Medicare Part D coverage · lidocaine · RxCUI 1543069

lidocaine 0.05 MG/MG Topical Ointment

Per the CMS 2026 Part D formulary file, lidocaine 0.05 MG/MG Topical Ointment is covered by 4,793 Medicare Part D plans (94.9% of enrollable products), averaging Tier 2.6, with prior authorization required on 67.8% of covering formularies.

94.9%
Plan coverage
4,793
Plans covering
T2.6
Avg tier
67.8%
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 lidocaine 0.05 MG/MG Topical Ointment

Per the CMS 2026 Part D formulary file, lidocaine 0.05 MG/MG Topical Ointment (RxNorm concept RXCUI 1543069, generic name lidocaine) appears on 289 distinct formulary files spanning 4,793 Medicare Part D plan offerings - 94.9% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.6.

Real-world access to lidocaine 0.05 MG/MG Topical Ointment depends on utilization management as much as tier placement: 67.8% of covering formularies require prior authorization. 0% require step therapy. 91.3% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 481,042 Part D beneficiaries filled lidocaine 0.05 MG/MG Topical Ointment in 2023, with total plan-and-beneficiary spending of $176,121,587 and an average per-beneficiary annual cost of $366.13. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry lidocaine 0.05 MG/MG Topical Ointment today.

Coverage Details

Formularies covering
289
Plans covering
4,793
Coverage rate
94.9%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
67.8% of formularies
Step therapy required
0% of formularies
Quantity limits
91.3% of formularies

2023 Medicare Spending

Beneficiaries
481,042
Total spending
$176,121,587
Avg per beneficiary
$366.13

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering lidocaine 0.05 MG/MG Topical Ointment

