Medicare Part D coverage · formoterol fumarate · RxCUI 1246319
formoterol fumarate 0.01 MG/ML Inhalation Solution
Per the CMS 2026 Part D formulary file, formoterol fumarate 0.01 MG/ML Inhalation Solution is covered by 1,255 Medicare Part D plans (24.8% of enrollable products), averaging Tier 3.3, with prior authorization required on 100% of covering formularies.
- 24.8%
- Plan coverage
- 1,255
- 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 96 distinct formulary files spanning 1,255 Medicare Part D plan offerings - 24.8% 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. 58.3% 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
- 96
- Plans covering
- 1,255
- Coverage rate
- 24.8%
- 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
- 58.3% of formularies
2023 Medicare Spending
- Beneficiaries
- 3,044
- Total spending
- $6,380,403
- Avg per beneficiary
- $2,096.06
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering formoterol fumarate 0.01 MG/ML Inhalation Solution
100 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 |
Show the next 30 plans
| 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 |
Showing top 50 of 100 plans.
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 1,255 Medicare Part D plans (24.8% 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: 58.3%.
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.
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
- 0.375 ML leuprolide acetate 60 MG/ML Prefilled Syringe [Eligard] T3.3
- 0.5 ML leuprolide acetate 60 MG/ML Prefilled Syringe [Eligard] T3.3
- 250 ML soybean oil 200 MG/ML Injection [Intralipid] T3.3
- cefotetan 1000 MG Injection T3.3
- cefotetan 2000 MG Injection T3.3
- {14 (lamotrigine 100 MG Oral Tablet [Subvenite]) / 84 (lamotrigine 25 MG Oral Tablet [Subvenite]) } Pack [Subvenite Green (for Patients Taking Carbamazepine, Phenytoin, Phenobarbital, or Primidone and Not Taking Valproate)] T3.3
Similar prior-authorization rate
- sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane] 100% PA
- lusutrombopag 3 MG Oral Tablet [Mulpleta] 100% PA
- 12 HR tapentadol 100 MG Extended Release Oral Tablet [Nucynta] 100% PA
- {14 (24 HR lamotrigine 100 MG Extended Release Oral Tablet [Lamictal]) / 7 (24 HR lamotrigine 200 MG Extended Release Oral Tablet [Lamictal]) / 14 (24 HR lamotrigine 50 MG Extended Release Oral Tablet [Lamictal]) } Pack [Lamictal XR Green Patient Titration Kit (for Patients Taking Carbamazepine, Phenytoin, Phenobarbital, or Primidone, and Not Taking Valproate)] 100% PA
- eltrombopag 25 MG Oral Tablet [Promacta] 100% PA
- eltrombopag 25 MG Powder for Oral Suspension [Promacta] 100% PA