Medicare Part D coverage · heparin · RxCUI 1361615

heparin sodium, porcine 5000 UNT/ML Injectable Solution

Per the CMS 2026 Part D formulary file, heparin sodium, porcine 5000 UNT/ML Injectable Solution is covered by 5,052 Medicare Part D plans (100% of enrollable products), averaging Tier 2.3, with prior authorization required on 25.3% of covering formularies.

100%
Plan coverage
5,052
Plans covering
T2.3
Avg tier
25.3%
Prior auth required

Verify with CMS →

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.

What the CMS Formulary Data Shows for heparin sodium, porcine 5000 UNT/ML Injectable Solution

Per the CMS 2026 Part D formulary file, heparin sodium, porcine 5000 UNT/ML Injectable Solution (RxNorm concept RXCUI 1361615, generic name heparin) 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 3, with a cross-plan average of Tier 2.3.

Real-world access to heparin sodium, porcine 5000 UNT/ML Injectable Solution depends on utilization management as much as tier placement: 25.3% 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 13,864 Part D beneficiaries filled heparin sodium, porcine 5000 UNT/ML Injectable Solution in 2023, with total plan-and-beneficiary spending of $2,796,464 and an average per-beneficiary annual cost of $201.71. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry heparin sodium, porcine 5000 UNT/ML Injectable Solution today.

Coverage Details

Formularies covering
328
Plans covering
5,052
Coverage rate
100%
Tier range
Tier 1 – Tier 3
Average tier
Tier 2, Generic

Restrictions

Prior authorization required
25.3% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

2023 Medicare Spending

Beneficiaries
13,864
Total spending
$2,796,464
Avg per beneficiary
$201.71

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering heparin sodium, porcine 5000 UNT/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
HealthSun HealthAdvantage Plan (HMO) Healthsun Health Plans, Inc. T1 Yes $0 FL
HealthSun MediMax (HMO) Healthsun Health Plans, Inc. T1 Yes $0 FL
HealthSun HealthAdvantage Plan (HMO) Healthsun Health Plans, Inc. T1 Yes $0 FL
HealthSun HealthAdvantage Plan (HMO) Healthsun Health Plans, Inc. T1 Yes $0 FL
HealthSun MediSun Plus (HMO D-SNP) Healthsun Health Plans, Inc. T1 Yes $0 FL
HealthSun HealthAdvantage Plus (HMO) Healthsun Health Plans, Inc. T1 Yes $0 FL
HealthSun HealthAdvantage Plus (HMO) Healthsun Health Plans, Inc. T1 Yes $0 FL
HealthSun MediSun Extra (HMO D-SNP) Healthsun Health Plans, Inc. T1 Yes $0 FL
HealthSun HealthAdvantage Plus (HMO) Healthsun Health Plans, Inc. T1 Yes $0 FL
HealthSun VitalCare (HMO C-SNP) Healthsun Health Plans, Inc. T1 Yes $0 FL
HealthSun VitalCare (HMO C-SNP) Healthsun Health Plans, Inc. T1 Yes $0 FL
HealthSun MediSun Full Dual Plus (HMO D-SNP) Healthsun Health Plans, Inc. T1 Yes $0 FL
HealthSun MediSun Full Dual Extra (HMO D-SNP) Healthsun Health Plans, Inc. T1 Yes $0 FL
Simply Complete (HMO D-SNP) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply More (HMO) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Complete (HMO D-SNP) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Level (HMO C-SNP) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Level (HMO C-SNP) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Show the next 30 plans
Simply More (HMO) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Level (HMO C-SNP) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply More (HMO) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Level (HMO C-SNP) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Complete (HMO D-SNP) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply More (HMO) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply More (HMO) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Level (HMO C-SNP) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Complete (HMO D-SNP) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply More (HMO) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Extra (HMO) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Extra Platinum (HMO) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply More Platinum (HMO) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Complete Platinum (HMO D-SNP) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Level Platinum (HMO C-SNP) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Extra Platinum (HMO) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Level Platinum (HMO C-SNP) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Extra Platinum (HMO) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Level Platinum (HMO C-SNP) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Extra Platinum (HMO) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply More Platinum (HMO) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Complete Platinum (HMO D-SNP) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Level Platinum (HMO C-SNP) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Integrated (HMO D-SNP) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Integrated (HMO D-SNP) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Integrated (HMO D-SNP) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Integrated (HMO D-SNP) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Integrated (HMO D-SNP) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Integrated (HMO D-SNP) Simply Healthcare Plans, Inc. T1 Yes $0 FL
Simply Integrated (HMO D-SNP) Simply Healthcare Plans, Inc. T1 Yes $0 FL

Showing top 50 of 100 plans.

Frequently Asked Questions

Is heparin sodium, porcine 5000 UNT/ML Injectable Solution covered by Medicare Part D?

Yes, heparin sodium, porcine 5000 UNT/ML Injectable Solution is covered by 5,052 Medicare Part D plans (100% of all Part D formularies).

What tier is heparin sodium, porcine 5000 UNT/ML Injectable Solution on Medicare Part D plans?

heparin sodium, porcine 5000 UNT/ML Injectable Solution averages Tier 2.3 across Part D plans, ranging from Tier 1 to Tier 3.

Does heparin sodium, porcine 5000 UNT/ML Injectable Solution require prior authorization?

25.3% of Part D formularies require prior authorization for heparin sodium, porcine 5000 UNT/ML Injectable Solution. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on heparin sodium, porcine 5000 UNT/ML Injectable Solution?

In 2023, total Medicare Part D spending on heparin sodium, porcine 5000 UNT/ML Injectable Solution was $2,796,464, covering 13,864 beneficiaries. The average spend per beneficiary was $201.71.

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.

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