leuprolide acetate 22.5 MG Injection [Lutrate]

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leuprolide acetate

RxCUI: 2709448

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.
25.1%
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 - 25.1% 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
25.1%
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

24 plans
Tier 1, Preferred Generic
4 plans
Tier 3, Preferred Brand
72 plans
Tier 4, Non-Preferred

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
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

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 (25.1% 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.

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