Medicare Part D coverage · levacetylleucine · RxCUI 2693623

levacetylleucine 1000 MG Granules for Oral Suspension [Aqneursa]

Per the CMS 2026 Part D formulary file, levacetylleucine 1000 MG Granules for Oral Suspension [Aqneursa] is covered by 203 Medicare Part D plans (4% of enrollable products), averaging Tier 4.1, with prior authorization required on 93.5% of covering formularies.

4%
Plan coverage
203
Plans covering
T4.1
Avg tier
93.5%
Prior auth required

Verify with CMS →

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.

What the CMS Formulary Data Shows for levacetylleucine 1000 MG Granules for Oral Suspension [Aqneursa]

Per the CMS 2026 Part D formulary file, levacetylleucine 1000 MG Granules for Oral Suspension [Aqneursa] (RxNorm concept RXCUI 2693623, generic name levacetylleucine) appears on 31 distinct formulary files spanning 203 Medicare Part D plan offerings - 4% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.1.

Real-world access to levacetylleucine 1000 MG Granules for Oral Suspension [Aqneursa] depends on utilization management as much as tier placement: 93.5% of covering formularies require prior authorization. 0% require step therapy. 77.4% apply quantity limits.

Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry levacetylleucine 1000 MG Granules for Oral Suspension [Aqneursa] today.

Coverage Details

Formularies covering
31
Plans covering
203
Coverage rate
4%
Tier range
Tier 1 – Tier 5
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
93.5% of formularies
Step therapy required
0% of formularies
Quantity limits
77.4% of formularies

Tier Distribution Across Plans

13 plans
Tier 1, Preferred Generic
1 plans
Tier 2, Generic
86 plans
Tier 5, Specialty

Medicare Advantage Plans (MA-PD) Covering levacetylleucine 1000 MG Granules for Oral Suspension [Aqneursa]

