loteprednol etabonate 0.005 MG/MG Ophthalmic Gel [Lotemax]

Verify with CMS →

loteprednol etabonate

RxCUI: 1312627

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.
15.6%
Plan Coverage
791
Plans Covering
T3.8
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for loteprednol etabonate 0.005 MG/MG Ophthalmic Gel [Lotemax]

Per the CMS 2026 Part D formulary file, loteprednol etabonate 0.005 MG/MG Ophthalmic Gel [Lotemax] (RxNorm concept RXCUI 1312627, generic name loteprednol etabonate) appears on 5 distinct formulary files spanning 791 Medicare Part D plan offerings - 15.6% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 3 to Tier 4, with a cross-plan average of Tier 3.8.

Real-world access to loteprednol etabonate 0.005 MG/MG Ophthalmic Gel [Lotemax] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 91,483 Part D beneficiaries filled loteprednol etabonate 0.005 MG/MG Ophthalmic Gel [Lotemax] 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 0.005 MG/MG Ophthalmic Gel [Lotemax] today.

Coverage Details

Formularies covering
5
Plans covering
791
Coverage rate
15.6%
Tier range
Tier 3 – Tier 4
Average tier
Tier 4, Non-Preferred

Restrictions

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

2023 Medicare Spending

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

Tier Distribution Across Plans

16 plans
Tier 3, Preferred Brand
84 plans
Tier 4, Non-Preferred

Standalone Drug Plans (PDP) Covering loteprednol etabonate 0.005 MG/MG Ophthalmic Gel [Lotemax]

2 standalone prescription drug plans include this drug.

Plan Insurer Tier PA ST Premium States
AARP Medicare Rx Preferred from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T4 No No $0 -
AARP Medicare Rx Preferred from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T4 No No $0 -

Medicare Advantage Plans (MA-PD) Covering loteprednol etabonate 0.005 MG/MG Ophthalmic Gel [Lotemax]

