Medicare Part D coverage · haloperidol · RxCUI 204416
haloperidol 5 MG/ML Injectable Solution
Per the CMS 2026 Part D formulary file, haloperidol 5 MG/ML Injectable Solution is covered by 5,052 Medicare Part D plans (100% of enrollable products), averaging Tier 2.5, with prior authorization required on 14% of covering formularies.
- 100%
- Plan coverage
- 5,052
- Plans covering
- T2.5
- Avg tier
- 14%
- Prior auth required
What the CMS Formulary Data Shows for haloperidol 5 MG/ML Injectable Solution
Per the CMS 2026 Part D formulary file, haloperidol 5 MG/ML Injectable Solution (RxNorm concept RXCUI 204416, generic name haloperidol) appears on 328 distinct formulary files spanning 5,052 Medicare Part D plan offerings - 100% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.5.
Real-world access to haloperidol 5 MG/ML Injectable Solution depends on utilization management as much as tier placement: 14% 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 136,327 Part D beneficiaries filled haloperidol 5 MG/ML Injectable Solution in 2023, with total plan-and-beneficiary spending of $31,508,253 and an average per-beneficiary annual cost of $231.12. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry haloperidol 5 MG/ML Injectable Solution today.
Coverage Details
- Formularies covering
- 328
- Plans covering
- 5,052
- Coverage rate
- 100%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 14% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 136,327
- Total spending
- $31,508,253
- Avg per beneficiary
- $231.12
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering haloperidol 5 MG/ML Injectable Solution
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Community Blue Medicare HMO Signature (HMO) | Highmark Western and Northeastern New York Inc. | T1 | No | $0 | NY |
| Community Blue Medicare HMO Merit (HMO) | Highmark Western and Northeastern New York Inc. | T1 | No | $0 | NY |
| Community Blue Medicare PPO Signature (PPO) | Highmark Senior Health Company | T1 | No | $0 | PA |
| Complete Blue PPO Signature (PPO) | Highmark Senior Health Company | T1 | No | $0 | PA |
| Community Blue Medicare Plus PPO Signature (PPO) | Highmark Senior Health Company | T1 | No | $0 | PA |
| Complete Blue PPO Signature (PPO) | Highmark Senior Health Company | T1 | No | $0 | PA |
| Complete Blue PPO Merit (PPO) | Highmark Senior Health Company | T1 | No | $0 | PA |
| Complete Blue PPO Signature (PPO) | Highmark Senior Health Company | T1 | No | $0 | PA |
| Complete Blue PPO Distinct (PPO) | Highmark Senior Health Company | T1 | No | $0 | PA |
| Community Blue Medicare Plus PPO Signature (PPO) | Highmark Senior Health Company | T1 | No | $0 | PA |
| Complete Blue Plus PPO Merit (PPO) | Highmark Senior Health Company | T1 | No | $0 | PA |
| Community Blue Medicare PPO Signature (PPO) | Highmark Senior Health Company | T1 | No | $0 | PA |
| Complete Blue PPO Merit (PPO) | Highmark Senior Health Company | T1 | No | $0 | PA |
| Community Blue Medicare HMO Signature (HMO) | Highmark Choice Company | T1 | No | $0 | PA |
| Security Blue HMO-POS ValueRx (HMO-POS) | Highmark Choice Company | T1 | No | $0 | PA |
| Community Blue Medicare HMO Signature (HMO) | Highmark Choice Company | T1 | No | $0 | PA |
| Together Blue Medicare HMO Signature (HMO) | Highmark Choice Company | T1 | No | $0 | PA |
| Community Blue Medicare HMO Distinct (HMO) | Highmark Choice Company | T1 | No | $0 | PA |
| Complete Blue HMO Distinct (HMO) | Highmark Choice Company | T1 | No | $0 | PA |
| Complete Blue PPO Distinct (PPO) | Highmark Senior Solutions Company | T1 | No | $0 | WV |
Show the next 30 plans
| Complete Blue PPO Signature (PPO) | Highmark Senior Solutions Company | T1 | No | $0 | WV |
| Complete Blue PPO Signature (PPO) | Highmark Senior Solutions Company | T1 | No | $0 | WV |
| Complete Blue PPO Merit (PPO) | Highmark Senior Solutions Company | T1 | No | $0 | WV |
| Complete Blue PPO Signature (PPO) | Highmark Bcbsd Inc. | T1 | No | $0 | DE |
| 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 |
| Freedom VIP Care (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Savings (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Freedom Medi-Medi Partial (HMO D-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Medi-Medi Full (HMO D-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Optimum Emerald Partial (HMO D-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Emerald Full (HMO D-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is haloperidol 5 MG/ML Injectable Solution covered by Medicare Part D?
Yes, haloperidol 5 MG/ML Injectable Solution is covered by 5,052 Medicare Part D plans (100% of all Part D formularies).
What tier is haloperidol 5 MG/ML Injectable Solution on Medicare Part D plans?
haloperidol 5 MG/ML Injectable Solution averages Tier 2.5 across Part D plans, ranging from Tier 1 to Tier 4.
Does haloperidol 5 MG/ML Injectable Solution require prior authorization?
14% of Part D formularies require prior authorization for haloperidol 5 MG/ML Injectable Solution. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on haloperidol 5 MG/ML Injectable Solution?
In 2023, total Medicare Part D spending on haloperidol 5 MG/ML Injectable Solution was $31,508,253, covering 136,327 beneficiaries. The average spend per beneficiary was $231.12.
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
- dexamethasone 1 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension T2.5
- fluorouracil 50 MG/ML Topical Solution T2.5
- moxifloxacin 400 MG Oral Tablet T2.5
- 100 ML glucose 50 MG/ML Injection T2.5
- 24 HR desvenlafaxine succinate 50 MG Extended Release Oral Tablet T2.5
- carbidopa 10 MG / levodopa 100 MG Disintegrating Oral Tablet T2.5
Similar prior-authorization rate
- 0.5 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Erzofri] 14% PA
- 0.75 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Erzofri] 14% PA
- 1 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Erzofri] 14% PA
- 1.5 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Erzofri] 14% PA
- colistin 75 MG/ML Injectable Solution 14% PA
- tigecycline 50 MG Injection 14% PA