immunoglobulin G, human 10000 MG Injection [Gammagard]

Verify with CMS →

immunoglobulin G, human

RxCUI: 1809738

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.
26.9%
Plan Coverage
1,361
Plans Covering
T4.1
Avg Tier
98.7%
Prior Auth Required

What the CMS Formulary Data Shows for immunoglobulin G, human 10000 MG Injection [Gammagard]

Per the CMS 2026 Part D formulary file, immunoglobulin G, human 10000 MG Injection [Gammagard] (RxNorm concept RXCUI 1809738, generic name immunoglobulin G, human) appears on 151 distinct formulary files spanning 1,361 Medicare Part D plan offerings - 26.9% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 4.1.

Real-world access to immunoglobulin G, human 10000 MG Injection [Gammagard] depends on utilization management as much as tier placement: 98.7% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 4,401 Part D beneficiaries filled immunoglobulin G, human 10000 MG Injection [Gammagard] in 2023, with total plan-and-beneficiary spending of $542,812,337 and an average per-beneficiary annual cost of $123,338.41. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry immunoglobulin G, human 10000 MG Injection [Gammagard] today.

Coverage Details

Formularies covering
151
Plans covering
1,361
Coverage rate
26.9%
Tier range
Tier 1 – Tier 6
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
98.7% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

2023 Medicare Spending

Beneficiaries
4,401
Total spending
$542,812,337
Avg per beneficiary
$123,338.41

Tier Distribution Across Plans

84 plans
Tier 1, Preferred Generic
2 plans
Tier 2, Generic
10 plans
Tier 4, Non-Preferred
4 plans
Tier 5, Specialty

Medicare Advantage Plans (MA-PD) Covering immunoglobulin G, human 10000 MG Injection [Gammagard]

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Florida Complete Care-Duals VIP (HMO-POS D-SNP) HPMP OF FLORIDA, INC. T1 Yes $0 FL
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 Yes $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 Yes $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 Yes $0 AZ
Elderplan Plus Long-Term Care (HMO-POS D-SNP) ELDERPLAN, INC. T1 Yes $0 NY
Health Choice Pathway (HMO D-SNP) HEALTH CHOICE ARIZONA, INC. T1 Yes $0 AZ
Healthfirst CompleteCare (HMO D-SNP) HEALTHFIRST HEALTH PLAN, INC. T1 Yes $0 NY
IMCare Classic (HMO D-SNP) ITASCA MEDICAL CARE T1 Yes $0 MN
Johns Hopkins Advantage MD D-SNP (HMO D-SNP) HOPKINS HEALTH ADVANTAGE, INC. T1 Yes $0 MD
MetroPlus UltraCare (HMO D-SNP) METROPLUS HEALTH PLAN, INC. T1 Yes $0 NY
Senior Whole Health SCO (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 Yes $0 MA
Senior Whole Health SCO NHC (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 Yes $0 MA
Molina One Care (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 Yes $0 MA
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
NaviCare (HMO D-SNP) FALLON COMMUNITY HEALTH PLAN T1 Yes $0 MA
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
CCA One Care (HMO D-SNP) COMMONWEALTH CARE ALLIANCE, INC. T1 Yes $0 MA
CCA Senior Care Options (HMO D-SNP) COMMONWEALTH CARE ALLIANCE, INC. T1 Yes $0 MA
Community Care's Partnership Program (HMO D-SNP) COMMUNITY CARE HEALTH PLAN, INC. T1 Yes $0 WI
Platino Blindao (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
Platino Enlace (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
PLATINO ADVANCE (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
PLATINO PLUS (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
Mass General Brigham SCO (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 Yes $0 MA
Mass General Brigham One Care (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 Yes $0 MA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $0 PA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $0 PA
Highmark Health Options Duals (HMO D-SNP) HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. T1 Yes $0 WV
Highmark Health Options Duals (HMO D-SNP) HIGHMARK BCBSD, INC. T1 Yes $0 DE
Florida Complete Care (HMO I-SNP) HPMP OF FLORIDA, INC. T1 Yes $4.80 FL
Florida Complete Care- In The Community (HMO-POS I-SNP) HPMP 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
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T1 Yes $4.80 FL
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
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $13.10 PA
Liberty Medicare Dual Plan (HMO D-SNP) LIBERTY ADVANTAGE, LLC T1 Yes $14.70 NC
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF ARIZONA T1 Yes $17.00 AZ
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $17.60 PA
Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) ELDERPLAN, INC. T1 Yes $22.70 NY

Frequently Asked Questions

Is immunoglobulin G, human 10000 MG Injection [Gammagard] covered by Medicare Part D?

Yes, immunoglobulin G, human 10000 MG Injection [Gammagard] is covered by 1,361 Medicare Part D plans (26.9% of all Part D formularies).

What tier is immunoglobulin G, human 10000 MG Injection [Gammagard] on Medicare Part D plans?

immunoglobulin G, human 10000 MG Injection [Gammagard] averages Tier 4.1 across Part D plans, ranging from Tier 1 to Tier 6.

Does immunoglobulin G, human 10000 MG Injection [Gammagard] require prior authorization?

98.7% of Part D formularies require prior authorization for immunoglobulin G, human 10000 MG Injection [Gammagard]. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on immunoglobulin G, human 10000 MG Injection [Gammagard]?

In 2023, total Medicare Part D spending on immunoglobulin G, human 10000 MG Injection [Gammagard] was $542,812,337, covering 4,401 beneficiaries. The average spend per beneficiary was $123,338.41.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial