mifepristone 300 MG Oral Tablet [Korlym]

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mifepristone

RxCUI: 1245268

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.
3%
Plan Coverage
153
Plans Covering
T4
Avg Tier
100%
Prior Auth Required

What the CMS Formulary Data Shows for mifepristone 300 MG Oral Tablet [Korlym]

Per the CMS 2026 Part D formulary file, mifepristone 300 MG Oral Tablet [Korlym] (RxNorm concept RXCUI 1245268, generic name mifepristone) appears on 8 distinct formulary files spanning 153 Medicare Part D plan offerings - 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.

Real-world access to mifepristone 300 MG Oral Tablet [Korlym] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 75% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,059 Part D beneficiaries filled mifepristone 300 MG Oral Tablet [Korlym] in 2023, with total plan-and-beneficiary spending of $228,814,734 and an average per-beneficiary annual cost of $216,066.79. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry mifepristone 300 MG Oral Tablet [Korlym] today.

Coverage Details

Formularies covering
8
Plans covering
153
Coverage rate
3%
Tier range
Tier 1 – Tier 5
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
100% of formularies
Step therapy required
0% of formularies
Quantity limits
75% of formularies

2023 Medicare Spending

Beneficiaries
1,059
Total spending
$228,814,734
Avg per beneficiary
$216,066.79

Tier Distribution Across Plans

6 plans
Tier 1, Preferred Generic
94 plans
Tier 5, Specialty

Medicare Advantage Plans (MA-PD) Covering mifepristone 300 MG Oral Tablet [Korlym]