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

Plan Insurer Tier PA Premium States
MMM Supremo (HMO C-SNP) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Diamante Platino (HMO D-SNP) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Unico (HMO-POS) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Elite (HMO-POS) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Deluxe (HMO-POS) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Dorado Platino (HMO D-SNP) MMM HEALTHCARE, LLC T3 No $0 PR
PMC Premier Platino (HMO D-SNP) MMM HEALTHCARE, LLC T3 No $0 PR
PMC Max (HMO-POS) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Plenitud (HMO-POS) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Valioso (HMO-POS) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Combo Platino (HMO D-SNP) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Flexi Platino (HMO D-SNP) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Grandioso (HMO-POS) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Mega Flex (HMO-POS) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Relax Platino (HMO D-SNP) MMM HEALTHCARE, LLC T3 No $0 PR
MMM Balance (HMO-POS) MMM HEALTHCARE, LLC T3 No $0 PR
UHC Dual Complete IA-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T4 No $0 IA
UHC Dual Complete MO-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T4 No $0 MO
UHC Dual Complete NE-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T4 No $0 NE
UHC Dual Complete KS-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T4 No $0 KS
UHC Dual Complete MO-S3 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T4 No $0 MO
UHC Dual Complete KS-Q1 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T4 No $0 KS
UHC Dual Complete TN-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. T4 No $0 TN
UHC Dual Complete TN-Y001 (HMO-POS D-SNP) UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. T4 No $0 TN
UHC Dual Complete TN-Y2 (HMO-POS D-SNP) UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. T4 No $0 TN
AARP Medicare Advantage from UHC MI-0001 (PPO) UNITEDHEALTHCARE INSURANCE COMPANY T4 No $0 MI
UHC Dual Complete NM-Y1 (PPO D-SNP) UNITEDHEALTHCARE INSURANCE COMPANY T4 No $0 NM
UHC Dual Complete NM-S1 (PPO D-SNP) UNITEDHEALTHCARE INSURANCE COMPANY T4 No $0 NM
UHC Dual Complete NM-V1 (PPO D-SNP) UNITEDHEALTHCARE INSURANCE COMPANY T4 No $0 NM
UHC Dual Complete AZ-S001 (HMO-POS D-SNP) ARIZONA PHYSICIANS IPA, INC. T4 No $0 AZ
UHC Dual Complete AZ-Y001 (HMO-POS D-SNP) ARIZONA PHYSICIANS IPA, INC. T4 No $0 AZ
UHC Dual Complete VA-Y4 (PPO D-SNP) CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. T4 No $0 VA
AARP Medicare Advantage from UHC AL-0001 (HMO-POS) UNITEDHEALTHCARE OF THE MIDLANDS, INC. T4 No $0 AL
AARP Medicare Advantage from UHC CA-0002 (HMO-POS) UHC OF CALIFORNIA T4 No $0 CA
UHC Sharp Medicare Advantage CA-001P (HMO-POS) UHC OF CALIFORNIA T4 No $0 CA
AARP Medicare Advantage from UHC CA-003P (HMO-POS) UHC OF CALIFORNIA T4 No $0 CA
AARP Medicare Advantage from UHC CA-0012 (HMO-POS) UHC OF CALIFORNIA T4 No $0 CA
AARP Medicare Advantage from UHC CA-004P (HMO-POS) UHC OF CALIFORNIA T4 No $0 CA
AARP Medicare Advantage from UHC CA-005P (HMO-POS) UHC OF CALIFORNIA T4 No $0 CA
AARP Medicare Advantage from UHC CA-006P (HMO-POS) UHC OF CALIFORNIA T4 No $0 CA
AARP Medicare Advantage from UHC CA-10 (HMO-POS) UHC OF CALIFORNIA T4 No $0 CA
UHC Sharp Medicare Advantage ValueRx CA-12P (HMO-POS) UHC OF CALIFORNIA T4 No $0 CA
AARP Medicare Advantage from UHC CA-021P (HMO-POS) UHC OF CALIFORNIA T4 No $0 CA
AARP Medicare Advantage from UHC CA-022P (HMO-POS) UHC OF CALIFORNIA T4 No $0 CA
AARP Medicare Advantage from UHC CA-023P (HMO-POS) UHC OF CALIFORNIA T4 No $0 CA
AARP Medicare Advantage from UHC CA-026P (HMO-POS) UHC OF CALIFORNIA T4 No $0 CA
AARP Medicare Advantage Giveback from UHC CA-19 (HMO-POS) UHC OF CALIFORNIA T4 No $0 CA
AARP Medicare Advantage Giveback from UHC CA-20 (HMO-POS) UHC OF CALIFORNIA T4 No $0 CA
AARP Medicare Advantage Giveback from UHC CA-21 (HMO-POS) UHC OF CALIFORNIA T4 No $0 CA
AARP Medicare Advantage Essentials from UHC CO-2 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T4 No $0 CO

Frequently Asked Questions

Is loteprednol etabonate 0.005 MG/MG Ophthalmic Gel [Lotemax] covered by Medicare Part D?

Yes, loteprednol etabonate 0.005 MG/MG Ophthalmic Gel [Lotemax] is covered by 791 Medicare Part D plans (15.6% of all Part D formularies).

What tier is loteprednol etabonate 0.005 MG/MG Ophthalmic Gel [Lotemax] on Medicare Part D plans?

loteprednol etabonate 0.005 MG/MG Ophthalmic Gel [Lotemax] averages Tier 3.8 across Part D plans, ranging from Tier 3 to Tier 4.

Does loteprednol etabonate 0.005 MG/MG Ophthalmic Gel [Lotemax] require prior authorization?

0% of Part D formularies require prior authorization for loteprednol etabonate 0.005 MG/MG Ophthalmic Gel [Lotemax]. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on loteprednol etabonate 0.005 MG/MG Ophthalmic Gel [Lotemax]?

In 2023, total Medicare Part D spending on loteprednol etabonate 0.005 MG/MG Ophthalmic Gel [Lotemax] 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