Medicare Part D coverage · metformin hydrochloride · RxCUI 861783
metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet
Per the CMS 2026 Part D formulary file, metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet is covered by 4,613 Medicare Part D plans (91.3% of enrollable products), averaging Tier 2.6, with prior authorization required on 0% of covering formularies.
- 91.3%
- Plan coverage
- 4,613
- Plans covering
- T2.6
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet
Per the CMS 2026 Part D formulary file, metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet (RxNorm concept RXCUI 861783, generic name metformin hydrochloride) appears on 276 distinct formulary files spanning 4,613 Medicare Part D plan offerings - 91.3% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 2.6.
Real-world access to metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 85.5% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 5,918,026 Part D beneficiaries filled metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $247,530,899 and an average per-beneficiary annual cost of $41.83. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 276
- Plans covering
- 4,613
- Coverage rate
- 91.3%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 85.5% of formularies
2023 Medicare Spending
- Beneficiaries
- 5,918,026
- Total spending
- $247,530,899
- Avg per beneficiary
- $41.83
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| UHC Dual Complete IA-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | IA |
| UHC Dual Complete MO-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | MO |
| UHC Dual Complete NE-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | NE |
| UHC Dual Complete KS-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | KS |
| UHC Dual Complete MO-S3 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | MO |
| UHC Dual Complete KS-Q1 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | KS |
| UHC Dual Complete TN-S001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T1 | No | $0 | TN |
| UHC Dual Complete TN-Y001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T1 | No | $0 | TN |
| UHC Dual Complete TN-Y2 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T1 | No | $0 | TN |
| AARP Medicare Advantage from UHC MI-0001 (PPO) | Unitedhealthcare Insurance Company | T1 | No | $0 | MI |
| UHC Dual Complete NM-Y1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T1 | No | $0 | NM |
| UHC Dual Complete NM-S1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T1 | No | $0 | NM |
| UHC Dual Complete NM-V1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T1 | No | $0 | NM |
| UHC Dual Complete AZ-S001 (HMO-POS D-SNP) | Arizona Physicians IPA, Inc. | T1 | No | $0 | AZ |
| UHC Dual Complete AZ-Y001 (HMO-POS D-SNP) | Arizona Physicians IPA, Inc. | T1 | No | $0 | AZ |
| UHC Dual Complete VA-Y4 (PPO D-SNP) | Care Improvement Plus South Central Insurance Co. | T1 | No | $0 | VA |
| AARP Medicare Advantage from UHC AL-0001 (HMO-POS) | Unitedhealthcare OF THE Midlands, Inc. | T1 | No | $0 | AL |
| AARP Medicare Advantage from UHC CA-0002 (HMO-POS) | UHC OF California | T1 | No | $0 | CA |
| UHC Sharp Medicare Advantage CA-001P (HMO-POS) | UHC OF California | T1 | No | $0 | CA |
| AARP Medicare Advantage from UHC CA-003P (HMO-POS) | UHC OF California | T1 | No | $0 | CA |
Show the next 30 plans
Showing top 50 of 100 plans.
Frequently Asked Questions
Is metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet covered by Medicare Part D?
Yes, metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet is covered by 4,613 Medicare Part D plans (91.3% of all Part D formularies).
What tier is metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet on Medicare Part D plans?
metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet averages Tier 2.6 across Part D plans, ranging from Tier 1 to Tier 6.
Does metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet. Step therapy: 0%. Quantity limits: 85.5%.
How much does Medicare spend on metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet?
In 2023, total Medicare Part D spending on metformin hydrochloride 500 MG / pioglitazone 15 MG Oral Tablet was $247,530,899, covering 5,918,026 beneficiaries. The average spend per beneficiary was $41.83.
Read our methodology - how this data is sourced, computed, and verified.
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.
Closest average formulary tier
- 0.65 ML medroxyprogesterone acetate 160 MG/ML Prefilled Syringe [depo-subQ provera] T2.6
- 100 ML ciprofloxacin 2 MG/ML Injection T2.6
- {42 (rivaroxaban 15 MG Oral Tablet [Xarelto]) / 9 (rivaroxaban 20 MG Oral Tablet [Xarelto]) } Pack [Xarelto Kit] T2.6
- clonazepam 2 MG Disintegrating Oral Tablet T2.6
- etonogestrel 68 MG Drug Implant [Nexplanon] T2.6
- haloperidol decanoate 100 MG/ML Injectable Solution T2.6
Similar prior-authorization rate
- metronidazole 10 MG/ML Topical Cream [Noritate] 0% PA
- 24 HR minocycline 40 MG Extended Release Oral Capsule [Emrosi] 0% PA
- buspirone hydrochloride 10 MG Oral Capsule [Bucapsol] 0% PA
- diflunisal 375 MG Oral Tablet [Dolobid] 0% PA
- hydrocortisone 1 MG/ML Oral Solution [Khindivi] 0% PA
- indomethacin 50 MG Rectal Suppository [Indocin] 0% PA