Medicare Part D coverage · isotretinoin · RxCUI 206880
isotretinoin 10 MG Oral Capsule [Accutane]
Per the CMS 2026 Part D formulary file, isotretinoin 10 MG Oral Capsule [Accutane] is covered by 4,459 Medicare Part D plans (88.3% of enrollable products), averaging Tier 3.1, with prior authorization required on 46.3% of covering formularies.
- 88.3%
- Plan coverage
- 4,459
- Plans covering
- T3.1
- Avg tier
- 46.3%
- Prior auth required
What the CMS Formulary Data Shows for isotretinoin 10 MG Oral Capsule [Accutane]
Per the CMS 2026 Part D formulary file, isotretinoin 10 MG Oral Capsule [Accutane] (RxNorm concept RXCUI 206880, generic name isotretinoin) appears on 240 distinct formulary files spanning 4,459 Medicare Part D plan offerings - 88.3% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.1.
Real-world access to isotretinoin 10 MG Oral Capsule [Accutane] depends on utilization management as much as tier placement: 46.3% 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 2,097 Part D beneficiaries filled isotretinoin 10 MG Oral Capsule [Accutane] in 2023, with total plan-and-beneficiary spending of $1,429,494 and an average per-beneficiary annual cost of $681.69. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry isotretinoin 10 MG Oral Capsule [Accutane] today.
Coverage Details
- Formularies covering
- 240
- Plans covering
- 4,459
- Coverage rate
- 88.3%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 46.3% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 2,097
- Total spending
- $1,429,494
- Avg per beneficiary
- $681.69
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering isotretinoin 10 MG Oral Capsule [Accutane]
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 |
| 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 | No | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | No | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | No | $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 | No | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | No | $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 |
Show the next 30 plans
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | No | $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 |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| 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 |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $0 | NY |
| PHP (HMO C-snp) | Aids Healthcare Foundation | T1 | No | $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 |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | No | $0 | NY |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | Yes | $0 | CA |
| 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 |
| 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 |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | No | $4.80 | FL |
| 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 |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is isotretinoin 10 MG Oral Capsule [Accutane] covered by Medicare Part D?
Yes, isotretinoin 10 MG Oral Capsule [Accutane] is covered by 4,459 Medicare Part D plans (88.3% of all Part D formularies).
What tier is isotretinoin 10 MG Oral Capsule [Accutane] on Medicare Part D plans?
isotretinoin 10 MG Oral Capsule [Accutane] averages Tier 3.1 across Part D plans, ranging from Tier 1 to Tier 4.
Does isotretinoin 10 MG Oral Capsule [Accutane] require prior authorization?
46.3% of Part D formularies require prior authorization for isotretinoin 10 MG Oral Capsule [Accutane]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on isotretinoin 10 MG Oral Capsule [Accutane]?
In 2023, total Medicare Part D spending on isotretinoin 10 MG Oral Capsule [Accutane] was $1,429,494, covering 2,097 beneficiaries. The average spend per beneficiary was $681.69.
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
- erythromycin 250 MG Delayed Release Oral Tablet T3.1
- 12 HR amoxicillin 1000 MG / clavulanate 62.5 MG Extended Release Oral Tablet T3.1
- 2500 MG testosterone 0.0162 MG/MG Topical Gel T3.1
- fluoxetine 25 MG / olanzapine 6 MG Oral Capsule T3.1
- ivermectin 10 MG/ML Topical Cream T3.1
- ketoprofen 50 MG Oral Capsule T3.1
Similar prior-authorization rate
- promethazine hydrochloride 50 MG Rectal Suppository [Promethegan] 46.3% PA
- lofexidine 0.18 MG Oral Tablet 46.2% PA
- istradefylline 20 MG Oral Tablet [Nourianz] 46.2% PA
- hydroxyzine pamoate 25 MG Oral Capsule 46.1% PA
- brivaracetam 10 MG Oral Tablet [Briviact] 46.6% PA
- 24 HR tramadol hydrochloride 300 MG Extended Release Oral Tablet 46.7% PA