Medicare Part D coverage · leuprolide acetate · RxCUI 2709448
leuprolide acetate 22.5 MG Injection [Lutrate]
Per the CMS 2026 Part D formulary file, leuprolide acetate 22.5 MG Injection [Lutrate] is covered by 1,273 Medicare Part D plans (25.2% of enrollable products), averaging Tier 3.4, with prior authorization required on 97.5% of covering formularies.
- 25.2%
- Plan coverage
- 1,273
- Plans covering
- T3.4
- Avg tier
- 97.5%
- Prior auth required
What the CMS Formulary Data Shows for leuprolide acetate 22.5 MG Injection [Lutrate]
Per the CMS 2026 Part D formulary file, leuprolide acetate 22.5 MG Injection [Lutrate] (RxNorm concept RXCUI 2709448, generic name leuprolide acetate) appears on 80 distinct formulary files spanning 1,273 Medicare Part D plan offerings - 25.2% 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 3.4.
Real-world access to leuprolide acetate 22.5 MG Injection [Lutrate] depends on utilization management as much as tier placement: 97.5% of covering formularies require prior authorization. 0% require step therapy. 15% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 8,570 Part D beneficiaries filled leuprolide acetate 22.5 MG Injection [Lutrate] in 2023, with total plan-and-beneficiary spending of $128,884,249 and an average per-beneficiary annual cost of $15,039.00. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry leuprolide acetate 22.5 MG Injection [Lutrate] today.
Coverage Details
- Formularies covering
- 80
- Plans covering
- 1,273
- Coverage rate
- 25.2%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 97.5% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 15% of formularies
2023 Medicare Spending
- Beneficiaries
- 8,570
- Total spending
- $128,884,249
- Avg per beneficiary
- $15,039.00
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering leuprolide acetate 22.5 MG Injection [Lutrate]
9 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T4 | Yes | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T4 | Yes | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T4 | Yes | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T4 | Yes | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T4 | Yes | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T4 | Yes | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T4 | Yes | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T4 | Yes | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | Medco Containment Life AND Medco Containment NY | T4 | Yes | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering leuprolide acetate 22.5 MG Injection [Lutrate]
91 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 |
| 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 |
| 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 |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | Yes | $4.80 | FL |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | Yes | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | Yes | $4.80 | TX |
| Tribute Select (HMO-POS I-SNP) | Arkansas Superior Select, Inc. | T1 | Yes | $8.90 | AR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | Yes | $10.50 | OR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | Yes | $10.50 | OR |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | Yes | $17.00 | AZ |
| Alterwood Advantage Dual Value (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | Yes | $31.20 | MD |
| Valor Health Plan (HMO I-SNP) | TSG Guard, Inc. | T1 | Yes | $31.40 | OH |
Show the next 30 plans
| WV Senior Advantage (HMO I-SNP) | West Virginia Senior Advantage, Inc. | T1 | Yes | $32.70 | WV |
| Abilis Health (HMO I-SNP) | Signature Advantage, LLC | T1 | Yes | $35.90 | KY, TN |
| CommuniCare Advantage ISNP (HMO I-SNP) | OH CHS SNP Inc. | T1 | Yes | $38.40 | IN, MD, OH |
| Nascentia Skilled Nursing Facility (HMO I-SNP) | Visiting Nurse Association OF Central NEW York | T1 | Yes | $58.80 | NY |
| PHP (HMO C-snp) | Aids Healthcare Foundation | T3 | Yes | $0 | CA |
| DualConnect (HMO D-SNP) | Santa Clara County Health Authority | T3 | Yes | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T3 | Yes | $0 | NY |
| VNS Health EasyCare Plus (HMO D-SNP) | VNS Choice | T3 | Yes | $51.60 | NY |
| HAP Medicare Explore (PPO) | Alliance Health AND Life Insurance Company | T4 | No | $0 | MI |
| HAP Medicare Prime (PPO) | Alliance Health AND Life Insurance Company | T4 | No | $0 | MI |
| HAP Medicare Connect (HMO) | Health Alliance Plan OF Michigan | T4 | No | $0 | MI |
| HAP Medicare Complete Duals (HMO D-SNP) | Health Alliance Plan OF Michigan | T4 | No | $0 | MI |
| HAP Medicare Superior (HMO) | Health Alliance Plan OF Michigan | T4 | No | $0 | MI |
| Henry Ford Select (HMO) | Health Alliance Plan OF Michigan | T4 | No | $0 | MI |
| HealthSpring Preferred (HMO) | Bravo Health Pennsylvania, Inc. | T4 | Yes | $0 | AZ |
| HealthSpring Alliance (HMO) | Bravo Health Pennsylvania, Inc. | T4 | Yes | $0 | AZ |
| HealthSpring Preferred Savings (HMO) | Bravo Health Pennsylvania, Inc. | T4 | Yes | $0 | AZ |
| HealthSpring Preferred Full Savings (HMO) | Bravo Health Pennsylvania, Inc. | T4 | Yes | $0 | AZ |
| HealthSpring Preferred GA (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | GA |
| HealthSpring Preferred Savings (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | GA |
| HealthSpring Preferred Savings (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | GA |
| HealthSpring Preferred Savings (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | GA |
| HealthSpring Preferred Savings (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | GA |
| HealthSpring Preferred (HMO) | Healthspring Life & Health Insurance Company, Inc. | T4 | Yes | $0 | MO |
Showing top 50 of 91 plans.