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
NaviCare (HMO D-SNP) Fallon Community Health Plan T1 Yes $0 MA
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
Mass General Brigham SCO (HMO D-SNP) Mass General Brigham Health Plan, Inc T1 Yes $0 MA
Mass General Brigham One Care (HMO D-SNP) Mass General Brigham Health Plan, Inc T1 Yes $0 MA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) Gateway Health Plan, Inc. T1 Yes $0 PA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) Gateway Health Plan, Inc. T1 Yes $0 PA
Highmark Health Options Duals (HMO D-SNP) Highmark Health Options West Virginia Inc. T1 Yes $0 WV
Highmark Health Options Duals (HMO D-SNP) Highmark Bcbsd, Inc. T1 Yes $0 DE
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) Gateway Health Plan, Inc. T1 Yes $13.10 PA
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) Gateway Health Plan, Inc. T1 Yes $17.60 PA
Highmark Health Options Duals Select (HMO D-SNP) Highmark Bcbsd, Inc. T1 Yes $31.20 DE
CalOptima Health OneCare Complete (HMO D-SNP) Orange County Health Authority T2 Yes $0 CA
Select Health Medicare Essential (HMO) Selecthealth, Inc. T5 Yes $0 UT
Select Health Medicare Essential (HMO) Selecthealth, Inc. T5 Yes $0 NV
Select Health Medicare Dual (HMO D-SNP) Selecthealth, Inc. T5 Yes $0 UT
Select Health Medicare Essential (HMO) Selecthealth, Inc. T5 Yes $0 UT
Select Health Medicare + Kroger (HMO) Selecthealth, Inc. T5 Yes $0 NV
Select Health Medicare + Kroger (HMO) Selecthealth, Inc. T5 Yes $0 UT
Show the next 30 plans
Select Health Medicare Essential (HMO) Selecthealth, Inc. T5 Yes $0 CO
Select Health Medicare Essential (HMO) Selecthealth, Inc. T5 Yes $0 CO
Select Health Medicare + Kroger (HMO) Selecthealth, Inc. T5 Yes $0 CO
Select Health Medicare Flex (HMO) Selecthealth, Inc. T5 Yes $0 CO
Select Health Medicare + Kroger (HMO) Selecthealth, Inc. T5 Yes $0 CO
Select Health Medicare Active (HMO) Selecthealth, Inc. T5 Yes $0 CO
Select Health Medicare Dual (HMO D-SNP) Selecthealth, Inc. T5 Yes $0 NV
Select Health Medicare Wellness (HMO) Selecthealth, Inc. T5 Yes $0 NV
Geisinger Gold Preferred Complete Rx (PPO) Geisinger Indemnity Insurance Company T5 Yes $0 PA
Geisinger Gold Secure Rx (HMO D-SNP) Geisinger Health Plan T5 Yes $0 PA
Geisinger Gold Classic 360 Rx (HMO) Geisinger Health Plan T5 Yes $0 PA
Geisinger Gold Classic Essential Rx (HMO) Geisinger Health Plan T5 Yes $0 PA
Fallon Medicare Plus Orange (HMO) Fallon Community Health Plan T5 Yes $0 MA
UPMC for Life HMO Premier Rx (HMO) Upmc Health Plan, Inc. T5 Yes $0 PA
UPMC for Life Complete Care (HMO D-SNP) Upmc FOR YOU, Inc T5 Yes $0 PA
UPMC for Life Complete Care (HMO D-SNP) Upmc FOR YOU, Inc T5 Yes $0 PA
UPMC for Life PPO Premier Rx (PPO) Upmc Health Network, Inc. T5 Yes $0 PA
UPMC for Life PPO Premier Rx (PPO) Upmc Health Network, Inc. T5 Yes $0 PA
UPMC for Life PPO Essential Care Rx (PPO) Upmc Health Network, Inc. T5 Yes $0 PA
UPMC for Life Complete Care (HMO D-SNP) Upmc Health Coverage, Inc. T5 Yes $0 PA
Troy Medicare (HMO) Troy Health, Inc. T5 Yes $0 NC
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) Troy Health, Inc. T5 Yes $0 NC
Contra Costa Health Care Plus (HMO D-SNP) Contra Costa County Medical Service DBA Contra Costa Health T5 Yes $0 CA
Keystone First VIP Choice (HMO D-SNP) Vista Health Plan, Inc. T5 Yes $0 PA
AmeriHealth Caritas VIP Care (HMO D-SNP) Vista Health Plan, Inc. T5 Yes $0 PA
First Choice VIP Care (HMO D-SNP) Select Health OF South Carolina, Inc. T5 Yes $0 SC
AmeriHealth Caritas VIP Care (HMO D-SNP) AmeriHealth Caritas VIP Next, Inc. T5 Yes $0 DE
AmeriHealth Caritas VIP Care Choice (HMO D-SNP) AmeriHealth Caritas VIP Next, Inc. T5 Yes $0 DE
AmeriHealth Caritas VIP Care (HMO D-SNP) Amerihealth Caritas Florida, Inc. T5 Yes $0 FL
AmeriHealth Caritas VIP Care (HMO D-SNP) Amerihealth Caritas Louisiana, Inc. T5 Yes $0 LA

Showing top 50 of 100 plans.

Frequently Asked Questions

Is levacetylleucine 1000 MG Granules for Oral Suspension [Aqneursa] covered by Medicare Part D?

Yes, levacetylleucine 1000 MG Granules for Oral Suspension [Aqneursa] is covered by 203 Medicare Part D plans (4% of all Part D formularies).

What tier is levacetylleucine 1000 MG Granules for Oral Suspension [Aqneursa] on Medicare Part D plans?

levacetylleucine 1000 MG Granules for Oral Suspension [Aqneursa] averages Tier 4.1 across Part D plans, ranging from Tier 1 to Tier 5.

Does levacetylleucine 1000 MG Granules for Oral Suspension [Aqneursa] require prior authorization?

93.5% of Part D formularies require prior authorization for levacetylleucine 1000 MG Granules for Oral Suspension [Aqneursa]. Step therapy: 0%. Quantity limits: 77.4%.

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.

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