Medicare Part D coverage · fluorometholone acetate · RxCUI 1249631
fluorometholone acetate 1 MG/ML Ophthalmic Suspension [Flarex]
Per the CMS 2026 Part D formulary file, fluorometholone acetate 1 MG/ML Ophthalmic Suspension [Flarex] is covered by 1,569 Medicare Part D plans (31.1% of enrollable products), averaging Tier 3.2, with prior authorization required on 0% of covering formularies.
- 31.1%
- Plan coverage
- 1,569
- Plans covering
- T3.2
- Avg tier
- 0%
- Prior auth required
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 41 distinct formulary files spanning 1,569 Medicare Part D plan offerings - 31.1% 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
- 41
- Plans covering
- 1,569
- Coverage rate
- 31.1%
- 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
Medicare Advantage Plans (MA-PD) Covering fluorometholone acetate 1 MG/ML Ophthalmic Suspension [Flarex]
100 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 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 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 |
Show the next 30 plans
| 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 |
| Blue Best Life Classic (HMO) | Medisun, Inc. | T3 | No | $0 | AZ |
| Blue Best Life Classic (HMO) | Medisun, Inc. | T3 | No | $0 | AZ |
| Regence MedAdvantage + Rx Primary (PPO) | Regence Bluecross Blueshield OF Oregon | T3 | No | $0 | OR, WA |
Showing top 50 of 100 plans.
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 1,569 Medicare Part D plans (31.1% 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.
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
- 0.5 ML diazepam 5 MG/ML Rectal Gel T3.2
- phenytoin sodium 30 MG Extended Release Oral Capsule [Dilantin] T3.2
- alanine 8.8 MG/ML / arginine 4.89 MG/ML / glucose 50 MG/ML / glycine 4.38 MG/ML / histidine 2.04 MG/ML / isoleucine 2.55 MG/ML / leucine 3.11 MG/ML / lysine 2.47 MG/ML / methionine 1.7 MG/ML / phenylalanine 2.38 MG/ML / proline 2.89 MG/ML / serine 2.13 MG/ML / threonine 1.79 MG/ML / tryptophan 0.77 MG/ML / tyrosine 0.17 MG/ML / valine 2.47 MG/ML Injectable Solution [Clinimix 4.25/5] T3.2
- alanine 10.4 MG/ML / arginine 5.75 MG/ML / glucose 200 MG/ML / glycine 5.15 MG/ML / histidine 2.4 MG/ML / isoleucine 3 MG/ML / leucine 3.65 MG/ML / lysine 2.9 MG/ML / methionine 2 MG/ML / phenylalanine 2.8 MG/ML / proline 3.4 MG/ML / serine 2.5 MG/ML / threonine 2.1 MG/ML / tryptophan 0.9 MG/ML / tyrosine 0.2 MG/ML / valine 2.9 MG/ML Injectable Solution [Clinimix 5/20] T3.2
- citric acid 68.6 MG/ML / magnesium oxide 20 MG/ML / picosulfate sodium 0.0571 MG/ML Oral Solution [Clenpiq] T3.2
- estradiol 0.0006 MG/MG Topical Gel T3.2