Medicare Part D coverage · ketoconazole · RxCUI 728550
ketoconazole 20 MG/ML Topical Foam
Per the CMS 2026 Part D formulary file, ketoconazole 20 MG/ML Topical Foam is covered by 734 Medicare Part D plans (14.5% of enrollable products), averaging Tier 3.2, with prior authorization required on 0% of covering formularies.
- 14.5%
- Plan coverage
- 734
- Plans covering
- T3.2
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for ketoconazole 20 MG/ML Topical Foam
Per the CMS 2026 Part D formulary file, ketoconazole 20 MG/ML Topical Foam (RxNorm concept RXCUI 728550, generic name ketoconazole) appears on 20 distinct formulary files spanning 734 Medicare Part D plan offerings - 14.5% 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 3.2.
Real-world access to ketoconazole 20 MG/ML Topical Foam depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 35% require step therapy. 70% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,750,875 Part D beneficiaries filled ketoconazole 20 MG/ML Topical Foam in 2023, with total plan-and-beneficiary spending of $95,927,988 and an average per-beneficiary annual cost of $54.79. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry ketoconazole 20 MG/ML Topical Foam today.
Coverage Details
- Formularies covering
- 20
- Plans covering
- 734
- Coverage rate
- 14.5%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 35% of formularies
- Quantity limits
- 70% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,750,875
- Total spending
- $95,927,988
- Avg per beneficiary
- $54.79
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering ketoconazole 20 MG/ML Topical Foam
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T4 | No | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T4 | No | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering ketoconazole 20 MG/ML Topical Foam
98 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| PHP (HMO C-snp) | Aids Healthcare Foundation | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | No | $0 | NY |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| Leon MediExtra (HMO) | Leon Health, Inc. | T1 | No | $0 | FL |
| Leon MediDual (HMO D-SNP) | Leon Health, Inc. | T1 | No | $0 | FL |
| Leon MediMore (HMO) | Leon Health, Inc. | T1 | No | $0 | FL |
| Leon MediMax (HMO D-SNP) | Leon Health, Inc. | T1 | No | $0 | FL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | No | $4.80 | FL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | No | $17.00 | AZ |
| VNS Health EasyCare Plus (HMO D-SNP) | VNS Choice | T1 | No | $51.60 | NY |
| Gold Heart & Diabetes (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T2 | No | $0 | FL |
| Gold Heart & Diabetes Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T2 | No | $0 | FL |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T2 | No | $0 | FL |
| Gold Health (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T2 | No | $0 | FL |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T2 | No | $0 | FL |
| Gold Heart & Diabetes (HMO-POS C-SNP) | Gold Kidney OF Arizona | T2 | No | $0 | AZ |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | Gold Kidney OF Arizona | T2 | No | $0 | AZ |
| Gold Heart & Diabetes (HMO-POS C-SNP) | Gold Kidney OF Arizona | T2 | No | $0 | AZ |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | Gold Kidney OF Arizona | T2 | No | $0 | AZ |
| Aetna Medicare Signature (HMO) | Aetna Health OF California Inc. | T4 | No | $0 | CA |
Show the next 30 plans
| Aetna Medicare Signature (HMO) | Aetna Health OF California Inc. | T4 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF California Inc. | T4 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T4 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T4 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T4 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T4 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T4 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T4 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T4 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T4 | No | $0 | CA |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T4 | No | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF Ohio Inc. | T4 | No | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T4 | No | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF Ohio Inc. | T4 | No | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T4 | No | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T4 | No | $0 | KY |
| Aetna Medicare HIDE (HMO D-SNP) | Aetna Health OF Ohio Inc. | T4 | No | $0 | KY |
| Aetna Medicare Dual Care (HMO D-SNP) | Aetna Health OF Ohio Inc. | T4 | No | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T4 | No | $0 | OH |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T4 | No | $0 | OH |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T4 | No | $0 | KY |
| Aetna Medicare Partial Dual (HMO D-SNP) | Aetna Health OF Ohio Inc. | T4 | No | $0 | KY |
| Aetna Medicare Partial Dual (HMO D-SNP) | Aetna Health OF Ohio Inc. | T4 | No | $0 | OH |
| Aetna Medicare Signature (HMO) | Aetna Health Inc. (GA) | T4 | No | $0 | GA |
| Aetna Medicare Signature (HMO-POS) | Coventry Health Care OF Illinois, Inc. | T4 | No | $0 | WI |
| Aetna Medicare Signature (HMO-POS) | Coventry Health Care OF Illinois, Inc. | T4 | No | $0 | IL |
| Aetna Medicare Prime Chronic Care (HMO C-SNP) | Coventry Health Care OF Illinois, Inc. | T4 | No | $0 | IL |
| Aetna Medicare Signature Extra (HMO-POS) | Coventry Health Care OF Illinois, Inc. | T4 | No | $0 | IL |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T4 | No | $0 | IA |
| Aetna Medicare Signature (PPO) | Coventry Health AND Life Insurance Company | T4 | No | $0 | NE |
Showing top 50 of 98 plans.
Frequently Asked Questions
Is ketoconazole 20 MG/ML Topical Foam covered by Medicare Part D?
Yes, ketoconazole 20 MG/ML Topical Foam is covered by 734 Medicare Part D plans (14.5% of all Part D formularies).
What tier is ketoconazole 20 MG/ML Topical Foam on Medicare Part D plans?
ketoconazole 20 MG/ML Topical Foam averages Tier 3.2 across Part D plans, ranging from Tier 1 to Tier 4.
Does ketoconazole 20 MG/ML Topical Foam require prior authorization?
0% of Part D formularies require prior authorization for ketoconazole 20 MG/ML Topical Foam. Step therapy: 35%. Quantity limits: 70%.
How much does Medicare spend on ketoconazole 20 MG/ML Topical Foam?
In 2023, total Medicare Part D spending on ketoconazole 20 MG/ML Topical Foam was $95,927,988, covering 1,750,875 beneficiaries. The average spend per beneficiary was $54.79.
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
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