methylprednisolone 16 MG Oral Tablet [Medrol]
methylprednisolone
RxCUI: 207138
What the CMS Formulary Data Shows for methylprednisolone 16 MG Oral Tablet [Medrol]
Per the CMS 2026 Part D formulary file, methylprednisolone 16 MG Oral Tablet [Medrol] (RxNorm concept RXCUI 207138, generic name methylprednisolone) appears on 2 distinct formulary files spanning 76 Medicare Part D plan offerings - 1.5% 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 2.5.
Real-world access to methylprednisolone 16 MG Oral Tablet [Medrol] depends on utilization management as much as tier placement: 50% 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 4,135,771 Part D beneficiaries filled methylprednisolone 16 MG Oral Tablet [Medrol] in 2023, with total plan-and-beneficiary spending of $53,086,422 and an average per-beneficiary annual cost of $12.84. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry methylprednisolone 16 MG Oral Tablet [Medrol] today.
Coverage Details
- Formularies covering
- 2
- Plans covering
- 76
- Coverage rate
- 1.5%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 50% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 4,135,771
- Total spending
- $53,086,422
- Avg per beneficiary
- $12.84
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering methylprednisolone 16 MG Oral Tablet [Medrol]
76 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $0 | NY |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $34.50 | NY |
| SCAN Connections (HMO D-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Connections at Home (HMO D-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN NEVADA, INC. | T4 | Yes | $0 | NV |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN NEVADA, INC. | T4 | Yes | $0 | NV |
| SCAN Strive (HMO C-SNP) | SCAN HEALTH PLAN NEVADA, INC. | T4 | Yes | $0 | NV |
| SCAN MyChoice (HMO) | SCAN HEALTH PLAN NEVADA, INC. | T4 | Yes | $0 | NV |
| SCAN Classic (HMO) | SCAN DESERT HEALTH PLAN, INC. | T4 | Yes | $0 | AZ |
| SCAN Balance (HMO C-SNP) | SCAN DESERT HEALTH PLAN, INC. | T4 | Yes | $0 | AZ |
| SCAN Embrace (HMO-POS I-SNP) | SCAN DESERT HEALTH PLAN, INC. | T4 | Yes | $0 | AZ |
| SCAN Strive (HMO C-SNP) | SCAN DESERT HEALTH PLAN, INC. | T4 | Yes | $0 | AZ |
| SCAN MyChoice (HMO) | SCAN DESERT HEALTH PLAN, INC. | T4 | Yes | $0 | AZ |
| SCAN Classic WA (HMO) | SCAN HEALTH PLAN (WA) | T4 | Yes | $0 | WA |
| SCAN MyChoice WA (HMO) | SCAN HEALTH PLAN (WA) | T4 | Yes | $0 | WA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN (NM) | T4 | Yes | $0 | NM |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN (NM) | T4 | Yes | $0 | NM |
| SCAN Strive (HMO C-SNP) | SCAN HEALTH PLAN (NM) | T4 | Yes | $0 | NM |
| SCAN MyChoice (HMO) | SCAN HEALTH PLAN (NM) | T4 | Yes | $0 | NM |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Prime (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Alta (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Venture (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Venture (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Embrace (HMO I-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Embrace (HMO I-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Embrace (HMO-POS I-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Affirm partnered with Included LGBTQ+ Health (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Affirm partnered with Included LGBTQ+ Health (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Strive (HMO C-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Strive (HMO C-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Inspired by women for women (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Affirm partnered with Included LGBTQ+ Health (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN MyChoice (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
Frequently Asked Questions
Is methylprednisolone 16 MG Oral Tablet [Medrol] covered by Medicare Part D?
Yes, methylprednisolone 16 MG Oral Tablet [Medrol] is covered by 76 Medicare Part D plans (1.5% of all Part D formularies).
What tier is methylprednisolone 16 MG Oral Tablet [Medrol] on Medicare Part D plans?
methylprednisolone 16 MG Oral Tablet [Medrol] averages Tier 2.5 across Part D plans, ranging from Tier 1 to Tier 4.
Does methylprednisolone 16 MG Oral Tablet [Medrol] require prior authorization?
50% of Part D formularies require prior authorization for methylprednisolone 16 MG Oral Tablet [Medrol]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on methylprednisolone 16 MG Oral Tablet [Medrol]?
In 2023, total Medicare Part D spending on methylprednisolone 16 MG Oral Tablet [Medrol] was $53,086,422, covering 4,135,771 beneficiaries. The average spend per beneficiary was $12.84.
Read our methodology - how this data is sourced, computed, and verified.