Medicare Part D coverage · hydrocortisone · RxCUI 1440936
hydrocortisone 25 MG/ML Topical Cream [Proctozone HC]
Per the CMS 2026 Part D formulary file, hydrocortisone 25 MG/ML Topical Cream [Proctozone HC] is covered by 4,210 Medicare Part D plans (83.3% of enrollable products), averaging Tier 1.9, with prior authorization required on 0% of covering formularies.
- 83.3%
- Plan coverage
- 4,210
- Plans covering
- T1.9
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for hydrocortisone 25 MG/ML Topical Cream [Proctozone HC]
Per the CMS 2026 Part D formulary file, hydrocortisone 25 MG/ML Topical Cream [Proctozone HC] (RxNorm concept RXCUI 1440936, generic name hydrocortisone) appears on 309 distinct formulary files spanning 4,210 Medicare Part D plan offerings - 83.3% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 1.9.
Real-world access to hydrocortisone 25 MG/ML Topical Cream [Proctozone HC] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 29.1% 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 Cream [Proctozone HC] 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 Cream [Proctozone HC] today.
Coverage Details
- Formularies covering
- 309
- Plans covering
- 4,210
- Coverage rate
- 83.3%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 29.1% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,257,661
- Total spending
- $47,540,093
- Avg per beneficiary
- $37.80
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering hydrocortisone 25 MG/ML Topical Cream [Proctozone HC]
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 |
| Anthem Medicare Advantage (HMO-POS) | Blue Cross OF California | T1 | No | $0 | CA |
| Anthem Medicare Advantage (HMO-POS) | Blue Cross OF California | T1 | No | $0 | CA |
| Anthem Medicare Advantage (HMO-POS) | Blue Cross OF California | T1 | No | $0 | CA |
| Anthem Medicare Advantage (HMO-POS) | Blue Cross OF California | T1 | No | $0 | CA |
| Anthem Full Dual Advantage (HMO D-SNP) | Anthem Insurance Companies, Inc. | T1 | No | $0 | IN |
| Anthem I PathWays Dual Care Advantage (HMO D-SNP) | Anthem Insurance Companies, Inc. | T1 | No | $0 | IN |
| Anthem I PathWays Dual Care Advantage NFLOC (HMO D-SNP) | Anthem Insurance Companies, Inc. | T1 | No | $0 | IN |
| Wellpoint Full Dual Advantage (HMO-POS D-SNP) | Wellpoint Iowa, Inc. | T1 | No | $0 | IA |
| Wellpoint Full Dual Advantage 2 (HMO-POS D-SNP) | Wellpoint Iowa, Inc. | T1 | No | $0 | IA |
| Wellpoint Full Dual Advantage (HMO D-SNP) | Wellpoint West Virginia , Inc. | T1 | No | $0 | WV |
| Wellpoint Full Dual Advantage (HMO D-SNP) | Wellpoint Washington, Inc. | T1 | No | $0 | WA |
| Wellpoint Dual Advantage (HMO D-SNP) | Wellpoint Washington, Inc. | T1 | No | $0 | WA |
| Healthy Blue Dual Advantage (HMO D-SNP) | Community Care Health Plan OF Louisiana, Inc. | T1 | No | $0 | LA |
| Healthy Blue Dual Advantage 2 (HMO D-SNP) | Community Care Health Plan OF Louisiana, Inc. | T1 | No | $0 | LA |
| Anthem Dual Advantage (PPO D-SNP) | Anthem Insurance Companies, Inc. | T1 | No | $0 | VA |
| Wellpoint Medicare Advantage 2 (HMO-POS) | Wellpoint Texas, Inc. | T1 | No | $0 | TX |
| Wellpoint Kidney Care (HMO-POS C-SNP) | Wellpoint Texas, Inc. | T1 | No | $0 | TX |
| Wellpoint Dual Advantage 2 (HMO D-SNP) | Wellpoint Texas, Inc. | T1 | No | $0 | TX |
Show the next 30 plans
Showing top 50 of 100 plans.
Frequently Asked Questions
Is hydrocortisone 25 MG/ML Topical Cream [Proctozone HC] covered by Medicare Part D?
Yes, hydrocortisone 25 MG/ML Topical Cream [Proctozone HC] is covered by 4,210 Medicare Part D plans (83.3% of all Part D formularies).
What tier is hydrocortisone 25 MG/ML Topical Cream [Proctozone HC] on Medicare Part D plans?
hydrocortisone 25 MG/ML Topical Cream [Proctozone HC] averages Tier 1.9 across Part D plans, ranging from Tier 1 to Tier 4.
Does hydrocortisone 25 MG/ML Topical Cream [Proctozone HC] require prior authorization?
0% of Part D formularies require prior authorization for hydrocortisone 25 MG/ML Topical Cream [Proctozone HC]. Step therapy: 0%. Quantity limits: 29.1%.
How much does Medicare spend on hydrocortisone 25 MG/ML Topical Cream [Proctozone HC]?
In 2023, total Medicare Part D spending on hydrocortisone 25 MG/ML Topical Cream [Proctozone HC] was $47,540,093, covering 1,257,661 beneficiaries. The average spend per beneficiary was $37.80.
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
Similar prior-authorization rate
- metronidazole 10 MG/ML Topical Cream [Noritate] 0% PA
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- diflunisal 375 MG Oral Tablet [Dolobid] 0% PA
- indomethacin 50 MG Rectal Suppository [Indocin] 0% PA
- sarecycline 100 MG Oral Tablet [Seysara] 0% PA