levonorgestrel 0.000729 MG/HR Intrauterine System [Kyleena]
levonorgestrel
RxCUI: 1856546
What the CMS Formulary Data Shows for levonorgestrel 0.000729 MG/HR Intrauterine System [Kyleena]
Per the CMS 2026 Part D formulary file, levonorgestrel 0.000729 MG/HR Intrauterine System [Kyleena] (RxNorm concept RXCUI 1856546, generic name levonorgestrel) appears on 71 distinct formulary files spanning 185 Medicare Part D plan offerings - 3.7% 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 3.1.
Real-world access to levonorgestrel 0.000729 MG/HR Intrauterine System [Kyleena] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 1.4% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 650 Part D beneficiaries filled levonorgestrel 0.000729 MG/HR Intrauterine System [Kyleena] in 2023, with total plan-and-beneficiary spending of $777,252 and an average per-beneficiary annual cost of $1,195.77. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry levonorgestrel 0.000729 MG/HR Intrauterine System [Kyleena] today.
Coverage Details
- Formularies covering
- 71
- Plans covering
- 185
- Coverage rate
- 3.7%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 1.4% of formularies
2023 Medicare Spending
- Beneficiaries
- 650
- Total spending
- $777,252
- Avg per beneficiary
- $1,195.77
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering levonorgestrel 0.000729 MG/HR Intrauterine System [Kyleena]
100 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 | No | $0 | MN |
| AbilityCare (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | No | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | ALAMEDA ALLIANCE FOR HEALTH | T1 | No | $0 | CA |
| Elevate Medicare Choice (HMO D-SNP) | DENVER HEALTH MEDICAL PLAN, INC. | T1 | No | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | ALLCARE HEALTH PLAN, INC. | T1 | No | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE | T1 | No | $0 | MN |
| Prime Health Complete (HMO D-SNP) | PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE | T1 | No | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | ALTERWOOD ADVANTAGE, INC. | T1 | No | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK | T1 | No | $0 | NY |
| Abilis Health Community (HMO I-SNP) | SIGNATURE ADVANTAGE, LLC | T1 | No | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | ARKANSAS SUPERIOR SELECT, INC. | T1 | No | $0 | AR |
| 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 |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA INC | T1 | No | $4.80 | FL |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | TEXAS INDEPENDENCE HEALTH PLAN, INC. | T1 | No | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | TEXAS INDEPENDENCE HEALTH PLAN, INC. | T1 | No | $4.80 | TX |
| Tribute Select (HMO-POS I-SNP) | ARKANSAS SUPERIOR SELECT, INC. | T1 | No | $8.90 | AR |
| ATRIO Special Needs Plan (HMO D-SNP) | ATRIO HEALTH PLANS | T1 | No | $10.50 | OR |
| ATRIO Special Needs Plan (HMO D-SNP) | ATRIO HEALTH PLANS | T1 | No | $10.50 | OR |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF ARIZONA | T1 | No | $17.00 | AZ |
| Alterwood Advantage Dual Value (HMO D-SNP) | ALTERWOOD ADVANTAGE, INC. | T1 | No | $31.20 | MD |
| Valor Health Plan (HMO I-SNP) | TSG GUARD, INC. | T1 | No | $31.40 | OH |
| WV Senior Advantage (HMO I-SNP) | WEST VIRGINIA SENIOR ADVANTAGE, INC. | T1 | No | $32.70 | WV |
| Abilis Health (HMO I-SNP) | SIGNATURE ADVANTAGE, LLC | T1 | No | $35.90 | KY, TN |
| CommuniCare Advantage ISNP (HMO I-SNP) | OH CHS SNP INC. | T1 | No | $38.40 | IN, MD, OH |
