Hyponatremia tolvaptan 30 MG Oral Tablet
Hyponatremia tolvaptan
RxCUI: 849833
What the CMS Formulary Data Shows for Hyponatremia tolvaptan 30 MG Oral Tablet
Per the CMS 2026 Part D formulary file, Hyponatremia tolvaptan 30 MG Oral Tablet (RxNorm concept RXCUI 849833, generic name Hyponatremia tolvaptan) appears on 125 distinct formulary files spanning 2,302 Medicare Part D plan offerings - 45.4% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.1.
Real-world access to Hyponatremia tolvaptan 30 MG Oral Tablet depends on utilization management as much as tier placement: 92.8% of covering formularies require prior authorization. 0% require step therapy. 46.4% apply quantity limits.
Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry Hyponatremia tolvaptan 30 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 125
- Plans covering
- 2,302
- Coverage rate
- 45.4%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 92.8% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 46.4% of formularies
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering Hyponatremia tolvaptan 30 MG Oral Tablet
5 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T4 | Yes | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T4 | Yes | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T4 | Yes | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T4 | Yes | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T4 | Yes | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering Hyponatremia tolvaptan 30 MG Oral Tablet
95 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 | Yes | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | SENTARA HEALTH PLANS | T1 | Yes | $0 | VA |
| ElderServe MAP (HMO D-SNP) | ELDERSERVE HEALTH, INC. | T1 | Yes | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | GROUP HEALTH COOPERATIVE OF EAU CLAIRE | T1 | Yes | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP | T1 | Yes | $0 | NJ |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | UPPER PENINSULA HEALTH PLAN, LLC | T1 | Yes | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | CARESOURCE GEORGIA CO. | T1 | Yes | $0 | GA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP CARESOURCE | T1 | Yes | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | PRUITTHEALTH PREMIER, INC. | T1 | Yes | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | SIMPRA ADVANTAGE, INC. | T1 | Yes | $0 | AL |
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | Yes | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | Yes | $0 | MN |
| AbilityCare (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | Yes | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | ALAMEDA ALLIANCE FOR HEALTH | T1 | Yes | $0 | CA |
| Community Care's Partnership Program (HMO D-SNP) | COMMUNITY CARE HEALTH PLAN, INC. | T1 | No | $0 | WI |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T1 | Yes | $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 |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF FLORIDA, INC. | T1 | Yes | $4.80 | FL |
| Senior Care (HMO I-SNP) | ALIGN SENIOR CARE FLORIDA, INC. | T1 | Yes | $4.80 | FL |
| ProCare Advantage (HMO-POS I-SNP) | PROCARE ADVANTAGE, LLC | T1 | Yes | $4.80 | TX |
| ProCare Advantage - Kidney Care (HMO-POS C-SNP) | PROCARE ADVANTAGE, LLC | T1 | Yes | $4.80 | TX |
| American Health Advantage of Florida (HMO I-SNP) | AMERICAN HEALTH PLAN OF FL, INC. | T1 | Yes | $4.80 | FL |
| SECUR Advantage (HMO I-SNP) | SECUR INC | T1 | Yes | $4.80 | FL |
| SECUR Enhanced (HMO I-SNP) | SECUR INC | T1 | Yes | $4.80 | FL |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF MICHIGAN, INC. | T1 | Yes | $8.80 | MI |
| Senior Care (HMO I-SNP) | ALIGN SENIOR CARE MI, LLC | T1 | Yes | $8.80 | MI |
| AgeRight Advantage Health Plan (HMO I-SNP) | MARQUIS ADVANTAGE, INC. | T1 | Yes | $10.50 | OR, WA |
| Senior Care (HMO I-SNP) | ALIGN SENIOR CARE CALIFORNIA INC. | T1 | Yes | $12.00 | CA |
| Liberty Medicare Dual Plan (HMO D-SNP) | LIBERTY ADVANTAGE, LLC | T1 | Yes | $14.70 | NC |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF ILLINOIS, INC. | T1 | Yes | $15.20 | IL |
| WellSense Added Value (HMO) | BOSTON MEDICAL CENTER HEALTH PLAN, INC. | T1 | Yes | $21.70 | NH |
| KeyCare Advantage (HMO I-SNP) | ISNP VENTURES, LLC | T1 | Yes | $23.20 | MD |
| American Health Advantage of Mississippi (HMO I-SNP) | AMERICAN HEALTH PLAN OF MS, INC. | T1 | Yes | $23.80 | MS |
| Senior Care (HMO I-SNP) | LIFEWORKS ADVANTAGE, LLC | T1 | Yes | $24.60 | VA |
| PruittHealth Premier (HMO I-SNP) | PRUITTHEALTH PREMIER, INC. | T1 | Yes | $25.40 | GA |
| Georgia Health Advantage (HMO I-SNP) | GEORGIA ASSURANCE, INC. | T1 | Yes | $25.40 | GA |
| Georgia Health Advantage Choice (HMO I-SNP) | GEORGIA ASSURANCE, INC. | T1 | Yes | $25.40 | GA |
| American Health Advantage of Tennessee (HMO I-SNP) | AMERICAN HEALTH PLAN, INC. | T1 | Yes | $27.70 | TN |
| Simpra Advantage Nursing Home Plan (PPO I-SNP) | SIMPRA ADVANTAGE, INC. | T1 | Yes | $27.70 | AL |
| American Health Advantage of Oklahoma (HMO I-SNP) | OKLAHOMA SUPERIOR SELECT, INC. | T1 | Yes | $28.20 | OK |
| NHC Advantage (HMO I-SNP) | NHC ADVANTAGE, LLC | T1 | Yes | $31.00 | MO, NC, SC, TN |
| Perennial Advantage Strive (HMO I-SNP) | PERENNIAL ADVANTAGE OF OHIO, INC. | T1 | Yes | $31.40 | OH |
| Perennial Advantage Strive (HMO I-SNP) | PERENNIAL ADVANTAGE OF COLORADO, INC. | T1 | Yes | $32.70 | PA |
| American Health Advantage of Pennsylvania (HMO I-SNP) | AMERICAN HEALTH PLAN OF PENNSYLVANIA INC | T1 | Yes | $32.70 | PA |
| Lagniappe Advantage (PPO I-SNP) | LAGNIAPPE ADVANTAGE INSURANCE COMPANY | T1 | Yes | $32.90 | LA |
| American Health Advantage of Louisiana (HMO I-SNP) | DIGNITY CARE CORPORATION | T1 | Yes | $32.90 | LA |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | Yes | $34.50 | NY |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF COLORADO, INC. | T1 | Yes | $35.20 | CO |
| Perennial Advantage Strive (HMO I-SNP) | PERENNIAL ADVANTAGE OF COLORADO, INC. | T1 | Yes | $35.20 | CO |
Frequently Asked Questions
Is Hyponatremia tolvaptan 30 MG Oral Tablet covered by Medicare Part D?
Yes, Hyponatremia tolvaptan 30 MG Oral Tablet is covered by 2,302 Medicare Part D plans (45.4% of all Part D formularies).
What tier is Hyponatremia tolvaptan 30 MG Oral Tablet on Medicare Part D plans?
Hyponatremia tolvaptan 30 MG Oral Tablet averages Tier 4.1 across Part D plans, ranging from Tier 1 to Tier 5.
Does Hyponatremia tolvaptan 30 MG Oral Tablet require prior authorization?
92.8% of Part D formularies require prior authorization for Hyponatremia tolvaptan 30 MG Oral Tablet. Step therapy: 0%. Quantity limits: 46.4%.
Read our methodology - how this data is sourced, computed, and verified.