Medicare Part D coverage · methyltestosterone · RxCUI 541524
methyltestosterone 10 MG Oral Tablet [Methitest]
Per the CMS 2026 Part D formulary file, methyltestosterone 10 MG Oral Tablet [Methitest] is covered by 143 Medicare Part D plans (2.8% of enrollable products), averaging Tier 4.7, with prior authorization required on 11.1% of covering formularies.
- 2.8%
- Plan coverage
- 143
- Plans covering
- T4.7
- Avg tier
- 11.1%
- Prior auth required
What the CMS Formulary Data Shows for methyltestosterone 10 MG Oral Tablet [Methitest]
Per the CMS 2026 Part D formulary file, methyltestosterone 10 MG Oral Tablet [Methitest] (RxNorm concept RXCUI 541524, generic name methyltestosterone) appears on 9 distinct formulary files spanning 143 Medicare Part D plan offerings - 2.8% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 4 to Tier 5, with a cross-plan average of Tier 4.7.
Real-world access to methyltestosterone 10 MG Oral Tablet [Methitest] depends on utilization management as much as tier placement: 11.1% 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 20 Part D beneficiaries filled methyltestosterone 10 MG Oral Tablet [Methitest] in 2023, with total plan-and-beneficiary spending of $390,812 and an average per-beneficiary annual cost of $19,540.61. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry methyltestosterone 10 MG Oral Tablet [Methitest] today.
Coverage Details
- Formularies covering
- 9
- Plans covering
- 143
- Coverage rate
- 2.8%
- Tier range
- Tier 4 – Tier 5
- Average tier
- Tier 5, Specialty
Restrictions
- Prior authorization required
- 11.1% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 20
- Total spending
- $390,812
- Avg per beneficiary
- $19,540.61
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering methyltestosterone 10 MG Oral Tablet [Methitest]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Medicare BlueEssential (PPO) | Excellus Health Plan, Inc. | T4 | No | $0 | NY |
| Medicare BlueActive (PPO) | Excellus Health Plan, Inc. | T4 | No | $0 | NY |
| Medicare BlueVital (PPO) | Excellus Health Plan, Inc. | T4 | No | $0 | NY |
| Univera SeniorChoice Basic (HMO) | Excellus Health Plan, Inc. | T4 | No | $0 | NY |
| Univera SeniorChoice Extra (HMO) | Excellus Health Plan, Inc. | T4 | No | $0 | NY |
| Medicare Blue Choice Core (HMO) | Excellus Health Plan, Inc. | T4 | No | $0 | NY |
| Univera Medicare Dual (HMO D-SNP) | Excellus Health Plan Community Care LLC | T4 | No | $0 | NY |
| Medicare Blue Dual (HMO D-SNP) | Excellus Health Plan Community Care LLC | T4 | No | $0 | NY |
| CDPHP $0 Medicare Rx (HMO) | Capital District Physicians' Health Plan, Inc. | T4 | No | $0 | NY |
| Univera SeniorChoice Core (PPO) | Excellus Health Plan, Inc. | T4 | No | $33.00 | NY |
| Univera SeniorChoice Advanced (HMO-POS) | Excellus Health Plan, Inc. | T4 | No | $36.90 | NY |
| Medicare BlueClassic (PPO) | Excellus Health Plan, Inc. | T4 | No | $51.00 | NY |
| Univera SeniorChoice Secure (HMO-POS) | Excellus Health Plan, Inc. | T4 | No | $54.90 | NY |
| Medicare BlueBalanced (PPO) | Excellus Health Plan, Inc. | T4 | No | $55.00 | NY |
| Medicare Blue Choice Prime (HMO) | Excellus Health Plan, Inc. | T4 | No | $55.00 | NY |
| Univera SeniorChoice Value Plus (HMO-POS) | Excellus Health Plan, Inc. | T4 | No | $58.60 | NY |
| Medicare BlueEnhanced (PPO) | Excellus Health Plan, Inc. | T4 | No | $70.30 | NY |
| Medicare BluePlus (PPO) | Excellus Health Plan, Inc. | T4 | No | $86.40 | NY |
| CDPHP Clear Rx (HMO) | Capital District Physicians' Health Plan, Inc. | T4 | No | $100.00 | NY |
| CDPHP Choice Rx (HMO) | Capital District Physicians' Health Plan, Inc. | T4 | No | $135.00 | NY |
Show the next 30 plans
Showing top 50 of 100 plans.
Frequently Asked Questions
Is methyltestosterone 10 MG Oral Tablet [Methitest] covered by Medicare Part D?
Yes, methyltestosterone 10 MG Oral Tablet [Methitest] is covered by 143 Medicare Part D plans (2.8% of all Part D formularies).
What tier is methyltestosterone 10 MG Oral Tablet [Methitest] on Medicare Part D plans?
methyltestosterone 10 MG Oral Tablet [Methitest] averages Tier 4.7 across Part D plans, ranging from Tier 4 to Tier 5.
Does methyltestosterone 10 MG Oral Tablet [Methitest] require prior authorization?
11.1% of Part D formularies require prior authorization for methyltestosterone 10 MG Oral Tablet [Methitest]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on methyltestosterone 10 MG Oral Tablet [Methitest]?
In 2023, total Medicare Part D spending on methyltestosterone 10 MG Oral Tablet [Methitest] was $390,812, covering 20 beneficiaries. The average spend per beneficiary was $19,540.61.
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
- nitisinone 10 MG Oral Tablet [Nityr] T4.7
- buspirone hydrochloride 15 MG Oral Capsule [Bucapsol] T4.7
- lonafarnib 50 MG Oral Capsule [Zokinvy] T4.7
- amifampridine 10 MG Oral Tablet [Firdapse] T4.7
- 0.1 ML adalimumab-adaz 100 MG/ML Prefilled Syringe T4.7
- 0.2 ML adalimumab-adaz 100 MG/ML Prefilled Syringe T4.7