $0 CA
AARP Medicare Advantage from UHC CA-023P (HMO-POS) UHC OF CALIFORNIA T5 No $0 CA
AARP Medicare Advantage from UHC CA-026P (HMO-POS) UHC OF CALIFORNIA T5 No $0 CA
AARP Medicare Advantage Giveback from UHC CA-19 (HMO-POS) UHC OF CALIFORNIA T5 No $0 CA
AARP Medicare Advantage Giveback from UHC CA-20 (HMO-POS) UHC OF CALIFORNIA T5 No $0 CA
AARP Medicare Advantage Giveback from UHC CA-21 (HMO-POS) UHC OF CALIFORNIA T5 No $0 CA
AARP Medicare Advantage Essentials from UHC CO-2 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T5 No $0 CO
AARP Medicare Advantage Essentials from UHC AZ-1 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T5 No $0 AZ
AARP Medicare Advantage Essentials from UHC AZ-2 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T5 No $0 AZ
AARP Medicare Advantage from UHC AZ-002P (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T5 No $0 AZ
AARP Medicare Advantage from UHC NV-0001 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T5 No $0 NV
AARP Medicare Advantage from UHC NV-0002 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T5 No $0 NV
UHC Medicare Advantage NV-001P (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T5 No $0 NV
AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T5 No $0 CO
AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T5 No $0 NV
AARP Medicare Advantage from UHC NV-0006 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T5 No $0 NV
AARP Medicare Advantage Extras from UHC AZ-4 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T5 No $0 AZ
AARP Medicare Advantage Extras from UHC AZ-5 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T5 No $0 AZ
AARP Medicare Advantage Extras from UHC CO-5 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T5 No $0 CO
AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T5 No $0 TX
AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T5 No $0 TX

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.

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