Medicare Part D coverage · insulin lispro · RxCUI 1992169
insulin lispro 100 UNT/ML Injectable Solution [Admelog]
Per the CMS 2026 Part D formulary file, insulin lispro 100 UNT/ML Injectable Solution [Admelog] is covered by 639 Medicare Part D plans (12.6% of enrollable products), averaging Tier 2.6, with prior authorization required on 93% of covering formularies.
- 12.6%
- Plan coverage
- 639
- Plans covering
- T2.6
- Avg tier
- 93%
- Prior auth required
What the CMS Formulary Data Shows for insulin lispro 100 UNT/ML Injectable Solution [Admelog]
Per the CMS 2026 Part D formulary file, insulin lispro 100 UNT/ML Injectable Solution [Admelog] (RxNorm concept RXCUI 1992169, generic name insulin lispro) appears on 57 distinct formulary files spanning 639 Medicare Part D plan offerings - 12.6% 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 2.6.
Real-world access to insulin lispro 100 UNT/ML Injectable Solution [Admelog] depends on utilization management as much as tier placement: 93% 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 418,431 Part D beneficiaries filled insulin lispro 100 UNT/ML Injectable Solution [Admelog] in 2023, with total plan-and-beneficiary spending of $1,208,385,334 and an average per-beneficiary annual cost of $2,887.90. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry insulin lispro 100 UNT/ML Injectable Solution [Admelog] today.
Coverage Details
- Formularies covering
- 57
- Plans covering
- 639
- Coverage rate
- 12.6%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 93% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 418,431
- Total spending
- $1,208,385,334
- Avg per beneficiary
- $2,887.90
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering insulin lispro 100 UNT/ML Injectable Solution [Admelog]
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 |
| 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 |
| 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 |
| 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 |
| Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) | Elderplan, Inc. | T1 | Yes | $22.70 | NY |
Show the next 30 plans
| VIVA Medicare Extra Value (HMO D-SNP) | Viva Health, Inc. | T1 | Yes | $27.70 | AL |
| VIVA Medicare Extra Care (HMO D-SNP) | Viva Health, Inc. | T1 | Yes | $27.70 | AL |
| Elderplan Advantage For Nursing Home Residents (HMO-POS I-SNP) | Elderplan, Inc. | T1 | Yes | $44.80 | NY |
| MetroPlus Platinum Plan (HMO) | Metroplus Health Plan, Inc. | T1 | Yes | $58.80 | NY |
| Sharp Direct Advantage Gold (HMO) | Sharp Health Plan | T3 | Yes | $0 | CA |
| Sharp Direct Advantage VIP (HMO) | Sharp Health Plan | T3 | Yes | $0 | CA |
| Sharp Direct Advantage VIP Plus (HMO) | Sharp Health Plan | T3 | Yes | $0 | CA |
| Blue Medicare Advantage PPO (PPO) | Wellmark Advantage Health Plan, Inc. | T3 | Yes | $0 | IA |
| BlueMedicare Premier (HMO) | Usable HMO, Inc. | T3 | Yes | $0 | AR |
| BlueMedicare Classic Plus (HMO) | Usable HMO, Inc. | T3 | Yes | $0 | AR |
| Medicare HMO Blue SaverRx (HMO-POS) | Bcbs OF Massachusetts HMO Blue, Inc. | T3 | Yes | $0 | MA |
| Clever Care Longevity (HMO) | Clever Care OF Golden State, Inc. | T3 | Yes | $0 | CA |
| Clever Care Value (HMO) | Clever Care OF Golden State, Inc. | T3 | Yes | $0 | CA |
| Clever Care Total+ (HMO C-SNP) | Clever Care OF Golden State, Inc. | T3 | Yes | $0 | CA |
| Clever Care Breathe+ (HMO C-SNP) | Clever Care OF Golden State, Inc. | T3 | Yes | $0 | CA |
| Clover Health Choice (PPO) | Clover Insurance Company | T3 | Yes | $0 | TX |
| Clover Health LiveHealthy (PPO) | Clover Insurance Company | T3 | Yes | $0 | GA |
| Clover Health LiveHealthy (PPO) | Clover Insurance Company | T3 | Yes | $0 | SC |
| Clover Health Choice (PPO) | Clover Insurance Company | T3 | Yes | $0 | PA |
| Clover Health LiveHealthy Giveback (PPO) | Clover Insurance Company | T3 | Yes | $0 | GA, SC |
| Clover Health Choice (PPO) | Clover Insurance Company | T3 | Yes | $0 | NJ |
| Clover Health Choice (PPO) | Clover Insurance Company | T3 | Yes | $0 | NJ |
| Clover Health Choice Giveback (PPO) | Clover Insurance Company | T3 | Yes | $0 | NJ |
| Clover Health Classic (HMO) | Clover HMO OF NEW Jersey Inc. | T3 | Yes | $0 | NJ |
| Elderplan Flex (HMO-POS) | Elderplan, Inc. | T3 | Yes | $0 | NY |
| Elderplan Select (HMO-POS I-SNP) | Elderplan, Inc. | T3 | Yes | $0 | NY |
| Healthfirst Life Improvement Plan (HMO D-SNP) | Healthfirst Health Plan, Inc. | T3 | Yes | $0 | NY |
| Healthfirst Connection Plan (HMO D-SNP) | Healthfirst Health Plan, Inc. | T3 | Yes | $0 | NY |
| Healthfirst 65 Plus Plan (HMO) | Healthfirst Health Plan, Inc. | T3 | Yes | $0 | NY |
| Healthfirst Signature (HMO) | Healthfirst Health Plan, Inc. | T3 | Yes | $0 | NY |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is insulin lispro 100 UNT/ML Injectable Solution [Admelog] covered by Medicare Part D?
Yes, insulin lispro 100 UNT/ML Injectable Solution [Admelog] is covered by 639 Medicare Part D plans (12.6% of all Part D formularies).
What tier is insulin lispro 100 UNT/ML Injectable Solution [Admelog] on Medicare Part D plans?
insulin lispro 100 UNT/ML Injectable Solution [Admelog] averages Tier 2.6 across Part D plans, ranging from Tier 1 to Tier 4.
Does insulin lispro 100 UNT/ML Injectable Solution [Admelog] require prior authorization?
93% of Part D formularies require prior authorization for insulin lispro 100 UNT/ML Injectable Solution [Admelog]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on insulin lispro 100 UNT/ML Injectable Solution [Admelog]?
In 2023, total Medicare Part D spending on insulin lispro 100 UNT/ML Injectable Solution [Admelog] was $1,208,385,334, covering 418,431 beneficiaries. The average spend per beneficiary was $2,887.90.
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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