fenofibrate 43 MG Oral Capsule
fenofibrate
RxCUI: 483427
What the CMS Formulary Data Shows for fenofibrate 43 MG Oral Capsule
Per the CMS 2026 Part D formulary file, fenofibrate 43 MG Oral Capsule (RxNorm concept RXCUI 483427, generic name fenofibrate) appears on 136 distinct formulary files spanning 3,307 Medicare Part D plan offerings - 65.3% 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 1.7.
Real-world access to fenofibrate 43 MG Oral Capsule depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 2.9% require step therapy. 9.6% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 500,170 Part D beneficiaries filled fenofibrate 43 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $74,983,711 and an average per-beneficiary annual cost of $149.92. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry fenofibrate 43 MG Oral Capsule today.
Coverage Details
- Formularies covering
- 136
- Plans covering
- 3,307
- Coverage rate
- 65.3%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 2.9% of formularies
- Quantity limits
- 9.6% of formularies
2023 Medicare Spending
- Beneficiaries
- 500,170
- Total spending
- $74,983,711
- Avg per beneficiary
- $149.92
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering fenofibrate 43 MG Oral Capsule
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| UHC Complete Care WI-1 (PPO C-SNP) | UNITEDHEALTHCARE INSURANCE COMPANY | T1 | No | $0 | WI |
| UHC Complete Care AL-5 (HMO-POS C-SNP) | UNITEDHEALTHCARE OF THE MIDLANDS, INC. | T1 | No | $0 | AL |
| UHC Complete Care CA-15P (HMO-POS C-SNP) | UHC OF CALIFORNIA | T1 | No | $0 | CA |
| UHC Complete Care CA-18P (HMO-POS C-SNP) | UHC OF CALIFORNIA | T1 | No | $0 | CA |
| UHC Complete Care CA-19P (HMO-POS C-SNP) | UHC OF CALIFORNIA | T1 | No | $0 | CA |
| UHC Complete Care CA-20P (HMO-POS C-SNP) | UHC OF CALIFORNIA | T1 | No | $0 | CA |
| UHC Complete Care CA-27P (HMO-POS C-SNP) | UHC OF CALIFORNIA | T1 | No | $0 | CA |
| UHC Complete Care NV-4 (HMO-POS C-SNP) | UnitedHealthcare Benefits of Texas, Inc. | T1 | No | $0 | NV |
| UHC Complete Care AZ-1P (HMO-POS C-SNP) | UnitedHealthcare Benefits of Texas, Inc. | T1 | No | $0 | AZ |
| UHC Complete Care AZ-3P (HMO-POS C-SNP) | UnitedHealthcare Benefits of Texas, Inc. | T1 | No | $0 | AZ |
| UHC Complete Care CO-1P (HMO-POS C-SNP) | UnitedHealthcare Benefits of Texas, Inc. | T1 | No | $0 | CO |
| UHC Complete Care CO-2P (HMO-POS C-SNP) | UnitedHealthcare Benefits of Texas, Inc. | T1 | No | $0 | CO |
| UHC Complete Care TX-24 (HMO-POS C-SNP) | UnitedHealthcare Benefits of Texas, Inc. | T1 | No | $0 | TX |
| UHC Complete Care TX-3P (HMO-POS C-SNP) | UnitedHealthcare Benefits of Texas, Inc. | T1 | No | $0 | TX |
| UHC Complete Care CO-19 (HMO-POS C-SNP) | UnitedHealthcare Benefits of Texas, Inc. | T1 | No | $0 | CO |
| UHC Complete Care Support NV-11 (HMO-POS C-SNP) | UnitedHealthcare Benefits of Texas, Inc. | T1 | No | $0 | NV |
| UHC Preferred Complete Care FL-0003 (HMO C-SNP) | PREFERRED CARE PARTNERS, INC. | T1 | No | $0 | FL |
| UHC Complete Care FL-14 (HMO-POS C-SNP) | PREFERRED CARE PARTNERS, INC. | T1 | No | $0 | FL |
| UHC Complete Care AR-5 (PPO C-SNP) | CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. | T1 | No | $0 | AR |
| UHC Complete Care GA-3 (PPO C-SNP) | CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. | T1 | No | $0 | GA |
| UHC Complete Care AR-6 (PPO C-SNP) | CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. | T1 | No | $0 | AR |
| Peoples Health Complete Care LA-5 (HMO-POS C-SNP) | PEOPLES HEALTH, INC. | T1 | No | $0 | LA |
| Peoples Health Complete Care LA-6 (HMO-POS C-SNP) | PEOPLES HEALTH, INC. | T1 | No | $0 | LA |
| Peoples Health Complete Care LA-7 (HMO-POS C-SNP) | PEOPLES HEALTH, INC. | T1 | No | $0 | LA |
