interferon beta-1b 0.3 MG Injection [Betaseron]

Verify with CMS →

interferon

RxCUI: 207059

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.
78.1%
Plan Coverage
3,956
Plans Covering
T4.2
Avg Tier
84.2%
Prior Auth Required

What the CMS Formulary Data Shows for interferon beta-1b 0.3 MG Injection [Betaseron]

Per the CMS 2026 Part D formulary file, interferon beta-1b 0.3 MG Injection [Betaseron] (RxNorm concept RXCUI 207059, generic name interferon) appears on 297 distinct formulary files spanning 3,956 Medicare Part D plan offerings - 78.1% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.2.

Real-world access to interferon beta-1b 0.3 MG Injection [Betaseron] depends on utilization management as much as tier placement: 84.2% of covering formularies require prior authorization. 0% require step therapy. 96.3% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 43 Part D beneficiaries filled interferon beta-1b 0.3 MG Injection [Betaseron] in 2023, with total plan-and-beneficiary spending of $26,300,697 and an average per-beneficiary annual cost of $611,644.11. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry interferon beta-1b 0.3 MG Injection [Betaseron] today.

Coverage Details

Formularies covering
297
Plans covering
3,956
Coverage rate
78.1%
Tier range
Tier 1 – Tier 5
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
84.2% of formularies
Step therapy required
0% of formularies
Quantity limits
96.3% of formularies

2023 Medicare Spending

Beneficiaries
43
Total spending
$26,300,697
Avg per beneficiary
$611,644.11

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering interferon beta-1b 0.3 MG Injection [Betaseron]

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 Yes $0 VA
Sentara Community Complete (HMO D-SNP) SENTARA HEALTH PLANS T1 Yes $0 VA
Florida Complete Care-Duals VIP (HMO-POS D-SNP) HPMP OF FLORIDA, INC. T1 Yes $0 FL
ElderServe MAP (HMO D-SNP) ELDERSERVE HEALTH, INC. T1 Yes $0 NY
Cooperative Advantage (HMO D-SNP) GROUP HEALTH COOPERATIVE OF EAU CLAIRE T1 Yes $0 WI
Longevity Health Plan (PPO I-SNP) LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP T1 Yes $0 NJ
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
Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) UPPER PENINSULA HEALTH PLAN, LLC T1 Yes $0 MI
CareSource Dual Advantage (HMO D-SNP) CARESOURCE GEORGIA CO. T1 Yes $0 GA
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
HAP CareSource MI Coordinated Health (HMO D-SNP) HAP CARESOURCE T1 Yes $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
Gold Coast Health Plan Total Care Advantage (HMO D-SNP) Ventura County Medi-Cal Managed Care Commission T1 Yes $0 CA
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) Health Care Service Corporation T1 Yes $0 NM
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) Health Care Service Corporation T1 Yes $0 NM
Horizon NJ TotalCare (HMO D-SNP) HORIZON HEALTHCARE OF NEW JERSEY, INC. T1 Yes $0 NJ
SecureBlue (HMO D-SNP) HMO Minnesota T1 Yes $0 MN
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
Elevate Medicare Choice (HMO D-SNP) DENVER HEALTH MEDICAL PLAN, INC. T1 Yes $0 CO
AllCare Advantage Redwood Rx (HMO D-SNP) ALLCARE HEALTH PLAN, INC. T1 Yes $0 OR
PrimeWest Senior Health Complete (HMO D-SNP) PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE T1 Yes $0 MN
Prime Health Complete (HMO D-SNP) PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE T1 Yes $0 MN
Alterwood Advantage Dual Secure (HMO D-SNP) ALTERWOOD ADVANTAGE, INC. T1 Yes $0 MD
Nascentia Dual Advantage (HMO D-SNP) VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK T1 Yes $0 NY
Provider Partners Pennsylvania Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC T1 Yes $0 PA
Provider Partners North Carolina Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA T1 Yes $0 NC
Provider Partners Indiana Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF INDIANA T1 Yes $0 IN
Provider Partners Maryland Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN, INC. T1 Yes $0 MD
Provider Partners Missouri Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. T1 Yes $0 MO
Abilis Health Community (HMO I-SNP) SIGNATURE ADVANTAGE, LLC T1 Yes $0 KY, TN
Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) ARKANSAS SUPERIOR SELECT, INC. T1 Yes $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 Yes $0 PR

Frequently Asked Questions

Is interferon beta-1b 0.3 MG Injection [Betaseron] covered by Medicare Part D?

Yes, interferon beta-1b 0.3 MG Injection [Betaseron] is covered by 3,956 Medicare Part D plans (78.1% of all Part D formularies).

What tier is interferon beta-1b 0.3 MG Injection [Betaseron] on Medicare Part D plans?

interferon beta-1b 0.3 MG Injection [Betaseron] averages Tier 4.2 across Part D plans, ranging from Tier 1 to Tier 5.

Does interferon beta-1b 0.3 MG Injection [Betaseron] require prior authorization?

84.2% of Part D formularies require prior authorization for interferon beta-1b 0.3 MG Injection [Betaseron]. Step therapy: 0%. Quantity limits: 96.3%.

How much does Medicare spend on interferon beta-1b 0.3 MG Injection [Betaseron]?

In 2023, total Medicare Part D spending on interferon beta-1b 0.3 MG Injection [Betaseron] was $26,300,697, covering 43 beneficiaries. The average spend per beneficiary was $611,644.11.

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