Medicare Part D coverage · Hyponatremia tolvaptan · RxCUI 849827
Hyponatremia tolvaptan 15 MG Oral Tablet
Per the CMS 2026 Part D formulary file, Hyponatremia tolvaptan 15 MG Oral Tablet is covered by 2,304 Medicare Part D plans (45.6% of enrollable products), averaging Tier 4.1, with prior authorization required on 92% of covering formularies.
- 45.6%
- Plan coverage
- 2,304
- Plans covering
- T4.1
- Avg tier
- 92%
- Prior auth required
What the CMS Formulary Data Shows for Hyponatremia tolvaptan 15 MG Oral Tablet
Per the CMS 2026 Part D formulary file, Hyponatremia tolvaptan 15 MG Oral Tablet (RxNorm concept RXCUI 849827, generic name Hyponatremia tolvaptan) appears on 125 distinct formulary files spanning 2,304 Medicare Part D plan offerings - 45.6% 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 15 MG Oral Tablet depends on utilization management as much as tier placement: 92% of covering formularies require prior authorization. 0% require step therapy. 50.4% 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 15 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 125
- Plans covering
- 2,304
- Coverage rate
- 45.6%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 92% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 50.4% of formularies
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering Hyponatremia tolvaptan 15 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 15 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 |
Show the next 30 plans
| 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 |
Showing top 50 of 95 plans.
Frequently Asked Questions
Is Hyponatremia tolvaptan 15 MG Oral Tablet covered by Medicare Part D?
Yes, Hyponatremia tolvaptan 15 MG Oral Tablet is covered by 2,304 Medicare Part D plans (45.6% of all Part D formularies).
What tier is Hyponatremia tolvaptan 15 MG Oral Tablet on Medicare Part D plans?
Hyponatremia tolvaptan 15 MG Oral Tablet averages Tier 4.1 across Part D plans, ranging from Tier 1 to Tier 5.
Does Hyponatremia tolvaptan 15 MG Oral Tablet require prior authorization?
92% of Part D formularies require prior authorization for Hyponatremia tolvaptan 15 MG Oral Tablet. Step therapy: 0%. Quantity limits: 50.4%.
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
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