Medicare Part D coverage · hydrocortisone · RxCUI 204874

hydrocortisone 10 MG/ML / neomycin 3.5 MG/ML / polymyxin B 10000 UNT/ML Ophthalmic Suspension

Per the CMS 2026 Part D formulary file, hydrocortisone 10 MG/ML / neomycin 3.5 MG/ML / polymyxin B 10000 UNT/ML Ophthalmic Suspension is covered by 4,268 Medicare Part D plans (84.5% of enrollable products), averaging Tier 2.9, with prior authorization required on 0% of covering formularies.

84.5%
Plan coverage
4,268
Plans covering
T2.9
Avg tier
0%
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 hydrocortisone 10 MG/ML / neomycin 3.5 MG/ML / polymyxin B 10000 UNT/ML Ophthalmic Suspension

Per the CMS 2026 Part D formulary file, hydrocortisone 10 MG/ML / neomycin 3.5 MG/ML / polymyxin B 10000 UNT/ML Ophthalmic Suspension (RxNorm concept RXCUI 204874, generic name hydrocortisone) appears on 169 distinct formulary files spanning 4,268 Medicare Part D plan offerings - 84.5% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.9.

Real-world access to hydrocortisone 10 MG/ML / neomycin 3.5 MG/ML / polymyxin B 10000 UNT/ML Ophthalmic Suspension depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 1.2% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,257,661 Part D beneficiaries filled hydrocortisone 10 MG/ML / neomycin 3.5 MG/ML / polymyxin B 10000 UNT/ML Ophthalmic Suspension 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 10 MG/ML / neomycin 3.5 MG/ML / polymyxin B 10000 UNT/ML Ophthalmic Suspension today.

Coverage Details

Formularies covering
169
Plans covering
4,268
Coverage rate
84.5%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
0% of formularies
Step therapy required
0% of formularies
Quantity limits
1.2% of formularies

2023 Medicare Spending

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

Tier Distribution Across Plans

69 plans
Tier 1, Preferred Generic
31 plans
Tier 2, Generic

Medicare Advantage Plans (MA-PD) Covering hydrocortisone 10 MG/ML / neomycin 3.5 MG/ML / polymyxin B 10000 UNT/ML Ophthalmic Suspension

