Medicare Part D coverage · epoetin alfa-epbx · RxCUI 2463737
epoetin alfa-epbx 20000 UNT/ML Injectable Solution [Retacrit]
Per the CMS 2026 Part D formulary file, epoetin alfa-epbx 20000 UNT/ML Injectable Solution [Retacrit] is covered by 2,740 Medicare Part D plans (54.2% of enrollable products), averaging Tier 3, with prior authorization required on 98.4% of covering formularies.
- 54.2%
- Plan coverage
- 2,740
- Plans covering
- T3
- Avg tier
- 98.4%
- Prior auth required
What the CMS Formulary Data Shows for epoetin alfa-epbx 20000 UNT/ML Injectable Solution [Retacrit]
Per the CMS 2026 Part D formulary file, epoetin alfa-epbx 20000 UNT/ML Injectable Solution [Retacrit] (RxNorm concept RXCUI 2463737, generic name epoetin alfa-epbx) appears on 252 distinct formulary files spanning 2,740 Medicare Part D plan offerings - 54.2% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.
Real-world access to epoetin alfa-epbx 20000 UNT/ML Injectable Solution [Retacrit] depends on utilization management as much as tier placement: 98.4% of covering formularies require prior authorization. 0% require step therapy. 40.1% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 12,187 Part D beneficiaries filled epoetin alfa-epbx 20000 UNT/ML Injectable Solution [Retacrit] in 2023, with total plan-and-beneficiary spending of $24,529,471 and an average per-beneficiary annual cost of $2,012.76. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry epoetin alfa-epbx 20000 UNT/ML Injectable Solution [Retacrit] today.
Coverage Details
- Formularies covering
- 252
- Plans covering
- 2,740
- Coverage rate
- 54.2%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 98.4% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 40.1% of formularies
2023 Medicare Spending
- Beneficiaries
- 12,187
- Total spending
- $24,529,471
- Avg per beneficiary
- $2,012.76
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering epoetin alfa-epbx 20000 UNT/ML Injectable Solution [Retacrit]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | Sentara Health Plans | T1 | Yes | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | Yes | $0 | VA |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | Yes | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | Yes | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | Yes | $0 | NJ |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | Yes | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | Yes | $0 | GA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | Yes | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | Yes | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | Yes | $0 | AL |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | Yes | $0 | CA |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | Yes | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare OF NEW Jersey, Inc. | T1 | Yes | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | Yes | $0 | MN |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | Yes | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
Show the next 30 plans
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | Yes | $0 | CA |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | Yes | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | Yes | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | Yes | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | Yes | $0 | NY |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | Yes | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | Yes | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | Yes | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | Yes | $0 | MO |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | Yes | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | Yes | $0 | AR |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | Yes | $0 | WI |
| Platino Blindao (HMO D-SNP) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Enlace (HMO D-SNP) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Advance (HMO D-snp) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Plus (HMO D-snp) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | Yes | $0 | CA |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | Yes | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | Yes | $0 | DE |
| 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 |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | Yes | $4.80 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is epoetin alfa-epbx 20000 UNT/ML Injectable Solution [Retacrit] covered by Medicare Part D?
Yes, epoetin alfa-epbx 20000 UNT/ML Injectable Solution [Retacrit] is covered by 2,740 Medicare Part D plans (54.2% of all Part D formularies).
What tier is epoetin alfa-epbx 20000 UNT/ML Injectable Solution [Retacrit] on Medicare Part D plans?
epoetin alfa-epbx 20000 UNT/ML Injectable Solution [Retacrit] averages Tier 3 across Part D plans, ranging from Tier 1 to Tier 4.
Does epoetin alfa-epbx 20000 UNT/ML Injectable Solution [Retacrit] require prior authorization?
98.4% of Part D formularies require prior authorization for epoetin alfa-epbx 20000 UNT/ML Injectable Solution [Retacrit]. Step therapy: 0%. Quantity limits: 40.1%.
How much does Medicare spend on epoetin alfa-epbx 20000 UNT/ML Injectable Solution [Retacrit]?
In 2023, total Medicare Part D spending on epoetin alfa-epbx 20000 UNT/ML Injectable Solution [Retacrit] was $24,529,471, covering 12,187 beneficiaries. The average spend per beneficiary was $2,012.76.
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
Similar prior-authorization rate
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