loteprednol etabonate 2.5 MG/ML Ophthalmic Suspension [Eysuvis]

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loteprednol etabonate

RxCUI: 2464843

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.
49%
Plan Coverage
2,483
Plans Covering
T2.9
Avg Tier
15%
Prior Auth Required

What the CMS Formulary Data Shows for loteprednol etabonate 2.5 MG/ML Ophthalmic Suspension [Eysuvis]

Per the CMS 2026 Part D formulary file, loteprednol etabonate 2.5 MG/ML Ophthalmic Suspension [Eysuvis] (RxNorm concept RXCUI 2464843, generic name loteprednol etabonate) appears on 153 distinct formulary files spanning 2,483 Medicare Part D plan offerings - 49% 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 2.9.

Real-world access to loteprednol etabonate 2.5 MG/ML Ophthalmic Suspension [Eysuvis] depends on utilization management as much as tier placement: 15% of covering formularies require prior authorization. 0% require step therapy. 42.5% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 91,483 Part D beneficiaries filled loteprednol etabonate 2.5 MG/ML Ophthalmic Suspension [Eysuvis] in 2023, with total plan-and-beneficiary spending of $33,190,775 and an average per-beneficiary annual cost of $362.81. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry loteprednol etabonate 2.5 MG/ML Ophthalmic Suspension [Eysuvis] today.

Coverage Details

Formularies covering
153
Plans covering
2,483
Coverage rate
49%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
15% of formularies
Step therapy required
0% of formularies
Quantity limits
42.5% of formularies

2023 Medicare Spending

Beneficiaries
91,483
Total spending
$33,190,775
Avg per beneficiary
$362.81

Tier Distribution Across Plans

54 plans
Tier 1, Preferred Generic
10 plans
Tier 2, Generic
36 plans
Tier 3, Preferred Brand

Medicare Advantage Plans (MA-PD) Covering loteprednol etabonate 2.5 MG/ML Ophthalmic Suspension [Eysuvis]

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

Plan Insurer Tier PA Premium States
Florida Complete Care-Duals VIP (HMO-POS D-SNP) HPMP OF FLORIDA, INC. T1 No $0 FL
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 No $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 No $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 No $0 AZ
Elderplan Plus Long-Term Care (HMO-POS D-SNP) ELDERPLAN, INC. T1 No $0 NY
Health Choice Pathway (HMO D-SNP) HEALTH CHOICE ARIZONA, INC. T1 No $0 AZ
Healthfirst CompleteCare (HMO D-SNP) HEALTHFIRST HEALTH PLAN, INC. T1 No $0 NY
IMCare Classic (HMO D-SNP) ITASCA MEDICAL CARE T1 No $0 MN
Johns Hopkins Advantage MD D-SNP (HMO D-SNP) HOPKINS HEALTH ADVANTAGE, INC. T1 No $0 MD
MetroPlus UltraCare (HMO D-SNP) METROPLUS HEALTH PLAN, INC. T1 No $0 NY
Senior Whole Health SCO (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 No $0 MA
Senior Whole Health SCO NHC (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 No $0 MA
Molina One Care (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 No $0 MA
Gold Coast Health Plan Total Care Advantage (HMO D-SNP) Ventura County Medi-Cal Managed Care Commission T1 Yes $0 CA
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) Health Care Service Corporation T1 Yes $0 NM
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) Health Care Service Corporation T1 Yes $0 NM
SecureBlue (HMO D-SNP) HMO Minnesota T1 Yes $0 MN
NaviCare (HMO D-SNP) FALLON COMMUNITY HEALTH PLAN T1 No $0 MA
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 Yes $0 NY
CCA One Care (HMO D-SNP) COMMONWEALTH CARE ALLIANCE, INC. T1 No $0 MA
CCA Senior Care Options (HMO D-SNP) COMMONWEALTH CARE ALLIANCE, INC. T1 No $0 MA
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
Florida Complete Care (HMO I-SNP) HPMP OF FLORIDA, INC. T1 No $4.80 FL
Florida Complete Care- In The Community (HMO-POS I-SNP) HPMP OF FLORIDA, INC. T1 No $4.80 FL
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) HCSC INSURANCE SERVICES COMPANY T1 Yes $4.80 TX
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
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) GHS INSURANCE COMPANY T1 Yes $5.00 OK
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
Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) ELDERPLAN, INC. T1 No $22.70 NY
VIVA Medicare Extra Value (HMO D-SNP) VIVA HEALTH, INC. T1 No $27.70 AL
VIVA Medicare Extra Care (HMO D-SNP) VIVA HEALTH, INC. T1 No $27.70 AL
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
Hamaspik Medicare Select (HMO D-SNP) HAMASPIK, INC. T1 Yes $34.50 NY
Abilis Health (HMO I-SNP) SIGNATURE ADVANTAGE, LLC T1 No $35.90 KY, TN

Frequently Asked Questions

Is loteprednol etabonate 2.5 MG/ML Ophthalmic Suspension [Eysuvis] covered by Medicare Part D?

Yes, loteprednol etabonate 2.5 MG/ML Ophthalmic Suspension [Eysuvis] is covered by 2,483 Medicare Part D plans (49% of all Part D formularies).

What tier is loteprednol etabonate 2.5 MG/ML Ophthalmic Suspension [Eysuvis] on Medicare Part D plans?

loteprednol etabonate 2.5 MG/ML Ophthalmic Suspension [Eysuvis] averages Tier 2.9 across Part D plans, ranging from Tier 1 to Tier 4.

Does loteprednol etabonate 2.5 MG/ML Ophthalmic Suspension [Eysuvis] require prior authorization?

15% of Part D formularies require prior authorization for loteprednol etabonate 2.5 MG/ML Ophthalmic Suspension [Eysuvis]. Step therapy: 0%. Quantity limits: 42.5%.

How much does Medicare spend on loteprednol etabonate 2.5 MG/ML Ophthalmic Suspension [Eysuvis]?

In 2023, total Medicare Part D spending on loteprednol etabonate 2.5 MG/ML Ophthalmic Suspension [Eysuvis] was $33,190,775, covering 91,483 beneficiaries. The average spend per beneficiary was $362.81.

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