| UHC Complete Care Support NM-1A (PPO C-SNP) | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | T1 | No | $0 | NM |
| UHC Complete Care Support EP-1A (PPO C-SNP) | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | T1 | No | $0 | NM |
| UHC Complete Care Support NM-2A (PPO C-SNP) | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | T1 | No | $0 | NM |
| UHC Complete Care MO-1 (PPO C-SNP) | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | T1 | No | $0 | MO |
| UHC Complete Care SC-1 (PPO C-SNP) | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | T1 | No | $0 | SC |
| UHC Complete Care NM-11 (PPO C-SNP) | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | T1 | No | $0 | NM |
| UHC Complete Care MN-7 (PPO C-SNP) | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | T1 | No | $0 | MN |
| UHC Complete Care IN-21 (HMO-POS C-SNP) | UNITEDHEALTHCARE OF THE MIDLANDS, INC. | T1 | No | $0 | IN |
| UHC Complete Care KS-4 (HMO-POS C-SNP) | UNITEDHEALTHCARE OF THE MIDLANDS, INC. | T1 | No | $0 | KS |
| UHC Complete Care NY-30 (HMO-POS C-SNP) | UNITEDHEALTHCARE OF NEW YORK, INC. | T1 | No | $0 | NY |
| UHC Complete Care NY-31 (HMO-POS C-SNP) | UNITEDHEALTHCARE OF NEW YORK, INC. | T1 | No | $0 | NY |
| UHC Complete Care NY-33 (HMO-POS C-SNP) | UNITEDHEALTHCARE OF NEW YORK, INC. | T1 | No | $0 | NY |
| UHC Complete Care OR-5 (HMO-POS C-SNP) | UnitedHealthcare Benefits of Texas, Inc. | T1 | No | $0 | OR |
| UHC Complete Care WA-13 (HMO-POS C-SNP) | UnitedHealthcare Benefits of Texas, Inc. | T1 | No | $0 | WA |
| UHC Complete Care TX-2P (HMO-POS C-SNP) | UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C. | T1 | No | $0 | TX |
| UHC Complete Care TX-16 (HMO-POS C-SNP) | PHYSICIANS HEALTH CHOICE OF TEXAS, LLC | T1 | No | $0 | TX |
| UHC Complete Care TX-17 (HMO-POS C-SNP) | PHYSICIANS HEALTH CHOICE OF TEXAS, LLC | T1 | No | $0 | TX |
| UHC Complete Care TX-18 (HMO-POS C-SNP) | PHYSICIANS HEALTH CHOICE OF TEXAS, LLC | T1 | No | $0 | TX |
| UHC Complete Care TX-19 (HMO-POS C-SNP) | PHYSICIANS HEALTH CHOICE OF TEXAS, LLC | T1 | No | $0 | TX |
| UHC Complete Care UT-6 (HMO-POS C-SNP) | UNITEDHEALTHCARE OF THE ROCKIES, INC. | T1 | No | $0 | UT |
| UHC Complete Care ID-12 (HMO-POS C-SNP) | UNITEDHEALTHCARE OF THE ROCKIES, INC. | T1 | No | $0 | ID |
| UHC Complete Care ID-13 (HMO-POS C-SNP) | UNITEDHEALTHCARE OF THE ROCKIES, INC. | T1 | No | $0 | ID |
| UHC Complete Care MA-7 (HMO-POS C-SNP) | UNITEDHEALTHCARE OF WISCONSIN, INC. | T1 | No | $0 | MA |
| UHC Complete Care ME-6 (HMO-POS C-SNP) | UNITEDHEALTHCARE OF WISCONSIN, INC. | T1 | No | $0 | ME |
| UHC Complete Care RI-4 (HMO-POS C-SNP) | UNITEDHEALTHCARE OF WISCONSIN, INC. | T1 | No | $0 | RI |
| UHC Complete Care OK-8 (HMO-POS C-SNP) | UNITEDHEALTHCARE OF WISCONSIN, INC. | T1 | No | $0 | OK |
Frequently Asked Questions
Is fenofibrate 43 MG Oral Capsule covered by Medicare Part D?
Yes, fenofibrate 43 MG Oral Capsule is covered by 3,307 Medicare Part D plans (65.3% of all Part D formularies).
What tier is fenofibrate 43 MG Oral Capsule on Medicare Part D plans?
fenofibrate 43 MG Oral Capsule averages Tier 1.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does fenofibrate 43 MG Oral Capsule require prior authorization?
0% of Part D formularies require prior authorization for fenofibrate 43 MG Oral Capsule. Step therapy: 2.9%. Quantity limits: 9.6%.
How much does Medicare spend on fenofibrate 43 MG Oral Capsule?
In 2023, total Medicare Part D spending on fenofibrate 43 MG Oral Capsule was $74,983,711, covering 500,170 beneficiaries. The average spend per beneficiary was $149.92.
Read our methodology - how this data is sourced, computed, and verified.