Medicare Part D coverage · icosapent ethyl · RxCUI 1304979
icosapent ethyl 1000 MG Oral Capsule
Per the CMS 2026 Part D formulary file, icosapent ethyl 1000 MG Oral Capsule is covered by 1,611 Medicare Part D plans (31.9% of enrollable products), averaging Tier 2.5, with prior authorization required on 0.5% of covering formularies.
- 31.9%
- Plan coverage
- 1,611
- Plans covering
- T2.5
- Avg tier
- 0.5%
- Prior auth required
What the CMS Formulary Data Shows for icosapent ethyl 1000 MG Oral Capsule
Per the CMS 2026 Part D formulary file, icosapent ethyl 1000 MG Oral Capsule (RxNorm concept RXCUI 1304979, generic name icosapent ethyl) appears on 206 distinct formulary files spanning 1,611 Medicare Part D plan offerings - 31.9% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.5.
Real-world access to icosapent ethyl 1000 MG Oral Capsule depends on utilization management as much as tier placement: 0.5% of covering formularies require prior authorization. 0.5% require step therapy. 56.8% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 279,946 Part D beneficiaries filled icosapent ethyl 1000 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $763,988,447 and an average per-beneficiary annual cost of $2,729.06. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry icosapent ethyl 1000 MG Oral Capsule today.
Coverage Details
- Formularies covering
- 206
- Plans covering
- 1,611
- Coverage rate
- 31.9%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0.5% of formularies
- Step therapy required
- 0.5% of formularies
- Quantity limits
- 56.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 279,946
- Total spending
- $763,988,447
- Avg per beneficiary
- $2,729.06
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering icosapent ethyl 1000 MG Oral Capsule
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 |
| 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 |
| 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 |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | No | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | No | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | No | $0 | AL |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | No | $0 | CA |
| PHP (HMO C-snp) | Aids Healthcare Foundation | T1 | No | $0 | CA |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | No | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | No | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
Show the next 30 plans
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| DualConnect (HMO D-SNP) | Santa Clara County Health Authority | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | No | $0 | NY |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | No | $0 | NY |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $0 | MO |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | No | $0 | AR |
| 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 |
| Prominence Plus (HMO) | Prominence Healthfirst | T1 | No | $0 | NV |
| Prominence Plus (HMO) | Prominence Healthfirst | T1 | No | $0 | NV |
| Prominence Dual (HMO D-SNP) | Prominence Healthfirst | T1 | No | $0 | NV |
| Prominence Dual (HMO D-SNP) | Prominence Healthfirst | T1 | No | $0 | NV |
| Prominence Giveback (HMO) | Prominence Healthfirst | T1 | No | $0 | NV |
| Prominence Plus (HMO) | Prominence Healthfirst OF Florida Inc | T1 | No | $0 | FL |
| Prominence Giveback (HMO) | Prominence Healthfirst OF Florida Inc | T1 | No | $0 | FL |
| Prominence Plus (HMO) | Prominence Healthfirst OF Texas | T1 | No | $0 | TX |
| Prominence Plus (HMO) | Prominence Healthfirst OF Texas | T1 | No | $0 | TX |
| Prominence Dual (HMO D-SNP) | Prominence Healthfirst OF Texas | T1 | No | $0 | TX |
| Prominence Extra Help (HMO) | Prominence Healthfirst OF Texas | T1 | No | $0 | TX |
| Prominence Beyond (HMO) | Prominence Healthfirst OF Texas | T1 | No | $0 | TX |
| Prominence Giveback (HMO) | Prominence Healthfirst OF Texas | T1 | No | $0 | TX |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is icosapent ethyl 1000 MG Oral Capsule covered by Medicare Part D?
Yes, icosapent ethyl 1000 MG Oral Capsule is covered by 1,611 Medicare Part D plans (31.9% of all Part D formularies).
What tier is icosapent ethyl 1000 MG Oral Capsule on Medicare Part D plans?
icosapent ethyl 1000 MG Oral Capsule averages Tier 2.5 across Part D plans, ranging from Tier 1 to Tier 4.
Does icosapent ethyl 1000 MG Oral Capsule require prior authorization?
0.5% of Part D formularies require prior authorization for icosapent ethyl 1000 MG Oral Capsule. Step therapy: 0.5%. Quantity limits: 56.8%.
How much does Medicare spend on icosapent ethyl 1000 MG Oral Capsule?
In 2023, total Medicare Part D spending on icosapent ethyl 1000 MG Oral Capsule was $763,988,447, covering 279,946 beneficiaries. The average spend per beneficiary was $2,729.06.
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
- mometasone furoate 0.05 MG/ACTUAT Metered Dose Nasal Spray 0.5% PA
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- 1000 ML glucose 50 MG/ML / potassium chloride 0.04 MEQ/ML / sodium chloride 9 MG/ML Injection 0.5% PA
- 24 HR fesoterodine fumarate 4 MG Extended Release Oral Tablet 0.5% PA
- 24 HR fesoterodine fumarate 8 MG Extended Release Oral Tablet 0.5% PA