Medicare Part D coverage · methyltestosterone · RxCUI 197975
methyltestosterone 10 MG Oral Capsule
Per the CMS 2026 Part D formulary file, methyltestosterone 10 MG Oral Capsule is covered by 1,024 Medicare Part D plans (20.3% of enrollable products), averaging Tier 4.2, with prior authorization required on 56.1% of covering formularies.
- 20.3%
- Plan coverage
- 1,024
- Plans covering
- T4.2
- Avg tier
- 56.1%
- Prior auth required
What the CMS Formulary Data Shows for methyltestosterone 10 MG Oral Capsule
Per the CMS 2026 Part D formulary file, methyltestosterone 10 MG Oral Capsule (RxNorm concept RXCUI 197975, generic name methyltestosterone) appears on 41 distinct formulary files spanning 1,024 Medicare Part D plan offerings - 20.3% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.2.
Real-world access to methyltestosterone 10 MG Oral Capsule depends on utilization management as much as tier placement: 56.1% 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 Capsule 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 Capsule today.
Coverage Details
- Formularies covering
- 41
- Plans covering
- 1,024
- Coverage rate
- 20.3%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 56.1% 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 Capsule
100 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 | Yes | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | Yes | $0 | CA |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | Yes | $0 | CA |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Hamaspik Medicare Select (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $34.50 | NY |
| Freedom VIP Care (HMO C-SNP) | Freedom Health, Inc. | T4 | No | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | Freedom Health, Inc. | T4 | No | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | Freedom Health, Inc. | T4 | No | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | Freedom Health, Inc. | T4 | No | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | Freedom Health, Inc. | T4 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | Optimum Healthcare, Inc. | T4 | No | $0 | FL |
| Optimum Diamond Savings (HMO C-SNP) | Optimum Healthcare, Inc. | T4 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | Optimum Healthcare, Inc. | T4 | No | $0 | FL |
| Optimum Diamond (HMO C-SNP) | Optimum Healthcare, Inc. | T4 | No | $0 | FL |
| Freedom Medi-Medi Partial (HMO D-SNP) | Freedom Health, Inc. | T4 | No | $0 | FL |
| Freedom Medi-Medi Full (HMO D-SNP) | Freedom Health, Inc. | T4 | No | $0 | FL |
| Optimum Emerald Partial (HMO D-SNP) | Optimum Healthcare, Inc. | T4 | No | $0 | FL |
Show the next 30 plans
| Optimum Emerald Full (HMO D-SNP) | Optimum Healthcare, Inc. | T4 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | Freedom Health, Inc. | T4 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | Freedom Health, Inc. | T4 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | Freedom Health, Inc. | T4 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | Freedom Health, Inc. | T4 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T4 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T4 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T4 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T4 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T4 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T4 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T4 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T4 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T4 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T4 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T4 | No | $0 | FL |
| Freedom Máximo (HMO-POS) | Freedom Health, Inc. | T4 | No | $0 | FL |
| Freedom Máximo (HMO-POS) | Freedom Health, Inc. | T4 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T4 | No | $0 | FL |
| Optimum Platinum Plan (HMO) | Optimum Healthcare, Inc. | T4 | No | $0 | FL |
| Optimum Gold Plan (HMO) | Optimum Healthcare, Inc. | T4 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T4 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T4 | No | $0 | FL |
| Optimum Diamond Rewards COPD (HMO C-SNP) | Optimum Healthcare, Inc. | T4 | No | $0 | FL |
| Optimum Diamond Savings COPD (HMO C-SNP) | Optimum Healthcare, Inc. | T4 | No | $0 | FL |
| Optimum Gold Plus Plan (HMO) | Optimum Healthcare, Inc. | T4 | No | $0 | FL |
| Optimum Diamond Rewards COPD (HMO C-SNP) | Optimum Healthcare, Inc. | T4 | No | $0 | FL |
| 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 |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is methyltestosterone 10 MG Oral Capsule covered by Medicare Part D?
Yes, methyltestosterone 10 MG Oral Capsule is covered by 1,024 Medicare Part D plans (20.3% of all Part D formularies).
What tier is methyltestosterone 10 MG Oral Capsule on Medicare Part D plans?
methyltestosterone 10 MG Oral Capsule averages Tier 4.2 across Part D plans, ranging from Tier 1 to Tier 5.
Does methyltestosterone 10 MG Oral Capsule require prior authorization?
56.1% of Part D formularies require prior authorization for methyltestosterone 10 MG Oral Capsule. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on methyltestosterone 10 MG Oral Capsule?
In 2023, total Medicare Part D spending on methyltestosterone 10 MG Oral Capsule 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
- 0.5 ML peginterferon alfa-2a 0.36 MG/ML Prefilled Syringe [Pegasys] T4.2
- 1 ML etanercept 50 MG/ML Prefilled Syringe [Enbrel] T4.2
- 12 HR fostemsavir 600 MG Extended Release Oral Tablet [Rukobia] T4.2
- {14 (venetoclax 10 MG Oral Tablet [Venclexta]) / 21 (venetoclax 100 MG Oral Tablet [Venclexta]) / 7 (venetoclax 50 MG Oral Tablet [Venclexta]) } Pack [Venclexta Starting Pack] T4.2
- 1.5 ML elapegademase-lvlr 1.6 MG/ML Injection [Revcovi] T4.2
- {16 (tovorafenib 100 MG Oral Tablet [Ojemda]) } Pack [Ojemda 400 MG Once Weekly Carton] T4.2
Similar prior-authorization rate
- bempedoic acid 180 MG / ezetimibe 10 MG Oral Tablet [Nexlizet] 56% PA
- eluxadoline 75 MG Oral Tablet [Viberzi] 55.9% PA
- lidocaine 25 MG/ML / prilocaine 25 MG/ML Topical Cream 56.4% PA
- promethazine hydrochloride 1.25 MG/ML Oral Solution 56.4% PA
- {21 (memantine hydrochloride 10 MG Oral Tablet) / 28 (memantine hydrochloride 5 MG Oral Tablet) } Pack 56.5% PA
- hydroxyzine hydrochloride 25 MG Oral Tablet 56.7% PA