fluorometholone acetate 1 MG/ML Ophthalmic Suspension [Flarex]
fluorometholone acetate
RxCUI: 1249631
What the CMS Formulary Data Shows for fluorometholone acetate 1 MG/ML Ophthalmic Suspension [Flarex]
Per the CMS 2026 Part D formulary file, fluorometholone acetate 1 MG/ML Ophthalmic Suspension [Flarex] (RxNorm concept RXCUI 1249631, generic name fluorometholone acetate) appears on 42 distinct formulary files spanning 1,583 Medicare Part D plan offerings - 31.2% 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 3.2.
Real-world access to fluorometholone acetate 1 MG/ML Ophthalmic Suspension [Flarex] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 15,372 Part D beneficiaries filled fluorometholone acetate 1 MG/ML Ophthalmic Suspension [Flarex] in 2023, with total plan-and-beneficiary spending of $4,002,192 and an average per-beneficiary annual cost of $260.36. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry fluorometholone acetate 1 MG/ML Ophthalmic Suspension [Flarex] today.
Coverage Details
- Formularies covering
- 42
- Plans covering
- 1,583
- Coverage rate
- 31.2%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 15,372
- Total spending
- $4,002,192
- Avg per beneficiary
- $260.36
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering fluorometholone acetate 1 MG/ML Ophthalmic Suspension [Flarex]
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| CarePartners Access (PPO) | CAREPARTNERS OF CONNECTICUT, INC. | T3 | No | No | $0 | CT |
| CarePartners of CT CareAdvantage Preferred (HMO) | CAREPARTNERS OF CONNECTICUT, INC. | T3 | No | No | $0 | CT |
Medicare Advantage Plans (MA-PD) Covering fluorometholone acetate 1 MG/ML Ophthalmic Suspension [Flarex]
98 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA | T1 | No | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF INDIANA | T1 | No | $0 | IN |
| Provider Partners Maryland Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN, INC. | T1 | No | $0 | MD |
| Provider Partners Missouri Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. | T1 | No | $0 | MO |
| Mass General Brigham SCO (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | No | $0 | MA |
| 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 |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC. | T1 | No | $4.80 | TX |
| Provider Partners Illinois Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS | T1 | No | $15.20 | IL |
| Provider Partners Maryland Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN, INC. | T1 | No | $31.20 | MD |
| Provider Partners Maryland Essential Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN, INC. | T1 | No | $31.20 | MD |
| Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC | T1 | No | $32.70 | PA |
| Provider Partners Pennsylvania Essential Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC | T1 | No | $32.70 | PA |
| Provider Partners North Carolina Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA | T1 | No | $36.20 | NC |
| Provider Partners North Carolina Essential Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA | T1 | No | $36.20 | NC |
| Provider Partners Indiana Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF INDIANA | T1 | No | $38.40 | IN |
| Provider Partners Indiana Essential Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF INDIANA | T1 | No | $38.40 | IN |
| Provider Partners Kentucky Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY | T1 | No | $38.40 | KY |
| Provider Partners Missouri Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. | T1 | No | $43.00 | MO |
| Provider Partners Missouri Essential Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. | T1 | No | $43.00 | MO |
| CareAdvantage (HMO D-SNP) | SAN MATEO HEALTH COMMISSION | T2 | No | $0 | CA |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T2 | No | $0 | CA |
| eternalHealth Forever (HMO) | ETERNALHEALTH, INC. | T3 | No | $0 | MA |
| eternalHealth Freedom (PPO) | ETERNALHEALTH, INC. | T3 | No | $0 | MA |
| eternalHealth Give Back (PPO) | ETERNALHEALTH, INC. | T3 | No | $0 | MA |
| eternalHealth Horizon (HMO) | ETERNALHEALTH OF ARIZONA INC | T3 | No | $0 | AZ |
| eternalHealth Grand Give Back (HMO) | ETERNALHEALTH OF ARIZONA INC | T3 | No | $0 | AZ |
| eternalHealth + Fry's Medicare Advantage (HMO) | ETERNALHEALTH OF ARIZONA INC | T3 | No | $0 | AZ |
| Senior Care Plus Essential plan (HMO) | HOMETOWN HEALTH PLAN, INC. | T3 | No | $0 | NV |
| Senior Care Plus Complete Plan (HMO) | HOMETOWN HEALTH PLAN, INC. | T3 | No | $0 | NV |
| Renown Preferred Plan by Senior Care Plus (HMO) | HOMETOWN HEALTH PLAN, INC. | T3 | No | $0 | NV |
| Senior Care Plus Extensive Duals Plan (HMO D-SNP) | HOMETOWN HEALTH PLAN, INC. | T3 | No | $0 | NV |
| Senior Care Plus Enriched Duals Plan (HMO D-SNP) | HOMETOWN HEALTH PLAN, INC. | T3 | No | $0 | NV |
| MyAdvocate Medicare Advantage SILVER (HMO-POS) | BESHP, INC. | T3 | No | $0 | NE |
| Great Plain Medicare Advantage Gold (HMO I-SNP) | SANFORD HEALTH PLAN | T3 | No | $0 | IA, SD |
| Align ChoicePlus (PPO) | SANFORD HEALTH PLAN OF MINNESOTA | T3 | No | $0 | MN |
| Great Plains Medicare Advantage Gold (HMO I-SNP) | GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC. | T3 | No | $0 | NE |
| Align ChoicePlus (PPO) | SANFORD HEALTH PLAN | T3 | No | $0 | IA, SD |
| Align ChoicePlus (PPO) | SANFORD HEALTH PLAN | T3 | No | $0 | ND |
| Great Plains Medicare Advantage Gold (HMO I-SNP) | SANFORD HEALTH PLAN | T3 | No | $0 | ND |
| Align Dual Partnership (HMO D-SNP) | SANFORD HEALTH PLAN | T3 | No | $0 | ND |
| Ally Rx (HMO D-SNP) | SECURITY HEALTH PLAN OF WISCONSIN, INC. | T3 | No | $0 | WI |
| Esteem Rx (HMO-POS) | SECURITY HEALTH PLAN OF WISCONSIN, INC. | T3 | No | $0 | WI |
| BlueCross Total Value (PPO) | BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA | T3 | No | $0 | SC |
| BlueCross Total Value (PPO) | BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA | T3 | No | $0 | SC |
| BlueCross Total Value (PPO) | BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA | T3 | No | $0 | SC |
Frequently Asked Questions
Is fluorometholone acetate 1 MG/ML Ophthalmic Suspension [Flarex] covered by Medicare Part D?
Yes, fluorometholone acetate 1 MG/ML Ophthalmic Suspension [Flarex] is covered by 1,583 Medicare Part D plans (31.2% of all Part D formularies).
What tier is fluorometholone acetate 1 MG/ML Ophthalmic Suspension [Flarex] on Medicare Part D plans?
fluorometholone acetate 1 MG/ML Ophthalmic Suspension [Flarex] averages Tier 3.2 across Part D plans, ranging from Tier 1 to Tier 4.
Does fluorometholone acetate 1 MG/ML Ophthalmic Suspension [Flarex] require prior authorization?
0% of Part D formularies require prior authorization for fluorometholone acetate 1 MG/ML Ophthalmic Suspension [Flarex]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on fluorometholone acetate 1 MG/ML Ophthalmic Suspension [Flarex]?
In 2023, total Medicare Part D spending on fluorometholone acetate 1 MG/ML Ophthalmic Suspension [Flarex] was $4,002,192, covering 15,372 beneficiaries. The average spend per beneficiary was $260.36.
Read our methodology - how this data is sourced, computed, and verified.