insulin lispro 100 UNT/ML Injectable Solution [Admelog]

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insulin lispro

RxCUI: 1992169

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.
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

24 plans
Tier 1, Preferred Generic
76 plans
Tier 3, Preferred Brand

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
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

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.

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