Medicare Part D coverage · insulin degludec · RxCUI 2107522
insulin degludec 100 UNT/ML Injectable Solution [Tresiba]
Per the CMS 2026 Part D formulary file, insulin degludec 100 UNT/ML Injectable Solution [Tresiba] is covered by 1,228 Medicare Part D plans (24.3% of enrollable products), averaging Tier 2.7, with prior authorization required on 1.1% of covering formularies.
- 24.3%
- Plan coverage
- 1,228
- Plans covering
- T2.7
- Avg tier
- 1.1%
- Prior auth required
What the CMS Formulary Data Shows for insulin degludec 100 UNT/ML Injectable Solution [Tresiba]
Per the CMS 2026 Part D formulary file, insulin degludec 100 UNT/ML Injectable Solution [Tresiba] (RxNorm concept RXCUI 2107522, generic name insulin degludec) appears on 87 distinct formulary files spanning 1,228 Medicare Part D plan offerings - 24.3% 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 2.7.
Real-world access to insulin degludec 100 UNT/ML Injectable Solution [Tresiba] depends on utilization management as much as tier placement: 1.1% of covering formularies require prior authorization. 0% require step therapy. 10.3% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 258,451 Part D beneficiaries filled insulin degludec 100 UNT/ML Injectable Solution [Tresiba] in 2023, with total plan-and-beneficiary spending of $726,928,549 and an average per-beneficiary annual cost of $2,812.64. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry insulin degludec 100 UNT/ML Injectable Solution [Tresiba] today.
Coverage Details
- Formularies covering
- 87
- Plans covering
- 1,228
- Coverage rate
- 24.3%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 1.1% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 10.3% of formularies
2023 Medicare Spending
- Beneficiaries
- 258,451
- Total spending
- $726,928,549
- Avg per beneficiary
- $2,812.64
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering insulin degludec 100 UNT/ML Injectable Solution [Tresiba]
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 |
| 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 |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| 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 |
| 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 |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | No | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $0 | DE |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
Show the next 30 plans
| Senior Care (HMO I-SNP) | Align Senior Care Florida, Inc. | T1 | No | $4.80 | FL |
| ProCare Advantage (HMO-POS I-SNP) | Procare Advantage, LLC | T1 | No | $4.80 | TX |
| ProCare Advantage - Kidney Care (HMO-POS C-SNP) | Procare Advantage, LLC | T1 | No | $4.80 | TX |
| American Health Advantage of Florida (HMO I-SNP) | American Health Plan OF FL, Inc. | T1 | No | $4.80 | FL |
| SECUR Advantage (HMO I-SNP) | Secur Inc | T1 | No | $4.80 | FL |
| SECUR Enhanced (HMO I-SNP) | Secur Inc | T1 | No | $4.80 | FL |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Texas, Inc. | T1 | No | $4.80 | TX |
| Senior Care (HMO I-SNP) | Align Senior Care MI, LLC | T1 | No | $8.80 | MI |
| AgeRight Advantage Health Plan (HMO I-SNP) | Marquis Advantage, Inc. | T1 | No | $10.50 | OR, WA |
| Senior Care (HMO I-SNP) | Align Senior Care California Inc. | T1 | No | $12.00 | CA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $13.10 | PA |
| Liberty Medicare Dual Plan (HMO D-SNP) | Liberty Advantage, LLC | T1 | No | $14.70 | NC |
| Provider Partners Illinois Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Illinois | T1 | No | $15.20 | IL |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $17.60 | PA |
| KeyCare Advantage (HMO I-SNP) | Isnp Ventures, LLC | T1 | No | $23.20 | MD |
| American Health Advantage of Mississippi (HMO I-SNP) | American Health Plan OF MS, Inc. | T1 | No | $23.80 | MS |
| Senior Care (HMO I-SNP) | Lifeworks Advantage, LLC | T1 | No | $24.60 | VA |
| PruittHealth Premier (HMO I-SNP) | Pruitthealth Premier, Inc. | T1 | No | $25.40 | GA |
| Georgia Health Advantage (HMO I-SNP) | Georgia Assurance, Inc. | T1 | No | $25.40 | GA |
| Georgia Health Advantage Choice (HMO I-SNP) | Georgia Assurance, Inc. | T1 | No | $25.40 | GA |
| American Health Advantage of Tennessee (HMO I-SNP) | American Health Plan, Inc. | T1 | No | $27.70 | TN |
| Simpra Advantage Nursing Home Plan (PPO I-SNP) | Simpra Advantage, Inc. | T1 | No | $27.70 | AL |
| American Health Advantage of Oklahoma (HMO I-SNP) | Oklahoma Superior Select, Inc. | T1 | No | $28.20 | OK |
| NHC Advantage (HMO I-SNP) | NHC Advantage, LLC | T1 | No | $31.00 | MO, NC, SC, TN |
| Highmark Health Options Duals Select (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $31.20 | DE |
| Perennial Advantage Strive (HMO I-SNP) | Perennial Advantage OF Ohio, Inc. | T1 | No | $31.40 | OH |
| Perennial Advantage Strive (HMO I-SNP) | Perennial Advantage OF Colorado, Inc. | T1 | No | $32.70 | PA |
| American Health Advantage of Pennsylvania (HMO I-SNP) | American Health Plan OF Pennsylvania Inc | T1 | No | $32.70 | PA |
| Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $32.70 | PA |
| Provider Partners Pennsylvania Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $32.70 | PA |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is insulin degludec 100 UNT/ML Injectable Solution [Tresiba] covered by Medicare Part D?
Yes, insulin degludec 100 UNT/ML Injectable Solution [Tresiba] is covered by 1,228 Medicare Part D plans (24.3% of all Part D formularies).
What tier is insulin degludec 100 UNT/ML Injectable Solution [Tresiba] on Medicare Part D plans?
insulin degludec 100 UNT/ML Injectable Solution [Tresiba] averages Tier 2.7 across Part D plans, ranging from Tier 1 to Tier 6.
Does insulin degludec 100 UNT/ML Injectable Solution [Tresiba] require prior authorization?
1.1% of Part D formularies require prior authorization for insulin degludec 100 UNT/ML Injectable Solution [Tresiba]. Step therapy: 0%. Quantity limits: 10.3%.
How much does Medicare spend on insulin degludec 100 UNT/ML Injectable Solution [Tresiba]?
In 2023, total Medicare Part D spending on insulin degludec 100 UNT/ML Injectable Solution [Tresiba] was $726,928,549, covering 258,451 beneficiaries. The average spend per beneficiary was $2,812.64.
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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- 3 ML insulin degludec 100 UNT/ML Pen Injector [Tresiba] 1.1% PA
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