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
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
Healthfirst CompleteCare (HMO D-SNP) Healthfirst Health Plan, Inc. T1 No $0 NY
IMCare Classic (HMO D-SNP) Itasca Medical Care T1 No $0 MN
Johns Hopkins Advantage MD D-SNP (HMO D-SNP) Hopkins Health Advantage, Inc. T1 No $0 MD
MetroPlus UltraCare (HMO D-SNP) Metroplus Health Plan, Inc. T1 No $0 NY
Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) Upper Peninsula Health Plan, LLC T1 No $0 MI
CareSource Dual Advantage (HMO D-SNP) Caresource Georgia Co. T1 No $0 GA
Senior Whole Health SCO (HMO D-SNP) Senior Whole Health, LLC T1 No $0 MA
Senior Whole Health SCO NHC (HMO D-SNP) Senior Whole Health, LLC T1 No $0 MA
Molina One Care (HMO D-SNP) Senior Whole Health, LLC T1 No $0 MA
Show the next 30 plans
HAP CareSource MI Coordinated Health (HMO D-SNP) HAP Caresource T1 No $0 MI
CareAdvantage (HMO D-SNP) SAN Mateo Health Commission T1 No $0 CA
NaviCare (HMO D-SNP) Fallon Community Health Plan T1 No $0 MA
PHP (HMO C-snp) Aids Healthcare Foundation T1 No $0 CA
CCA One Care (HMO D-SNP) Commonwealth Care Alliance, Inc. T1 No $0 MA
CCA Senior Care Options (HMO D-SNP) Commonwealth Care Alliance, Inc. T1 No $0 MA
VNS Health Total (HMO D-SNP) VNS Choice T1 No $0 NY
Community Care's Partnership Program (HMO D-SNP) Community Care Health Plan, Inc. T1 No $0 WI
Platino Blindao (HMO D-SNP) Triple S Advantage, Inc. T1 No $0 PR
Platino Enlace (HMO D-SNP) Triple S Advantage, Inc. T1 No $0 PR
Platino Advance (HMO D-snp) Triple S Advantage, Inc. T1 No $0 PR
Platino Plus (HMO D-snp) Triple S Advantage, Inc. T1 No $0 PR
CalOptima Health OneCare Complete (HMO D-SNP) Orange County Health Authority T1 No $0 CA
Mass General Brigham SCO (HMO D-SNP) Mass General Brigham Health Plan, Inc T1 No $0 MA
Mass General Brigham One Care (HMO D-SNP) Mass General Brigham Health Plan, Inc T1 No $0 MA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) Gateway Health Plan, Inc. T1 No $0 PA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) Gateway Health Plan, Inc. T1 No $0 PA
Highmark Health Options Duals (HMO D-SNP) Highmark Health Options West Virginia Inc. T1 No $0 WV
Highmark Health Options Duals (HMO D-SNP) Highmark Bcbsd, Inc. T1 No $0 DE
Tufts Health One Care (HMO D-SNP) Tufts Health Public Plans, Inc. T1 No $0 MA
Tufts Health One Care CW (HMO D-SNP) Tufts Health Public Plans, Inc. T1 No $0 MA
Tufts Health Plan Senior Care Options (HMO D-SNP) Tufts Associated Health Maintenance Organization T1 No $0 MA
Tufts Health Plan Senior Care Options CW (HMO D-SNP) Tufts Associated Health Maintenance Organization T1 No $0 MA
Leon MediExtra (HMO) Leon Health, Inc. T1 No $0 FL
Leon MediDual (HMO D-SNP) Leon Health, Inc. T1 No $0 FL
Leon MediMore (HMO) Leon Health, Inc. T1 No $0 FL
Leon MediMax (HMO D-SNP) Leon Health, Inc. T1 No $0 FL
Florida Complete Care (HMO I-SNP) Hpmp OF Florida, Inc. T1 No $4.80 FL
Florida Complete Care- In The Community (HMO-POS I-SNP) Hpmp OF Florida, Inc. T1 No $4.80 FL
Longevity Health Plan (HMO I-SNP) Longevity Health Plan OF Florida, Inc. T1 No $4.80 FL

Showing top 50 of 100 plans.

Frequently Asked Questions

Is hydrocortisone 10 MG/ML / neomycin 3.5 MG/ML / polymyxin B 10000 UNT/ML Ophthalmic Suspension covered by Medicare Part D?

Yes, hydrocortisone 10 MG/ML / neomycin 3.5 MG/ML / polymyxin B 10000 UNT/ML Ophthalmic Suspension is covered by 4,268 Medicare Part D plans (84.5% of all Part D formularies).

What tier is hydrocortisone 10 MG/ML / neomycin 3.5 MG/ML / polymyxin B 10000 UNT/ML Ophthalmic Suspension on Medicare Part D plans?

hydrocortisone 10 MG/ML / neomycin 3.5 MG/ML / polymyxin B 10000 UNT/ML Ophthalmic Suspension averages Tier 2.9 across Part D plans, ranging from Tier 1 to Tier 4.

Does hydrocortisone 10 MG/ML / neomycin 3.5 MG/ML / polymyxin B 10000 UNT/ML Ophthalmic Suspension require prior authorization?

0% of Part D formularies require prior authorization for hydrocortisone 10 MG/ML / neomycin 3.5 MG/ML / polymyxin B 10000 UNT/ML Ophthalmic Suspension. Step therapy: 0%. Quantity limits: 1.2%.

How much does Medicare spend on hydrocortisone 10 MG/ML / neomycin 3.5 MG/ML / polymyxin B 10000 UNT/ML Ophthalmic Suspension?

In 2023, total Medicare Part D spending on hydrocortisone 10 MG/ML / neomycin 3.5 MG/ML / polymyxin B 10000 UNT/ML Ophthalmic Suspension was $47,540,093, covering 1,257,661 beneficiaries. The average spend per beneficiary was $37.80.

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