fenofibrate 130 MG Oral Capsule
fenofibrate
RxCUI: 483425
What the CMS Formulary Data Shows for fenofibrate 130 MG Oral Capsule
Per the CMS 2026 Part D formulary file, fenofibrate 130 MG Oral Capsule (RxNorm concept RXCUI 483425, generic name fenofibrate) appears on 52 distinct formulary files spanning 1,990 Medicare Part D plan offerings - 39.3% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.3.
Real-world access to fenofibrate 130 MG Oral Capsule depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 7.7% require step therapy. 19.2% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 500,170 Part D beneficiaries filled fenofibrate 130 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 130 MG Oral Capsule today.
Coverage Details
- Formularies covering
- 52
- Plans covering
- 1,990
- Coverage rate
- 39.3%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 7.7% of formularies
- Quantity limits
- 19.2% 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 130 MG Oral Capsule
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA HEALTH OF OHIO INC. | T1 | No | $0 | OH |
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA HEALTH OF OHIO INC. | T1 | No | $0 | OH |
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA HEALTH OF OHIO INC. | T1 | No | $0 | OH |
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA HEALTH OF OHIO INC. | T1 | No | $0 | OH |
| Aetna Medicare Chronic Care (PPO C-SNP) | SILVERSCRIPT INSURANCE COMPANY | T1 | No | $0 | GA |
| Aetna Medicare Chronic Care (HMO C-SNP) | COVENTRY HEALTH CARE OF MISSOURI, INC. | T1 | No | $0 | KS, MO |
| Aetna Medicare Chronic Care (HMO C-SNP) | COVENTRY HEALTH CARE OF MISSOURI, INC. | T1 | No | $0 | IL |
| Aetna Medicare Chronic Care (HMO C-SNP) | COVENTRY HEALTH CARE OF MISSOURI, INC. | T1 | No | $0 | MO |
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA BETTER HEALTH INC. (GA) | T1 | No | $0 | NC |
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA BETTER HEALTH INC. (GA) | T1 | No | $0 | SC |
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA HEALTH OF MICHIGAN INC. | T1 | No | $0 | MI |
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA BETTER HEALTH, INC. (LA) | T1 | No | $0 | LA |
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA HEALTH INC. (NY) | T1 | No | $0 | NY |
| Aetna Medicare Prime Chronic Care (HMO C-SNP) | AETNA HEALTH INC. (PA) | T1 | No | $0 | AZ |
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA HEALTH INC. (PA) | T1 | No | $0 | NV |
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA HEALTH INC. (PA) | T1 | No | $0 | PA |
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA HEALTH INC. (PA) | T1 | No | $0 | DE |
| Aetna Medicare Prime Chronic Care (HMO C-SNP) | AETNA HEALTH INC. (TX) | T1 | No | $0 | TX |
| Aetna Medicare Prime Chronic Care (HMO C-SNP) | AETNA HEALTH INC. (TX) | T1 | No | $0 | TX |
| Aetna Medicare Chronic Care (HMO C-SNP) | AETNA HEALTH INC. (GA) | T1 | No | $0 | GA |
| Freedom VIP Care (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Diamond Savings (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Diamond (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Freedom Medi-Medi Partial (HMO D-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Medi-Medi Full (HMO D-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Optimum Emerald Partial (HMO D-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Emerald Full (HMO D-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Máximo (HMO-POS) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Máximo (HMO-POS) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
Frequently Asked Questions
Is fenofibrate 130 MG Oral Capsule covered by Medicare Part D?
Yes, fenofibrate 130 MG Oral Capsule is covered by 1,990 Medicare Part D plans (39.3% of all Part D formularies).
What tier is fenofibrate 130 MG Oral Capsule on Medicare Part D plans?
fenofibrate 130 MG Oral Capsule averages Tier 2.3 across Part D plans, ranging from Tier 1 to Tier 4.
Does fenofibrate 130 MG Oral Capsule require prior authorization?
0% of Part D formularies require prior authorization for fenofibrate 130 MG Oral Capsule. Step therapy: 7.7%. Quantity limits: 19.2%.
How much does Medicare spend on fenofibrate 130 MG Oral Capsule?
In 2023, total Medicare Part D spending on fenofibrate 130 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.