Medicare Part D coverage · haloperidol decanoate · RxCUI 859871
haloperidol decanoate 100 MG/ML Injectable Solution
Per the CMS 2026 Part D formulary file, haloperidol decanoate 100 MG/ML Injectable Solution is covered by 5,052 Medicare Part D plans (100% of enrollable products), averaging Tier 2.6, with prior authorization required on 14.9% of covering formularies.
- 100%
- Plan coverage
- 5,052
- Plans covering
- T2.6
- Avg tier
- 14.9%
- Prior auth required
What the CMS Formulary Data Shows for haloperidol decanoate 100 MG/ML Injectable Solution
Per the CMS 2026 Part D formulary file, haloperidol decanoate 100 MG/ML Injectable Solution (RxNorm concept RXCUI 859871, generic name haloperidol decanoate) 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 2.6.
Real-world access to haloperidol decanoate 100 MG/ML Injectable Solution depends on utilization management as much as tier placement: 14.9% 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 34,910 Part D beneficiaries filled haloperidol decanoate 100 MG/ML Injectable Solution in 2023, with total plan-and-beneficiary spending of $16,620,859 and an average per-beneficiary annual cost of $476.11. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry haloperidol decanoate 100 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 3, Preferred Brand
Restrictions
- Prior authorization required
- 14.9% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 34,910
- Total spending
- $16,620,859
- Avg per beneficiary
- $476.11
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering haloperidol decanoate 100 MG/ML Injectable 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 |
| 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 |
Show the next 30 plans
| 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 |
| 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 |
| 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 |
| Freedom Máximo (HMO-POS) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Máximo (HMO-POS) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Platinum Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Gold Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Rewards COPD (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Savings COPD (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Gold Plus Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Rewards COPD (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| 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 |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is haloperidol decanoate 100 MG/ML Injectable Solution covered by Medicare Part D?
Yes, haloperidol decanoate 100 MG/ML Injectable Solution is covered by 5,052 Medicare Part D plans (100% of all Part D formularies).
What tier is haloperidol decanoate 100 MG/ML Injectable Solution on Medicare Part D plans?
haloperidol decanoate 100 MG/ML Injectable Solution averages Tier 2.6 across Part D plans, ranging from Tier 1 to Tier 4.
Does haloperidol decanoate 100 MG/ML Injectable Solution require prior authorization?
14.9% of Part D formularies require prior authorization for haloperidol decanoate 100 MG/ML Injectable Solution. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on haloperidol decanoate 100 MG/ML Injectable Solution?
In 2023, total Medicare Part D spending on haloperidol decanoate 100 MG/ML Injectable Solution was $16,620,859, covering 34,910 beneficiaries. The average spend per beneficiary was $476.11.
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
- 0.65 ML medroxyprogesterone acetate 160 MG/ML Prefilled Syringe [depo-subQ provera] T2.6
- 100 ML ciprofloxacin 2 MG/ML Injection T2.6
- {42 (rivaroxaban 15 MG Oral Tablet [Xarelto]) / 9 (rivaroxaban 20 MG Oral Tablet [Xarelto]) } Pack [Xarelto Kit] T2.6
- clonazepam 2 MG Disintegrating Oral Tablet T2.6
- etonogestrel 68 MG Drug Implant [Nexplanon] T2.6
- rivaroxaban 10 MG Oral Tablet [Xarelto] T2.6
Similar prior-authorization rate
- tamoxifen 2 MG/ML Oral Solution [Soltamox] 14.9% PA
- lurasidone hydrochloride 120 MG Oral Tablet 14.9% PA
- lurasidone hydrochloride 40 MG Oral Tablet 14.9% PA
- vilazodone hydrochloride 10 MG Oral Tablet 14.9% PA
- 1 ML haloperidol decanoate 50 MG/ML Injection 14.9% PA
- loteprednol etabonate 2.5 MG/ML Ophthalmic Suspension [Eysuvis] 15% PA