gatifloxacin 5 MG/ML Ophthalmic Solution

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gatifloxacin

RxCUI: 992395

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.
82.7%
Plan Coverage
4,192
Plans Covering
T2.6
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for gatifloxacin 5 MG/ML Ophthalmic Solution

Per the CMS 2026 Part D formulary file, gatifloxacin 5 MG/ML Ophthalmic Solution (RxNorm concept RXCUI 992395, generic name gatifloxacin) appears on 190 distinct formulary files spanning 4,192 Medicare Part D plan offerings - 82.7% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.6.

Real-world access to gatifloxacin 5 MG/ML Ophthalmic Solution depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 6.8% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 26,914 Part D beneficiaries filled gatifloxacin 5 MG/ML Ophthalmic Solution in 2023, with total plan-and-beneficiary spending of $2,419,976 and an average per-beneficiary annual cost of $89.92. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry gatifloxacin 5 MG/ML Ophthalmic Solution today.

Coverage Details

Formularies covering
190
Plans covering
4,192
Coverage rate
82.7%
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
6.8% of formularies

2023 Medicare Spending

Beneficiaries
26,914
Total spending
$2,419,976
Avg per beneficiary
$89.92

Tier Distribution Across Plans

84 plans
Tier 1, Preferred Generic
16 plans
Tier 2, Generic

Medicare Advantage Plans (MA-PD) Covering gatifloxacin 5 MG/ML Ophthalmic 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 No $0 VA
Sentara Community Complete (HMO D-SNP) SENTARA HEALTH PLANS T1 No $0 VA
Florida Complete Care-Duals VIP (HMO-POS D-SNP) HPMP OF FLORIDA, INC. T1 No $0 FL
ElderServe MAP (HMO D-SNP) ELDERSERVE HEALTH, INC. T1 No $0 NY
Cooperative Advantage (HMO D-SNP) GROUP HEALTH COOPERATIVE OF EAU CLAIRE T1 No $0 WI
Longevity Health Plan (PPO I-SNP) LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP T1 No $0 NJ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 No $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 No $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 No $0 AZ
Elderplan Plus Long-Term Care (HMO-POS D-SNP) ELDERPLAN, INC. T1 No $0 NY
Health Choice Pathway (HMO D-SNP) HEALTH CHOICE ARIZONA, INC. T1 No $0 AZ
Healthfirst CompleteCare (HMO D-SNP) HEALTHFIRST HEALTH PLAN, INC. T1 No $0 NY
IMCare Classic (HMO D-SNP) ITASCA MEDICAL CARE T1 No $0 MN
Johns Hopkins Advantage MD D-SNP (HMO D-SNP) HOPKINS HEALTH ADVANTAGE, INC. T1 No $0 MD
MetroPlus UltraCare (HMO D-SNP) METROPLUS HEALTH PLAN, INC. T1 No $0 NY
Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) UPPER PENINSULA HEALTH PLAN, LLC T1 No $0 MI
CareSource Dual Advantage (HMO D-SNP) CARESOURCE GEORGIA CO. T1 No $0 GA
Senior Whole Health SCO (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 No $0 MA
Senior Whole Health SCO NHC (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 No $0 MA
Molina One Care (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 No $0 MA
HAP CareSource MI Coordinated Health (HMO D-SNP) HAP CARESOURCE T1 No $0 MI
CareAdvantage (HMO D-SNP) SAN MATEO HEALTH COMMISSION T1 No $0 CA
Gold Coast Health Plan Total Care Advantage (HMO D-SNP) Ventura County Medi-Cal Managed Care Commission T1 No $0 CA
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) Health Care Service Corporation T1 No $0 NM
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) Health Care Service Corporation T1 No $0 NM
SecureBlue (HMO D-SNP) HMO Minnesota T1 No $0 MN
NaviCare (HMO D-SNP) FALLON COMMUNITY HEALTH PLAN T1 No $0 MA
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 No $0 NY
PHP (HMO C-SNP) AIDS HEALTHCARE FOUNDATION T1 No $0 CA
CCA One Care (HMO D-SNP) COMMONWEALTH CARE ALLIANCE, INC. T1 No $0 MA
CCA Senior Care Options (HMO D-SNP) COMMONWEALTH CARE ALLIANCE, INC. T1 No $0 MA
VNS Health Total (HMO D-SNP) VNS CHOICE T1 No $0 NY
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
Community Care's Partnership Program (HMO D-SNP) COMMUNITY CARE HEALTH PLAN, INC. T1 No $0 WI
CalOptima Health OneCare Complete (HMO D-SNP) ORANGE COUNTY HEALTH AUTHORITY T1 No $0 CA
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
Leon MediExtra (HMO) LEON HEALTH, INC. T1 No $0 FL
Leon MediDual (HMO D-SNP) LEON HEALTH, INC. T1 No $0 FL
Leon MediMore (HMO) LEON HEALTH, INC. T1 No $0 FL
Leon MediMax (HMO D-SNP) LEON HEALTH, INC. T1 No $0 FL
Florida Complete Care (HMO I-SNP) HPMP OF FLORIDA, INC. T1 No $4.80 FL

Frequently Asked Questions

Is gatifloxacin 5 MG/ML Ophthalmic Solution covered by Medicare Part D?

Yes, gatifloxacin 5 MG/ML Ophthalmic Solution is covered by 4,192 Medicare Part D plans (82.7% of all Part D formularies).

What tier is gatifloxacin 5 MG/ML Ophthalmic Solution on Medicare Part D plans?

gatifloxacin 5 MG/ML Ophthalmic Solution averages Tier 2.6 across Part D plans, ranging from Tier 1 to Tier 4.

Does gatifloxacin 5 MG/ML Ophthalmic Solution require prior authorization?

0% of Part D formularies require prior authorization for gatifloxacin 5 MG/ML Ophthalmic Solution. Step therapy: 0%. Quantity limits: 6.8%.

How much does Medicare spend on gatifloxacin 5 MG/ML Ophthalmic Solution?

In 2023, total Medicare Part D spending on gatifloxacin 5 MG/ML Ophthalmic Solution was $2,419,976, covering 26,914 beneficiaries. The average spend per beneficiary was $89.92.

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