Medicare Part D coverage · loteprednol etabonate · RxCUI 545259

loteprednol etabonate 5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Zylet]

Per the CMS 2026 Part D formulary file, loteprednol etabonate 5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Zylet] is covered by 1,607 Medicare Part D plans (31.8% of enrollable products), averaging Tier 3, with prior authorization required on 0% of covering formularies.

31.8%
Plan coverage
1,607
Plans covering
T3
Avg tier
0%
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 loteprednol etabonate 5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Zylet]

Per the CMS 2026 Part D formulary file, loteprednol etabonate 5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Zylet] (RxNorm concept RXCUI 545259, generic name loteprednol etabonate) appears on 99 distinct formulary files spanning 1,607 Medicare Part D plan offerings - 31.8% 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.

Real-world access to loteprednol etabonate 5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Zylet] 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 5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Zylet] 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 5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Zylet] today.

Coverage Details

Formularies covering
99
Plans covering
1,607
Coverage rate
31.8%
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
0% of formularies

2023 Medicare Spending

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

Tier Distribution Across Plans

39 plans
Tier 1, Preferred Generic
61 plans
Tier 3, Preferred Brand

Medicare Advantage Plans (MA-PD) Covering loteprednol etabonate 5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Zylet]

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
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
Provider Partners Pennsylvania Community Plan (HMO I-SNP) Provider Partners Health Plan OF Pennsylvania, Inc T1 No $0 PA
Provider Partners North Carolina Community Plan (HMO I-SNP) Provider Partners Health Plan OF North Carolina T1 No $0 NC
Provider Partners Indiana Community Plan (HMO I-SNP) Provider Partners Health Plan OF Indiana T1 No $0 IN
Provider Partners Missouri Community Plan (HMO I-SNP) Provider Partners Health Plan OF Missouri, Inc. T1 No $0 MO
Mass General Brigham SCO (HMO D-SNP) Mass General Brigham Health Plan, Inc T1 No $0 MA
Show the next 30 plans
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
Provider Partners Texas Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF Texas, Inc. T1 No $4.80 TX
Provider Partners Illinois Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF Illinois T1 No $15.20 IL
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
Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF Pennsylvania, Inc T1 No $32.70 PA
Provider Partners Pennsylvania Essential Plan (HMO I-SNP) Provider Partners Health Plan OF Pennsylvania, Inc T1 No $32.70 PA
Provider Partners North Carolina Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF North Carolina T1 No $36.20 NC
Provider Partners North Carolina Essential Plan (HMO I-SNP) Provider Partners Health Plan OF North Carolina T1 No $36.20 NC
Provider Partners Indiana Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF Indiana T1 No $38.40 IN
Provider Partners Indiana Essential Plan (HMO I-SNP) Provider Partners Health Plan OF Indiana T1 No $38.40 IN
Provider Partners Kentucky Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF Kentucky T1 No $38.40 KY
Provider Partners Missouri Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF Missouri, Inc. T1 No $43.00 MO
Provider Partners Missouri Essential Plan (HMO I-SNP) Provider Partners Health Plan OF Missouri, Inc. T1 No $43.00 MO
Elderplan Advantage For Nursing Home Residents (HMO-POS I-SNP) Elderplan, Inc. T1 No $44.80 NY
MetroPlus Platinum Plan (HMO) Metroplus Health Plan, Inc. T1 No $58.80 NY
Aetna Medicare Signature (HMO) Aetna Health OF California Inc. T3 No $0 CA
Aetna Medicare Signature (HMO) Aetna Health OF California Inc. T3 No $0 CA
Aetna Medicare Signature Extra (HMO-POS) Aetna Health OF California Inc. T3 No $0 CA
Aetna Medicare Prime (HMO-POS) Aetna Health OF California Inc. T3 No $0 CA
Aetna Medicare Prime (HMO-POS) Aetna Health OF California Inc. T3 No $0 CA
Aetna Medicare Prime (HMO-POS) Aetna Health OF California Inc. T3 No $0 CA
Aetna Medicare Signature Extra (HMO) Aetna Health OF California Inc. T3 No $0 CA
Aetna Medicare Prime (HMO-POS) Aetna Health OF California Inc. T3 No $0 CA
Aetna Medicare Signature Extra (HMO) Aetna Health OF California Inc. T3 No $0 CA
Aetna Medicare Signature Extra (HMO) Aetna Health OF California Inc. T3 No $0 CA
Aetna Medicare Signature Extra (HMO) Aetna Health OF California Inc. T3 No $0 CA

Showing top 50 of 100 plans.

Frequently Asked Questions

Is loteprednol etabonate 5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Zylet] covered by Medicare Part D?

Yes, loteprednol etabonate 5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Zylet] is covered by 1,607 Medicare Part D plans (31.8% of all Part D formularies).

What tier is loteprednol etabonate 5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Zylet] on Medicare Part D plans?

loteprednol etabonate 5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Zylet] averages Tier 3 across Part D plans, ranging from Tier 1 to Tier 4.

Does loteprednol etabonate 5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Zylet] require prior authorization?

0% of Part D formularies require prior authorization for loteprednol etabonate 5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Zylet]. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on loteprednol etabonate 5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Zylet]?

In 2023, total Medicare Part D spending on loteprednol etabonate 5 MG/ML / tobramycin 3 MG/ML Ophthalmic Suspension [Zylet] was $33,190,775, covering 91,483 beneficiaries. The average spend per beneficiary was $362.81.

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