Medicare Part D coverage · mifepristone · RxCUI 1245268
mifepristone 300 MG Oral Tablet [Korlym]
Per the CMS 2026 Part D formulary file, mifepristone 300 MG Oral Tablet [Korlym] is covered by 153 Medicare Part D plans (3% of enrollable products), averaging Tier 4, with prior authorization required on 100% of covering formularies.
- 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
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 |
Show the next 30 plans
Showing top 50 of 100 plans.
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.
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
- dihydroergotamine mesylate 0.5 MG/ACTUAT Metered Dose Nasal Spray T4
- 0.5 ML darbepoetin alfa 0.2 MG/ML Prefilled Syringe [Aranesp] T4
- amoxicillin 250 MG / omeprazole 10 MG / rifabutin 12.5 MG Delayed Release Oral Capsule [Talicia] T4
- timolol hemihydrate 5 MG/ML Ophthalmic Solution [Betimol] T4
- deflazacort 18 MG Oral Tablet [Jaythari] T4
- bepotastine besilate 15 MG/ML Ophthalmic Solution [Bepreve] T4
Similar prior-authorization rate
- azathioprine 50 MG Oral Tablet 100% PA
- 0.5 ML hepatitis B surface antigen vaccine 0.04 MG/ML Prefilled Syringe [Heplisav-B] 100% PA
- 0.5 ML hepatitis B surface antigen vaccine 0.02 MG/ML Prefilled Syringe [Engerix-B] 100% PA
- 1 ML hepatitis B surface antigen vaccine 0.02 MG/ML Prefilled Syringe [Engerix-B] 100% PA
- sotagliflozin 200 MG Oral Tablet [Inpefa] 100% PA
- mycophenolate mofetil 250 MG Oral Capsule 100% PA