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

Plan Insurer Tier PA Premium States
Sentara Community Complete Select (HMO D-SNP) Sentara Health Plans T1 No $0 VA
Sentara Community Complete (HMO D-SNP) Sentara Health Plans T1 No $0 VA
Florida Complete Care-Duals VIP (HMO-POS D-SNP) Hpmp OF Florida, Inc. T1 Yes $0 FL
ElderServe MAP (HMO D-SNP) Elderserve Health, Inc. T1 No $0 NY
Cooperative Advantage (HMO D-SNP) Group Health Cooperative OF EAU Claire T1 No $0 WI
Longevity Health Plan (PPO I-SNP) Longevity Health Plan OF NEW Jersey Insurance Comp T1 No $0 NJ
Mercy Care Advantage (HMO D-SNP) Mercy Care T1 Yes $0 AZ
Mercy Care Advantage (HMO D-SNP) Mercy Care T1 Yes $0 AZ
Mercy Care Advantage (HMO D-SNP) Mercy Care T1 Yes $0 AZ
Elderplan Plus Long-Term Care (HMO-POS D-SNP) Elderplan, Inc. T1 Yes $0 NY
Health Choice Pathway (HMO D-SNP) Health Choice Arizona, Inc. T1 Yes $0 AZ
Healthfirst CompleteCare (HMO D-SNP) Healthfirst Health Plan, Inc. T1 Yes $0 NY
IMCare Classic (HMO D-SNP) Itasca Medical Care T1 Yes $0 MN
Johns Hopkins Advantage MD D-SNP (HMO D-SNP) Hopkins Health Advantage, Inc. T1 Yes $0 MD
MetroPlus UltraCare (HMO D-SNP) Metroplus Health Plan, Inc. T1 Yes $0 NY
Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) Upper Peninsula Health Plan, LLC T1 No $0 MI
CareSource Dual Advantage (HMO D-SNP) Caresource Georgia Co. T1 No $0 GA
Senior Whole Health SCO (HMO D-SNP) Senior Whole Health, LLC T1 Yes $0 MA
Senior Whole Health SCO NHC (HMO D-SNP) Senior Whole Health, LLC T1 Yes $0 MA
Molina One Care (HMO D-SNP) Senior Whole Health, LLC T1 Yes $0 MA
Show the next 30 plans
HAP CareSource MI Coordinated Health (HMO D-SNP) HAP Caresource T1 No $0 MI
PruittHealth Premier D-SNP (HMO D-SNP) Pruitthealth Premier, Inc. T1 Yes $0 GA
KeyCare Advantage Plus (HMO C-SNP) Isnp Ventures, LLC T1 Yes $0 MD
Premier Care (HMO-POS I-SNP) Lifeworks Advantage, LLC T1 Yes $0 VA
Premier Care (HMO I-SNP) Align Senior Care California Inc. T1 Yes $0 CA
Advantage Care (HMO) Align Senior Care California Inc. T1 Yes $0 CA
Premier Care (HMO-POS I-SNP) Align Senior Care MI, LLC T1 Yes $0 MI
Premier Care (HMO I-SNP) Align Senior Care Florida, Inc. T1 Yes $0 FL
Perennial Advantage Freedom (HMO-POS) Perennial Advantage OF Colorado, Inc. T1 Yes $0 CO
Perennial Advantage Premier (HMO-POS I-SNP) Perennial Advantage OF Colorado, Inc. T1 Yes $0 CO
Perennial Advantage Freedom (HMO) Perennial Advantage OF Colorado, Inc. T1 Yes $0 PA
Perennial Advantage Premier (HMO I-SNP) Perennial Advantage OF Colorado, Inc. T1 Yes $0 PA
Perennial Advantage Freedom (HMO-POS) Perennial Advantage OF Ohio, Inc. T1 Yes $0 OH
Perennial Advantage Premier (HMO-POS I-SNP) Perennial Advantage OF Ohio, Inc. T1 Yes $0 OH
ProCare Advantage - Diabetes Care Management (HMO-POS C-SNP) Procare Advantage, LLC T1 Yes $0 TX
PruittHealth Premier Advantage (HMO I-SNP) Pruitthealth Premier, Inc. T1 Yes $0 GA
Senior Health Plan Silver Plus (HMO) Communitycare Government Programs, Inc. T1 Yes $0 OK
Senior Health Plan Oklahoma Dual Complete (HMO D-SNP) Communitycare Government Programs, Inc. T1 Yes $0 OK
Community First Medicare Advantage Alamo Plan (HMO) Community First Health Plans, Inc. T1 Yes $0 TX
Community First Medicare Advantage D-SNP (HMO D-SNP) Community First Health Plans, Inc. T1 Yes $0 TX
Community DualCare Aligned (HMO D-SNP) Community Health Choice Texas, Inc. T1 Yes $0 TX
Community DualCare Access (HMO D-SNP) Community Health Choice Texas, Inc. T1 Yes $0 TX
El Paso Health Medicare Advantage Dual (HMO D-SNP) EL Paso First Health Plans, Inc. T1 Yes $0 TX
El Paso Health Total (HMO) EL Paso First Health Plans, Inc. T1 Yes $0 TX
El Paso Health Giveback (HMO) EL Paso First Health Plans, Inc. T1 Yes $0 TX
Liberty Medicare Advantage (HMO C-SNP) Liberty Advantage, LLC T1 Yes $0 NC
Peak Advantage Vista (PPO) Peak Health Insurance Corporation T1 Yes $0 PA, WV
SECUR Edge (HMO I-SNP) Secur Inc T1 Yes $0 FL
Simpra Advantage Dual Care (PPO D-SNP) Simpra Advantage, Inc. T1 Yes $0 AL
CareAdvantage (HMO D-SNP) SAN Mateo Health Commission T1 No $0 CA

Showing top 50 of 100 plans.

Frequently Asked Questions

Is lidocaine 0.05 MG/MG Topical Ointment covered by Medicare Part D?

Yes, lidocaine 0.05 MG/MG Topical Ointment is covered by 4,793 Medicare Part D plans (94.9% of all Part D formularies).

What tier is lidocaine 0.05 MG/MG Topical Ointment on Medicare Part D plans?

lidocaine 0.05 MG/MG Topical Ointment averages Tier 2.6 across Part D plans, ranging from Tier 1 to Tier 4.

Does lidocaine 0.05 MG/MG Topical Ointment require prior authorization?

67.8% of Part D formularies require prior authorization for lidocaine 0.05 MG/MG Topical Ointment. Step therapy: 0%. Quantity limits: 91.3%.

How much does Medicare spend on lidocaine 0.05 MG/MG Topical Ointment?

In 2023, total Medicare Part D spending on lidocaine 0.05 MG/MG Topical Ointment was $176,121,587, covering 481,042 beneficiaries. The average spend per beneficiary was $366.13.

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