Frequently Asked Questions
Is leuprolide acetate 22.5 MG Injection [Lutrate] covered by Medicare Part D?
Yes, leuprolide acetate 22.5 MG Injection [Lutrate] is covered by 1,273 Medicare Part D plans (25.2% of all Part D formularies).
What tier is leuprolide acetate 22.5 MG Injection [Lutrate] on Medicare Part D plans?
leuprolide acetate 22.5 MG Injection [Lutrate] averages Tier 3.4 across Part D plans, ranging from Tier 1 to Tier 4.
Does leuprolide acetate 22.5 MG Injection [Lutrate] require prior authorization?
97.5% of Part D formularies require prior authorization for leuprolide acetate 22.5 MG Injection [Lutrate]. Step therapy: 0%. Quantity limits: 15%.
How much does Medicare spend on leuprolide acetate 22.5 MG Injection [Lutrate]?
In 2023, total Medicare Part D spending on leuprolide acetate 22.5 MG Injection [Lutrate] was $128,884,249, covering 8,570 beneficiaries. The average spend per beneficiary was $15,039.00.
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
- colistin 75 MG/ML Injectable Solution T3.4
- 4 ML penicillin G benzathine 600000 UNT/ML Prefilled Syringe [Bicillin L-A] T3.4
- 2 ML penicillin G benzathine 600000 UNT/ML Prefilled Syringe [Bicillin L-A] T3.4
- 24 HR tacrolimus 0.5 MG Extended Release Oral Capsule [Astagraf] T3.4
- 2 ML penicillin G benzathine 300000 UNT/ML / penicillin G procaine 300000 UNT/ML Prefilled Syringe [Bicillin] T3.4
- phenytoin 50 MG Chewable Tablet [Dilantin] T3.4
Similar prior-authorization rate
- alanine 5.4 MG/ML / arginine 12 MG/ML / aspartate 3.2 MG/ML / cysteine 0.16 MG/ML / glutamate 5 MG/ML / glycine 3.6 MG/ML / histidine 4.8 MG/ML / isoleucine 8.2 MG/ML / leucine 14 MG/ML / lysine 8.2 MG/ML / methionine 3.4 MG/ML / phenylalanine 4.8 MG/ML / proline 6.8 MG/ML / serine 3.8 MG/ML / taurine 0.25 MG/ML / threonine 4.2 MG/ML / tryptophan 2 MG/ML / tyrosine 2.4 MG/ML / valine 7.8 MG/ML Injectable Solution [PremaSol] 97.5% PA
- miglustat 100 MG Oral Capsule [Yargesa] 97.6% PA
- nilotinib d-tartrate 50 MG Oral Capsule 97.6% PA
- C1 esterase inhibitor (human) 500 UNT Injection [Berinert] 97.4% PA
- 0.5 ML ustekinumab-aekn 90 MG/ML Injection [Selarsdi] 97.4% PA
- C1 esterase inhibitor (human) 500 UNT Injection [Cinryze] 97.6% PA