emtricitabine 200 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Truvada]
emtricitabine
RxCUI: 639888
What the CMS Formulary Data Shows for emtricitabine 200 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Truvada]
Per the CMS 2026 Part D formulary file, emtricitabine 200 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Truvada] (RxNorm concept RXCUI 639888, generic name emtricitabine) appears on 9 distinct formulary files spanning 17 Medicare Part D plan offerings - 0.3% 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 4.6.
Real-world access to emtricitabine 200 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Truvada] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 100% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 997 Part D beneficiaries filled emtricitabine 200 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Truvada] 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 / tenofovir disoproxil fumarate 300 MG Oral Tablet [Truvada] today.
Coverage Details
- Formularies covering
- 9
- Plans covering
- 17
- Coverage rate
- 0.3%
- 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
- 100% of formularies
2023 Medicare Spending
- Beneficiaries
- 997
- Total spending
- $2,662,092
- Avg per beneficiary
- $2,670.10
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering emtricitabine 200 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Truvada]
17 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 |
| Keystone First VIP Choice (HMO D-SNP) | VISTA HEALTH PLAN, INC. | T5 | No | $0 | PA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | VISTA HEALTH PLAN, INC. | T5 | No | $0 | PA |
| First Choice VIP Care (HMO D-SNP) | SELECT HEALTH OF SOUTH CAROLINA, INC. | T5 | No | $0 | SC |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T5 | No | $0 | DE |
| AmeriHealth Caritas VIP Care Choice (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T5 | No | $0 | DE |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AMERIHEALTH CARITAS FLORIDA INC | T5 | No | $0 | FL |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AMERIHEALTH CARITAS LOUISIANA, INC. | T5 | No | $0 | LA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AMERIHEALTH CARITAS NORTH CAROLINA, INC. | T5 | No | $0 | NC |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AMERIHEALTH MICHIGAN, INC. | T5 | No | $0 | MI |
| Keystone 65 Select Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | No | $47.00 | PA |
| Keystone 65 Preferred Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | No | $59.70 | PA |
| Keystone 65 Select Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | No | $63.50 | PA |
| Keystone 65 Preferred Rx (HMO) | KEYSTONE HEALTH PLAN EAST, INC. | T5 | No | $79.70 | PA |
| Personal Choice 65 Rx (PPO) | QCC INSURANCE COMPANY | T5 | No | $102.20 | PA |
| Personal Choice 65 Rx (PPO) | QCC INSURANCE COMPANY | T5 | No | $112.70 | PA |
Frequently Asked Questions
Is emtricitabine 200 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Truvada] covered by Medicare Part D?
Yes, emtricitabine 200 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Truvada] is covered by 17 Medicare Part D plans (0.3% of all Part D formularies).
What tier is emtricitabine 200 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Truvada] on Medicare Part D plans?
emtricitabine 200 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Truvada] averages Tier 4.6 across Part D plans, ranging from Tier 1 to Tier 5.
Does emtricitabine 200 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Truvada] require prior authorization?
0% of Part D formularies require prior authorization for emtricitabine 200 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Truvada]. Step therapy: 0%. Quantity limits: 100%.
How much does Medicare spend on emtricitabine 200 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Truvada]?
In 2023, total Medicare Part D spending on emtricitabine 200 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet [Truvada] 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.