| Nascentia Skilled Nursing Facility (HMO I-SNP) | VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK | T1 | No | $58.80 | NY |
| CareAdvantage (HMO D-SNP) | SAN MATEO HEALTH COMMISSION | T2 | No | $0 | CA |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T2 | No | $0 | CA |
| Regence MedAdvantage + Rx Primary (PPO) | REGENCE BLUECROSS BLUESHIELD OF OREGON | T3 | No | $0 | OR, WA |
| Regence BlueAdvantage HMO (HMO) | REGENCE BLUECROSS BLUESHIELD OF OREGON | T3 | No | $0 | OR |
| PHP (HMO C-SNP) | AIDS HEALTHCARE FOUNDATION | T3 | No | $0 | CA |
| DualConnect (HMO D-SNP) | SANTA CLARA COUNTY HEALTH AUTHORITY | T3 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS CHOICE | T3 | No | $0 | NY |
| Mass General Brigham Advantage (PPO) | Mass General Brigham Health Plan, Inc. | T3 | No | $0 | MA |
| CareOregon Advantage Plus (HMO D-SNP) | HEALTH PLAN OF CAREOREGON, INC. | T3 | No | $0 | OR |
| Regence MedAdvantage + Rx Primary (PPO) | REGENCE BLUESHIELD | T3 | No | $4.70 | WA |
| Regence BlueAdvantage HMO (HMO) | REGENCE BLUESHIELD | T3 | No | $8.90 | WA |
| Regence MedAdvantage + Rx Classic (PPO) | REGENCE BLUECROSS BLUESHIELD OF OREGON | T3 | No | $28.00 | OR, WA |
| Regence MedAdvantage + Rx Classic (PPO) | REGENCE BLUECROSS BLUESHIELD OF UTAH | T3 | No | $34.70 | UT |
| VNS Health EasyCare Plus (HMO D-SNP) | VNS CHOICE | T3 | No | $51.60 | NY |
| Mass General Brigham Advantage Secure (HMO-POS) | Mass General Brigham Health Plan, Inc. | T3 | No | $62.00 | MA |
| Regence MedAdvantage + Rx Enhanced (PPO) | REGENCE BLUECROSS BLUESHIELD OF OREGON | T3 | No | $62.50 | OR, WA |
| Mass General Brigham Advantage Premier (PPO) | Mass General Brigham Health Plan, Inc. | T3 | No | $79.70 | MA |
| Regence MedAdvantage + Rx Enhanced (PPO) | REGENCE BLUECROSS BLUESHIELD OF UTAH | T3 | No | $81.70 | UT |
| Regence MedAdvantage + Rx Enhanced (PPO) | REGENCE BLUESHIELD | T3 | No | $91.50 | WA |
| Mass General Brigham Advantage Signature (PPO) | Mass General Brigham Health Plan, Inc. | T3 | No | $147.20 | MA |
| MCS Classicare RxMax (HMO) | MCS ADVANTAGE, INC. | T4 | No | $0 | PR |
| MCS Classicare Platino Ideal (HMO D-SNP) | MCS ADVANTAGE, INC. | T4 | No | $0 | PR |
| MCS Classicare Efectivo (HMO) | MCS ADVANTAGE, INC. | T4 | No | $0 | PR |
| MCS Classicare Essential (HMO-POS) | MCS ADVANTAGE, INC. | T4 | No | $0 | PR |
Frequently Asked Questions
Is levonorgestrel 0.000729 MG/HR Intrauterine System [Kyleena] covered by Medicare Part D?
Yes, levonorgestrel 0.000729 MG/HR Intrauterine System [Kyleena] is covered by 185 Medicare Part D plans (3.7% of all Part D formularies).
What tier is levonorgestrel 0.000729 MG/HR Intrauterine System [Kyleena] on Medicare Part D plans?
levonorgestrel 0.000729 MG/HR Intrauterine System [Kyleena] averages Tier 3.1 across Part D plans, ranging from Tier 1 to Tier 4.
Does levonorgestrel 0.000729 MG/HR Intrauterine System [Kyleena] require prior authorization?
0% of Part D formularies require prior authorization for levonorgestrel 0.000729 MG/HR Intrauterine System [Kyleena]. Step therapy: 0%. Quantity limits: 1.4%.
How much does Medicare spend on levonorgestrel 0.000729 MG/HR Intrauterine System [Kyleena]?
In 2023, total Medicare Part D spending on levonorgestrel 0.000729 MG/HR Intrauterine System [Kyleena] was $777,252, covering 650 beneficiaries. The average spend per beneficiary was $1,195.77.
Read our methodology - how this data is sourced, computed, and verified.