Medicare Part D coverage · ezetimibe · RxCUI 476345
ezetimibe 10 MG / simvastatin 10 MG Oral Tablet
Per the CMS 2026 Part D formulary file, ezetimibe 10 MG / simvastatin 10 MG Oral Tablet is covered by 4,766 Medicare Part D plans (94.3% of enrollable products), averaging Tier 2.5, with prior authorization required on 0% of covering formularies.
- 94.3%
- Plan coverage
- 4,766
- Plans covering
- T2.5
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for ezetimibe 10 MG / simvastatin 10 MG Oral Tablet
Per the CMS 2026 Part D formulary file, ezetimibe 10 MG / simvastatin 10 MG Oral Tablet (RxNorm concept RXCUI 476345, generic name ezetimibe) appears on 300 distinct formulary files spanning 4,766 Medicare Part D plan offerings - 94.3% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 2.5.
Real-world access to ezetimibe 10 MG / simvastatin 10 MG Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0.7% require step therapy. 82% 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 10 MG Oral Tablet 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 10 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 300
- Plans covering
- 4,766
- Coverage rate
- 94.3%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0.7% of formularies
- Quantity limits
- 82% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,921,217
- Total spending
- $289,739,836
- Avg per beneficiary
- $150.81
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering ezetimibe 10 MG / simvastatin 10 MG Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| UHC Dual Complete IA-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | IA |
| UHC Dual Complete MO-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | MO |
| UHC Dual Complete NE-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | NE |
| UHC Dual Complete KS-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | KS |
| UHC Dual Complete MO-S3 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | MO |
| UHC Dual Complete KS-Q1 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | KS |
| UHC Dual Complete TN-S001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T1 | No | $0 | TN |
| UHC Dual Complete TN-Y001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T1 | No | $0 | TN |
| UHC Dual Complete TN-Y2 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T1 | No | $0 | TN |
| AARP Medicare Advantage from UHC MI-0001 (PPO) | Unitedhealthcare Insurance Company | T1 | No | $0 | MI |
| UHC Dual Complete NM-Y1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T1 | No | $0 | NM |
| UHC Dual Complete NM-S1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T1 | No | $0 | NM |
| UHC Dual Complete NM-V1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T1 | No | $0 | NM |
| UHC Dual Complete AZ-S001 (HMO-POS D-SNP) | Arizona Physicians IPA, Inc. | T1 | No | $0 | AZ |
| UHC Dual Complete AZ-Y001 (HMO-POS D-SNP) | Arizona Physicians IPA, Inc. | T1 | No | $0 | AZ |
| UHC Dual Complete VA-Y4 (PPO D-SNP) | Care Improvement Plus South Central Insurance Co. | T1 | No | $0 | VA |
| AARP Medicare Advantage from UHC AL-0001 (HMO-POS) | Unitedhealthcare OF THE Midlands, Inc. | T1 | No | $0 | AL |
| AARP Medicare Advantage from UHC CA-0002 (HMO-POS) | UHC OF California | T1 | No | $0 | CA |
| UHC Sharp Medicare Advantage CA-001P (HMO-POS) | UHC OF California | T1 | No | $0 | CA |
| AARP Medicare Advantage from UHC CA-003P (HMO-POS) | UHC OF California | T1 | No | $0 | CA |
Show the next 30 plans
Showing top 50 of 100 plans.
Frequently Asked Questions
Is ezetimibe 10 MG / simvastatin 10 MG Oral Tablet covered by Medicare Part D?
Yes, ezetimibe 10 MG / simvastatin 10 MG Oral Tablet is covered by 4,766 Medicare Part D plans (94.3% of all Part D formularies).
What tier is ezetimibe 10 MG / simvastatin 10 MG Oral Tablet on Medicare Part D plans?
ezetimibe 10 MG / simvastatin 10 MG Oral Tablet averages Tier 2.5 across Part D plans, ranging from Tier 1 to Tier 6.
Does ezetimibe 10 MG / simvastatin 10 MG Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for ezetimibe 10 MG / simvastatin 10 MG Oral Tablet. Step therapy: 0.7%. Quantity limits: 82%.
How much does Medicare spend on ezetimibe 10 MG / simvastatin 10 MG Oral Tablet?
In 2023, total Medicare Part D spending on ezetimibe 10 MG / simvastatin 10 MG Oral Tablet 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
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