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
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
Hamaspik Medicare Select (HMO D-SNP) HAMASPIK, INC. T1 Yes $34.50 NY
MCS Classicare RxMax (HMO) MCS ADVANTAGE, INC. T5 Yes $0 PR
MCS Classicare Platino Ideal (HMO D-SNP) MCS ADVANTAGE, INC. T5 Yes $0 PR
MCS Classicare Efectivo (HMO) MCS ADVANTAGE, INC. T5 Yes $0 PR
MCS Classicare Essential (HMO-POS) MCS ADVANTAGE, INC. T5 Yes $0 PR
MCS Classicare Platino Progreso (HMO D-SNP) MCS ADVANTAGE, INC. T5 Yes $0 PR
MCS Classicare Primero (HMO C-SNP) MCS ADVANTAGE, INC. T5 Yes $0 PR
MCS Classicare Firme (HMO) MCS ADVANTAGE, INC. T5 Yes $0 PR
MCS Classicare En Tu Hogar (HMO) MCS ADVANTAGE, INC. T5 Yes $0 PR
MCS Classicare Hero (HMO) MCS ADVANTAGE, INC. T5 Yes $0 PR
MCS Classicare Platino Total (HMO D-SNP) MCS ADVANTAGE, INC. T5 Yes $0 PR
MCS Classicare InteliCare (HMO) MCS ADVANTAGE, INC. T5 Yes $0 PR
MCS Classicare Platino Maximo (HMO D-SNP) MCS ADVANTAGE, INC. T5 Yes $0 PR
MCS Classicare Excede (HMO) MCS ADVANTAGE, INC. T5 Yes $0 PR
MCS Classicare Estrella (HMO) MCS ADVANTAGE, INC. T5 Yes $0 PR
MCS Classicare Platino Superior (HMO D-SNP) MCS ADVANTAGE, INC. T5 Yes $0 PR
MCS Classicare Platino 185 (HMO D-SNP) MCS ADVANTAGE, INC. T5 Yes $0 PR
Health First Rewards H1099-014 (HMO) HEALTH FIRST HEALTH PLANS T5 Yes $0 FL
Health First SunSaver H1099-016 (HMO) HEALTH FIRST HEALTH PLANS T5 Yes $0 FL
Health First Complete Care H1099-023 (HMO) HEALTH FIRST HEALTH PLANS T5 Yes $0 FL
Health First Emerald Plus H1099-024 (HMO) HEALTH FIRST HEALTH PLANS T5 Yes $0 FL
Health First Premier Access H1099-025 (HMO-POS) HEALTH FIRST HEALTH PLANS T5 Yes $0 FL
Health First Emerald Plus H1099-026 (HMO) HEALTH FIRST HEALTH PLANS T5 Yes $0 FL
Health First Premier Access H1099-027 (HMO-POS) HEALTH FIRST HEALTH PLANS T5 Yes $0 FL
Health First Emerald Plus H1099-028 (HMO) HEALTH FIRST HEALTH PLANS T5 Yes $0 FL
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO) KAISER FOUNDATION HP, INC. T5 Yes $0 CA
Kaiser Permanente Senior Advantage Enhanced Solano (HMO) KAISER FOUNDATION HP, INC. T5 Yes $0 CA
Kaiser Permanente Senior Advantage Inland Empire (HMO) KAISER FOUNDATION HP, INC. T5 Yes $0 CA
Kaiser Permanente Sr Adv Enhanced Marin San Mateo (HMO) KAISER FOUNDATION HP, INC. T5 Yes $0 CA
Kaiser Permanente Senior Advantage Ventura (HMO) KAISER FOUNDATION HP, INC. T5 Yes $0 CA
Kaiser Permanente Senior Advantage Enhanced Kern (HMO) KAISER FOUNDATION HP, INC. T5 Yes $0 CA
Kaiser Permanente Senior Advantage Basic Kern (HMO) KAISER FOUNDATION HP, INC. T5 Yes $0 CA
Kaiser Permanente Senior Advantage San Diego (HMO) KAISER FOUNDATION HP, INC. T5 Yes $0 CA
Kaiser Permanente Sr Adv Enhanced Santa Clara (HMO) KAISER FOUNDATION HP, INC. T5 Yes $0 CA
Kaiser Permanente Senior Advantage Enhanced Stanis (HMO) KAISER FOUNDATION HP, INC. T5 Yes $0 CA
Kaiser Permanente Senior Advantage Basic Stanis (HMO) KAISER FOUNDATION HP, INC. T5 Yes $0 CA
Kaiser Permanente Senior Advantage Basic SnJoaq (HMO) KAISER FOUNDATION HP, INC. T5 Yes $0 CA
Kaiser Permanente Senior Advantage Basic Fresno (HMO) KAISER FOUNDATION HP, INC. T5 Yes $0 CA
Kaiser Permanente Sr Advantage Basic Sac., Sonoma (HMO) KAISER FOUNDATION HP, INC. T5 Yes $0 CA
Kaiser Permanente Senior Advantage Santa Cruz (HMO) KAISER FOUNDATION HP, INC. T5 Yes $0 CA
Kaiser Permanente Senior Advantage Basic Alameda (HMO) KAISER FOUNDATION HP, INC. T5 Yes $0 CA
Kaiser Permanente Senior Advantage Basic SF (HMO) KAISER FOUNDATION HP, INC. T5 Yes $0 CA
Kaiser Permanente Sr Adv Basic Contra Costa (HMO) KAISER FOUNDATION HP, INC. T5 Yes $0 CA
Kaiser Permanente Sr Adv Basic Santa Clara (HMO) KAISER FOUNDATION HP, INC. T5 Yes $0 CA
Kaiser Permanente Senior Advantage Basic Solano (HMO) KAISER FOUNDATION HP, INC. T5 Yes $0 CA

Frequently Asked Questions

Is mifepristone 300 MG Oral Tablet [Korlym] covered by Medicare Part D?

Yes, mifepristone 300 MG Oral Tablet [Korlym] is covered by 153 Medicare Part D plans (3% of all Part D formularies).

What tier is mifepristone 300 MG Oral Tablet [Korlym] on Medicare Part D plans?

mifepristone 300 MG Oral Tablet [Korlym] averages Tier 4 across Part D plans, ranging from Tier 1 to Tier 5.

Does mifepristone 300 MG Oral Tablet [Korlym] require prior authorization?

100% of Part D formularies require prior authorization for mifepristone 300 MG Oral Tablet [Korlym]. Step therapy: 0%. Quantity limits: 75%.

How much does Medicare spend on mifepristone 300 MG Oral Tablet [Korlym]?

In 2023, total Medicare Part D spending on mifepristone 300 MG Oral Tablet [Korlym] was $228,814,734, covering 1,059 beneficiaries. The average spend per beneficiary was $216,066.79.

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