formoterol fumarate 0.01 MG/ML Inhalation Solution

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formoterol fumarate

RxCUI: 1246319

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
25%
Plan Coverage
1,267
Plans Covering
T3.3
Avg Tier
100%
Prior Auth Required

What the CMS Formulary Data Shows for formoterol fumarate 0.01 MG/ML Inhalation Solution

Per the CMS 2026 Part D formulary file, formoterol fumarate 0.01 MG/ML Inhalation Solution (RxNorm concept RXCUI 1246319, generic name formoterol fumarate) appears on 98 distinct formulary files spanning 1,267 Medicare Part D plan offerings - 25% 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 3.3.

Real-world access to formoterol fumarate 0.01 MG/ML Inhalation Solution depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 59.2% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 3,044 Part D beneficiaries filled formoterol fumarate 0.01 MG/ML Inhalation Solution in 2023, with total plan-and-beneficiary spending of $6,380,403 and an average per-beneficiary annual cost of $2,096.06. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry formoterol fumarate 0.01 MG/ML Inhalation Solution today.

Coverage Details

Formularies covering
98
Plans covering
1,267
Coverage rate
25%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
100% of formularies
Step therapy required
0% of formularies
Quantity limits
59.2% of formularies

2023 Medicare Spending

Beneficiaries
3,044
Total spending
$6,380,403
Avg per beneficiary
$2,096.06

Tier Distribution Across Plans

26 plans
Tier 1, Preferred Generic
65 plans
Tier 2, Generic
9 plans
Tier 3, Preferred Brand

Standalone Drug Plans (PDP) Covering formoterol fumarate 0.01 MG/ML Inhalation Solution

1 standalone prescription drug plans include this drug.

Plan Insurer Tier PA ST Premium States
Wellcare Dual Liberty (HMO D-SNP) WELLCARE OF CONNECTICUT, INC. T3 Yes No $0 CT

Medicare Advantage Plans (MA-PD) Covering formoterol fumarate 0.01 MG/ML Inhalation Solution

