Medicare Part D coverage · ezetimibe · RxCUI 1245430

ezetimibe 10 MG / simvastatin 20 MG Oral Tablet [Vytorin]

Per the CMS 2026 Part D formulary file, ezetimibe 10 MG / simvastatin 20 MG Oral Tablet [Vytorin] is covered by 2 Medicare Part D plans (0% of enrollable products), averaging Tier 1, with prior authorization required on 0% of covering formularies.

0%
Plan coverage
2
Plans covering
T1
Avg tier
0%
Prior auth required

Verify with CMS →

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.

What the CMS Formulary Data Shows for ezetimibe 10 MG / simvastatin 20 MG Oral Tablet [Vytorin]

Per the CMS 2026 Part D formulary file, ezetimibe 10 MG / simvastatin 20 MG Oral Tablet [Vytorin] (RxNorm concept RXCUI 1245430, generic name ezetimibe) appears on 1 distinct formulary file spanning 2 Medicare Part D plan offerings - 0% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 1, with a cross-plan average of Tier 1.

Real-world access to ezetimibe 10 MG / simvastatin 20 MG Oral Tablet [Vytorin] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 100% require step therapy. 100% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,921,217 Part D beneficiaries filled ezetimibe 10 MG / simvastatin 20 MG Oral Tablet [Vytorin] in 2023, with total plan-and-beneficiary spending of $289,739,836 and an average per-beneficiary annual cost of $150.81. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry ezetimibe 10 MG / simvastatin 20 MG Oral Tablet [Vytorin] today.

Coverage Details

Formularies covering
1
Plans covering
2
Coverage rate
0%
Tier range
Tier 1, Preferred Generic
Average tier
Tier 1, Preferred Generic

Restrictions

Prior authorization required
0% of formularies
Step therapy required
100% of formularies
Quantity limits
100% of formularies

2023 Medicare Spending

Beneficiaries
1,921,217
Total spending
$289,739,836
Avg per beneficiary
$150.81

Tier Distribution Across Plans

2 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering ezetimibe 10 MG / simvastatin 20 MG Oral Tablet [Vytorin]

2 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

Frequently Asked Questions

Is ezetimibe 10 MG / simvastatin 20 MG Oral Tablet [Vytorin] covered by Medicare Part D?

Yes, ezetimibe 10 MG / simvastatin 20 MG Oral Tablet [Vytorin] is covered by 2 Medicare Part D plans (0% of all Part D formularies).

What tier is ezetimibe 10 MG / simvastatin 20 MG Oral Tablet [Vytorin] on Medicare Part D plans?

ezetimibe 10 MG / simvastatin 20 MG Oral Tablet [Vytorin] averages Tier 1 across Part D plans, ranging from Tier 1 to Tier 1.

Does ezetimibe 10 MG / simvastatin 20 MG Oral Tablet [Vytorin] require prior authorization?

0% of Part D formularies require prior authorization for ezetimibe 10 MG / simvastatin 20 MG Oral Tablet [Vytorin]. Step therapy: 100%. Quantity limits: 100%.

How much does Medicare spend on ezetimibe 10 MG / simvastatin 20 MG Oral Tablet [Vytorin]?

In 2023, total Medicare Part D spending on ezetimibe 10 MG / simvastatin 20 MG Oral Tablet [Vytorin] was $289,739,836, covering 1,921,217 beneficiaries. The average spend per beneficiary was $150.81.

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

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