magnesium chloride 0.00148 MEQ/ML / potassium chloride 0.00497 MEQ/ML / sodium acetate 0.027 MEQ/ML / sodium chloride 0.0899 MEQ/ML / sodium gluconate 5.02 MG/ML Injectable Solution [Plasmalyte A]

Verify with CMS →

magnesium chloride

RxCUI: 801112

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.
21.4%
Plan Coverage
1,083
Plans Covering
T3.1
Avg Tier
8.6%
Prior Auth Required

What the CMS Formulary Data Shows for magnesium chloride 0.00148 MEQ/ML / potassium chloride 0.00497 MEQ/ML / sodium acetate 0.027 MEQ/ML / sodium chloride 0.0899 MEQ/ML / sodium gluconate 5.02 MG/ML Injectable Solution [Plasmalyte A]

Per the CMS 2026 Part D formulary file, magnesium chloride 0.00148 MEQ/ML / potassium chloride 0.00497 MEQ/ML / sodium acetate 0.027 MEQ/ML / sodium chloride 0.0899 MEQ/ML / sodium gluconate 5.02 MG/ML Injectable Solution [Plasmalyte A] (RxNorm concept RXCUI 801112, generic name magnesium chloride) appears on 35 distinct formulary files spanning 1,083 Medicare Part D plan offerings - 21.4% 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 magnesium chloride 0.00148 MEQ/ML / potassium chloride 0.00497 MEQ/ML / sodium acetate 0.027 MEQ/ML / sodium chloride 0.0899 MEQ/ML / sodium gluconate 5.02 MG/ML Injectable Solution [Plasmalyte A] depends on utilization management as much as tier placement: 8.6% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.

Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry magnesium chloride 0.00148 MEQ/ML / potassium chloride 0.00497 MEQ/ML / sodium acetate 0.027 MEQ/ML / sodium chloride 0.0899 MEQ/ML / sodium gluconate 5.02 MG/ML Injectable Solution [Plasmalyte A] today.

Coverage Details

Formularies covering
35
Plans covering
1,083
Coverage rate
21.4%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
8.6% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

Tier Distribution Across Plans

8 plans
Tier 1, Preferred Generic
46 plans
Tier 2, Generic
46 plans
Tier 3, Preferred Brand

Medicare Advantage Plans (MA-PD) Covering magnesium chloride 0.00148 MEQ/ML / potassium chloride 0.00497 MEQ/ML / sodium acetate 0.027 MEQ/ML / sodium chloride 0.0899 MEQ/ML / sodium gluconate 5.02 MG/ML Injectable Solution [Plasmalyte A]

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
Platino Blindao (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
Platino Enlace (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
PLATINO ADVANCE (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
PLATINO PLUS (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T1 No $4.80 FL
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF ARIZONA T1 No $17.00 AZ
Freedom VIP Care (HMO C-SNP) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom VIP Savings (HMO C-SNP) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom VIP Savings (HMO C-SNP) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom VIP Rewards (HMO C-SNP) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom VIP Rewards (HMO C-SNP) FREEDOM HEALTH, INC. T2 No $0 FL
Optimum Diamond Rewards (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Optimum Diamond Savings (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Optimum Diamond Rewards (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Optimum Diamond (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Freedom Medi-Medi Partial (HMO D-SNP) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Medi-Medi Full (HMO D-SNP) FREEDOM HEALTH, INC. T2 No $0 FL
Optimum Emerald Partial (HMO D-SNP) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Optimum Emerald Full (HMO D-SNP) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Freedom Medicare Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Medicare Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom VIP Savings COPD (HMO C-SNP) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom VIP Savings COPD (HMO C-SNP) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Máximo (HMO-POS) FREEDOM HEALTH, INC. T2 No $0 FL
Freedom Máximo (HMO-POS) FREEDOM HEALTH, INC. T2 No $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Optimum Platinum Plan (HMO) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Optimum Gold Plan (HMO) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Optimum Diamond Savings COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Optimum Gold Plus Plan (HMO) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T2 No $0 FL
Óptimo Plus (PPO) TRIPLE S ADVANTAGE, INC. T2 Yes $0 PR
Contigo Plus (HMO C-SNP) TRIPLE S ADVANTAGE, INC. T2 Yes $0 PR
Brillante (HMO-POS) TRIPLE S ADVANTAGE, INC. T2 Yes $0 PR

Frequently Asked Questions

Is magnesium chloride 0.00148 MEQ/ML / potassium chloride 0.00497 MEQ/ML / sodium acetate 0.027 MEQ/ML / sodium chloride 0.0899 MEQ/ML / sodium gluconate 5.02 MG/ML Injectable Solution [Plasmalyte A] covered by Medicare Part D?

Yes, magnesium chloride 0.00148 MEQ/ML / potassium chloride 0.00497 MEQ/ML / sodium acetate 0.027 MEQ/ML / sodium chloride 0.0899 MEQ/ML / sodium gluconate 5.02 MG/ML Injectable Solution [Plasmalyte A] is covered by 1,083 Medicare Part D plans (21.4% of all Part D formularies).

What tier is magnesium chloride 0.00148 MEQ/ML / potassium chloride 0.00497 MEQ/ML / sodium acetate 0.027 MEQ/ML / sodium chloride 0.0899 MEQ/ML / sodium gluconate 5.02 MG/ML Injectable Solution [Plasmalyte A] on Medicare Part D plans?

magnesium chloride 0.00148 MEQ/ML / potassium chloride 0.00497 MEQ/ML / sodium acetate 0.027 MEQ/ML / sodium chloride 0.0899 MEQ/ML / sodium gluconate 5.02 MG/ML Injectable Solution [Plasmalyte A] averages Tier 3.1 across Part D plans, ranging from Tier 1 to Tier 4.

Does magnesium chloride 0.00148 MEQ/ML / potassium chloride 0.00497 MEQ/ML / sodium acetate 0.027 MEQ/ML / sodium chloride 0.0899 MEQ/ML / sodium gluconate 5.02 MG/ML Injectable Solution [Plasmalyte A] require prior authorization?

8.6% of Part D formularies require prior authorization for magnesium chloride 0.00148 MEQ/ML / potassium chloride 0.00497 MEQ/ML / sodium acetate 0.027 MEQ/ML / sodium chloride 0.0899 MEQ/ML / sodium gluconate 5.02 MG/ML Injectable Solution [Plasmalyte A]. Step therapy: 0%. Quantity limits: 0%.

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