99 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Sentara Community Complete Select (HMO D-SNP) SENTARA HEALTH PLANS T1 Yes $0 VA
Sentara Community Complete (HMO D-SNP) SENTARA HEALTH PLANS T1 Yes $0 VA
ElderServe MAP (HMO D-SNP) ELDERSERVE HEALTH, INC. T1 Yes $0 NY
Cooperative Advantage (HMO D-SNP) GROUP HEALTH COOPERATIVE OF EAU CLAIRE T1 Yes $0 WI
Longevity Health Plan (PPO I-SNP) LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP T1 Yes $0 NJ
Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) UPPER PENINSULA HEALTH PLAN, LLC T1 Yes $0 MI
CareSource Dual Advantage (HMO D-SNP) CARESOURCE GEORGIA CO. T1 Yes $0 GA
HAP CareSource MI Coordinated Health (HMO D-SNP) HAP CARESOURCE T1 Yes $0 MI
SeniorCare Complete (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 Yes $0 MN
AbilityCare (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 Yes $0 MN
Alameda Alliance Wellness (HMO D-SNP) ALAMEDA ALLIANCE FOR HEALTH T1 Yes $0 CA
Mass General Brigham SCO (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 Yes $0 MA
Mass General Brigham One Care (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 Yes $0 MA
Tufts Health One Care (HMO D-SNP) TUFTS HEALTH PUBLIC PLANS, INC. T1 Yes $0 MA
Tufts Health One Care CW (HMO D-SNP) TUFTS HEALTH PUBLIC PLANS, INC. T1 Yes $0 MA
Tufts Health Plan Senior Care Options (HMO D-SNP) TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION T1 Yes $0 MA
Tufts Health Plan Senior Care Options CW (HMO D-SNP) TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION T1 Yes $0 MA
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF FLORIDA, INC. T1 Yes $4.80 FL
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF MICHIGAN, INC. T1 Yes $8.80 MI
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF ILLINOIS, INC. T1 Yes $15.20 IL
WellSense Added Value (HMO) BOSTON MEDICAL CENTER HEALTH PLAN, INC. T1 Yes $21.70 NH
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF COLORADO, INC. T1 Yes $35.20 CO
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC. T1 Yes $36.20 NC
Longevity Health Plan (PPO I-SNP) LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP T1 Yes $40.00 NJ
ElderServe Star (HMO I-SNP) ELDERSERVE HEALTH, INC. T1 Yes $58.80 NY
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF NEW YORK, INC. T1 Yes $58.80 NY
HAP Medicare Explore (PPO) ALLIANCE HEALTH AND LIFE INSURANCE COMPANY T2 Yes $0 MI
HAP Medicare Prime (PPO) ALLIANCE HEALTH AND LIFE INSURANCE COMPANY T2 Yes $0 MI
HAP Medicare Connect (HMO) HEALTH ALLIANCE PLAN OF MICHIGAN T2 Yes $0 MI
HAP Medicare Complete Duals (HMO D-SNP) HEALTH ALLIANCE PLAN OF MICHIGAN T2 Yes $0 MI
HAP Medicare Superior (HMO) HEALTH ALLIANCE PLAN OF MICHIGAN T2 Yes $0 MI
Henry Ford Select (HMO) HEALTH ALLIANCE PLAN OF MICHIGAN T2 Yes $0 MI
DEVOTED CORE 001 FL (HMO) DEVOTED HEALTH PLAN OF FLORIDA, INC. T2 Yes $0 FL
DEVOTED CORE 002 FL (HMO) DEVOTED HEALTH PLAN OF FLORIDA, INC. T2 Yes $0 FL
DEVOTED CORE 003 FL (HMO) DEVOTED HEALTH PLAN OF FLORIDA, INC. T2 Yes $0 FL
DEVOTED CORE 005 FL (HMO) DEVOTED HEALTH PLAN OF FLORIDA, INC. T2 Yes $0 FL
DEVOTED GIVEBACK 013 FL (HMO) DEVOTED HEALTH PLAN OF FLORIDA, INC. T2 Yes $0 FL
DEVOTED GIVEBACK 014 FL (HMO) DEVOTED HEALTH PLAN OF FLORIDA, INC. T2 Yes $0 FL
DEVOTED GIVEBACK 015 FL (HMO) DEVOTED HEALTH PLAN OF FLORIDA, INC. T2 Yes $0 FL
DEVOTED GIVEBACK 018 FL (HMO) DEVOTED HEALTH PLAN OF FLORIDA, INC. T2 Yes $0 FL
DEVOTED CORE 025 FL (HMO) DEVOTED HEALTH PLAN OF FLORIDA, INC. T2 Yes $0 FL
DEVOTED CORE 027 FL (HMO) DEVOTED HEALTH PLAN OF FLORIDA, INC. T2 Yes $0 FL
DEVOTED CORE 029 FL (HMO) DEVOTED HEALTH PLAN OF FLORIDA, INC. T2 Yes $0 FL
DEVOTED GIVEBACK 031 FL (HMO) DEVOTED HEALTH PLAN OF FLORIDA, INC. T2 Yes $0 FL
DEVOTED GIVEBACK 032 FL (HMO) DEVOTED HEALTH PLAN OF FLORIDA, INC. T2 Yes $0 FL
DEVOTED GIVEBACK 035 FL (HMO) DEVOTED HEALTH PLAN OF FLORIDA, INC. T2 Yes $0 FL
DEVOTED CORE 036 FL (HMO) DEVOTED HEALTH PLAN OF FLORIDA, INC. T2 Yes $0 FL
DEVOTED GIVEBACK 045 FL (HMO) DEVOTED HEALTH PLAN OF FLORIDA, INC. T2 Yes $0 FL
DEVOTED CORE 046 FL (HMO) DEVOTED HEALTH PLAN OF FLORIDA, INC. T2 Yes $0 FL
DEVOTED GIVEBACK 049 FL (HMO) DEVOTED HEALTH PLAN OF FLORIDA, INC. T2 Yes $0 FL

Frequently Asked Questions

Is formoterol fumarate 0.01 MG/ML Inhalation Solution covered by Medicare Part D?

Yes, formoterol fumarate 0.01 MG/ML Inhalation Solution is covered by 1,267 Medicare Part D plans (25% of all Part D formularies).

What tier is formoterol fumarate 0.01 MG/ML Inhalation Solution on Medicare Part D plans?

formoterol fumarate 0.01 MG/ML Inhalation Solution averages Tier 3.3 across Part D plans, ranging from Tier 1 to Tier 4.

Does formoterol fumarate 0.01 MG/ML Inhalation Solution require prior authorization?

100% of Part D formularies require prior authorization for formoterol fumarate 0.01 MG/ML Inhalation Solution. Step therapy: 0%. Quantity limits: 59.2%.

How much does Medicare spend on formoterol fumarate 0.01 MG/ML Inhalation Solution?

In 2023, total Medicare Part D spending on formoterol fumarate 0.01 MG/ML Inhalation Solution was $6,380,403, covering 3,044 beneficiaries. The average spend per beneficiary was $2,096.06.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial