hydrocortisone 0.01 MG/MG Topical Ointment

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hydrocortisone

RxCUI: 203105

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.
88.3%
Plan Coverage
4,474
Plans Covering
T1.6
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for hydrocortisone 0.01 MG/MG Topical Ointment

Per the CMS 2026 Part D formulary file, hydrocortisone 0.01 MG/MG Topical Ointment (RxNorm concept RXCUI 203105, generic name hydrocortisone) appears on 279 distinct formulary files spanning 4,474 Medicare Part D plan offerings - 88.3% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 3, with a cross-plan average of Tier 1.6.

Real-world access to hydrocortisone 0.01 MG/MG Topical Ointment depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 33% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,257,661 Part D beneficiaries filled hydrocortisone 0.01 MG/MG Topical Ointment in 2023, with total plan-and-beneficiary spending of $47,540,093 and an average per-beneficiary annual cost of $37.80. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry hydrocortisone 0.01 MG/MG Topical Ointment today.

Coverage Details

Formularies covering
279
Plans covering
4,474
Coverage rate
88.3%
Tier range
Tier 1 – Tier 3
Average tier
Tier 2, Generic

Restrictions

Prior authorization required
0% of formularies
Step therapy required
0% of formularies
Quantity limits
33% of formularies

2023 Medicare Spending

Beneficiaries
1,257,661
Total spending
$47,540,093
Avg per beneficiary
$37.80

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering hydrocortisone 0.01 MG/MG Topical Ointment

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
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

Frequently Asked Questions

Is hydrocortisone 0.01 MG/MG Topical Ointment covered by Medicare Part D?

Yes, hydrocortisone 0.01 MG/MG Topical Ointment is covered by 4,474 Medicare Part D plans (88.3% of all Part D formularies).

What tier is hydrocortisone 0.01 MG/MG Topical Ointment on Medicare Part D plans?

hydrocortisone 0.01 MG/MG Topical Ointment averages Tier 1.6 across Part D plans, ranging from Tier 1 to Tier 3.

Does hydrocortisone 0.01 MG/MG Topical Ointment require prior authorization?

0% of Part D formularies require prior authorization for hydrocortisone 0.01 MG/MG Topical Ointment. Step therapy: 0%. Quantity limits: 33%.

How much does Medicare spend on hydrocortisone 0.01 MG/MG Topical Ointment?

In 2023, total Medicare Part D spending on hydrocortisone 0.01 MG/MG Topical Ointment was $47,540,093, covering 1,257,661 beneficiaries. The average spend per beneficiary was $37.80.

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