hydrocortisone 25 MG/ML Topical Solution

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hydrocortisone

RxCUI: 197786

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.
0.6%
Plan Coverage
29
Plans Covering
T3
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for hydrocortisone 25 MG/ML Topical Solution

Per the CMS 2026 Part D formulary file, hydrocortisone 25 MG/ML Topical Solution (RxNorm concept RXCUI 197786, generic name hydrocortisone) appears on 2 distinct formulary files spanning 29 Medicare Part D plan offerings - 0.6% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 2 to Tier 4, with a cross-plan average of Tier 3.

Real-world access to hydrocortisone 25 MG/ML Topical Solution depends on utilization management as much as tier placement: 0% 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 1,257,661 Part D beneficiaries filled hydrocortisone 25 MG/ML Topical Solution 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 25 MG/ML Topical Solution today.

Coverage Details

Formularies covering
2
Plans covering
29
Coverage rate
0.6%
Tier range
Tier 2 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

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

2023 Medicare Spending

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

Tier Distribution Across Plans

10 plans
Tier 2, Generic
19 plans
Tier 4, Non-Preferred

Medicare Advantage Plans (MA-PD) Covering hydrocortisone 25 MG/ML Topical Solution

29 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Health First Rewards H1099-014 (HMO) HEALTH FIRST HEALTH PLANS T2 No $0 FL
Health First SunSaver H1099-016 (HMO) HEALTH FIRST HEALTH PLANS T2 No $0 FL
Health First Complete Care H1099-023 (HMO) HEALTH FIRST HEALTH PLANS T2 No $0 FL
Health First Emerald Plus H1099-024 (HMO) HEALTH FIRST HEALTH PLANS T2 No $0 FL
Health First Premier Access H1099-025 (HMO-POS) HEALTH FIRST HEALTH PLANS T2 No $0 FL
Health First Emerald Plus H1099-026 (HMO) HEALTH FIRST HEALTH PLANS T2 No $0 FL
Health First Premier Access H1099-027 (HMO-POS) HEALTH FIRST HEALTH PLANS T2 No $0 FL
Health First Emerald Plus H1099-028 (HMO) HEALTH FIRST HEALTH PLANS T2 No $0 FL
Health First Value H1099-006 (HMO) HEALTH FIRST HEALTH PLANS T2 No $15.00 FL
Health First Classic H1099-001 (HMO-POS) HEALTH FIRST HEALTH PLANS T2 No $49.40 FL
Wellpoint Medicare Advantage (HMO-POS) WELLPOINT WEST VIRGINIA , INC. T4 No $0 WV
Anthem Medicare Advantage 3 (HMO-POS) HealthKeepers, Inc. T4 No $0 VA
Anthem Medicare Advantage 3 (HMO-POS) HealthKeepers, Inc. T4 No $0 VA
Anthem Medicare Advantage 3 (HMO-POS) HealthKeepers, Inc. T4 No $0 VA
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TENNESSEE, INC. T4 No $0 TN
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TENNESSEE, INC. T4 No $0 TN
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TENNESSEE, INC. T4 No $0 TN
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TENNESSEE, INC. T4 No $0 TN
Wellpoint Medicare Advantage (HMO) WELLPOINT SOUTH CAROLINA, INC. T4 No $14.00 SC
Anthem Medicare Advantage 3 (HMO-POS) HealthKeepers, Inc. T4 No $24.00 VA
Anthem Medicare Advantage 2 (HMO-POS) Anthem HP, LLC T4 No $30.00 NY
Anthem Medicare Advantage 2 (HMO-POS) Anthem HP, LLC T4 No $34.00 NY
Anthem Medicare Advantage 2 (HMO-POS) ANTHEM HP, LLC. T4 No $44.00 NY
Anthem Medicare Advantage (HMO-POS) ANTHEM HP, LLC. T4 No $44.00 NY
Anthem Medicare Advantage 2 (HMO-POS) Anthem HP, LLC T4 No $56.00 NY
Anthem Medicare Advantage (HMO) ANTHEM HP, LLC. T4 No $65.00 NY
Anthem Medicare Advantage 3 (HMO-POS) Anthem HP, LLC T4 No $70.00 NY
Anthem Medicare Advantage (HMO) ANTHEM HP, LLC. T4 No $80.00 NY
Anthem Medicare Advantage (HMO) ANTHEM HP, LLC. T4 No $90.00 NY

Frequently Asked Questions

Is hydrocortisone 25 MG/ML Topical Solution covered by Medicare Part D?

Yes, hydrocortisone 25 MG/ML Topical Solution is covered by 29 Medicare Part D plans (0.6% of all Part D formularies).

What tier is hydrocortisone 25 MG/ML Topical Solution on Medicare Part D plans?

hydrocortisone 25 MG/ML Topical Solution averages Tier 3 across Part D plans, ranging from Tier 2 to Tier 4.

Does hydrocortisone 25 MG/ML Topical Solution require prior authorization?

0% of Part D formularies require prior authorization for hydrocortisone 25 MG/ML Topical Solution. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on hydrocortisone 25 MG/ML Topical Solution?

In 2023, total Medicare Part D spending on hydrocortisone 25 MG/ML Topical Solution 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