mometasone furoate 0.05 MG/ACTUAT Metered Dose Nasal Spray

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mometasone furoate

RxCUI: 1797865

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.
82.8%
Plan Coverage
4,195
Plans Covering
T2.8
Avg Tier
0.5%
Prior Auth Required

What the CMS Formulary Data Shows for mometasone furoate 0.05 MG/ACTUAT Metered Dose Nasal Spray

Per the CMS 2026 Part D formulary file, mometasone furoate 0.05 MG/ACTUAT Metered Dose Nasal Spray (RxNorm concept RXCUI 1797865, generic name mometasone furoate) appears on 217 distinct formulary files spanning 4,195 Medicare Part D plan offerings - 82.8% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.8.

Real-world access to mometasone furoate 0.05 MG/ACTUAT Metered Dose Nasal Spray depends on utilization management as much as tier placement: 0.5% of covering formularies require prior authorization. 1.4% require step therapy. 85.7% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 490,025 Part D beneficiaries filled mometasone furoate 0.05 MG/ACTUAT Metered Dose Nasal Spray in 2023, with total plan-and-beneficiary spending of $54,728,321 and an average per-beneficiary annual cost of $111.68. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry mometasone furoate 0.05 MG/ACTUAT Metered Dose Nasal Spray today.

Coverage Details

Formularies covering
217
Plans covering
4,195
Coverage rate
82.8%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
0.5% of formularies
Step therapy required
1.4% of formularies
Quantity limits
85.7% of formularies

2023 Medicare Spending

Beneficiaries
490,025
Total spending
$54,728,321
Avg per beneficiary
$111.68

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering mometasone furoate 0.05 MG/ACTUAT Metered Dose Nasal Spray

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Sentara Community Complete Select (HMO D-SNP) SENTARA HEALTH PLANS T1 No $0 VA
Sentara Community Complete (HMO D-SNP) SENTARA HEALTH PLANS T1 No $0 VA
Wellpoint Medicare Advantage (HMO-POS) WELLPOINT WEST VIRGINIA , INC. T1 No $0 WV
Anthem Medicare Advantage 3 (HMO-POS) HealthKeepers, Inc. T1 No $0 VA
Anthem Medicare Advantage 3 (HMO-POS) HealthKeepers, Inc. T1 No $0 VA
Anthem Medicare Advantage 3 (HMO-POS) HealthKeepers, Inc. T1 No $0 VA
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TENNESSEE, INC. T1 No $0 TN
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TENNESSEE, INC. T1 No $0 TN
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TENNESSEE, INC. T1 No $0 TN
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TENNESSEE, INC. T1 No $0 TN
ElderServe MAP (HMO D-SNP) ELDERSERVE HEALTH, INC. T1 No $0 NY
Cooperative Advantage (HMO D-SNP) GROUP HEALTH COOPERATIVE OF EAU CLAIRE T1 No $0 WI
Longevity Health Plan (PPO I-SNP) LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP T1 No $0 NJ
Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) UPPER PENINSULA HEALTH PLAN, LLC T1 No $0 MI
CareSource Dual Advantage (HMO D-SNP) CARESOURCE GEORGIA CO. T1 No $0 GA
HAP CareSource MI Coordinated Health (HMO D-SNP) HAP CARESOURCE T1 No $0 MI
Gold Coast Health Plan Total Care Advantage (HMO D-SNP) Ventura County Medi-Cal Managed Care Commission T1 No $0 CA
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) Health Care Service Corporation T1 No $0 NM
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) Health Care Service Corporation T1 No $0 NM
SecureBlue (HMO D-SNP) HMO Minnesota T1 No $0 MN
NaviCare (HMO D-SNP) FALLON COMMUNITY HEALTH PLAN T1 No $0 MA
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 No $0 NY
SeniorCare Complete (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 No $0 MN
AbilityCare (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 No $0 MN
Alameda Alliance Wellness (HMO D-SNP) ALAMEDA ALLIANCE FOR HEALTH T1 No $0 CA
PHP (HMO C-SNP) AIDS HEALTHCARE FOUNDATION T1 No $0 CA
Elevate Medicare Choice (HMO D-SNP) DENVER HEALTH MEDICAL PLAN, INC. T1 No $0 CO
AllCare Advantage Redwood Rx (HMO D-SNP) ALLCARE HEALTH PLAN, INC. T1 No $0 OR
PrimeWest Senior Health Complete (HMO D-SNP) PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE T1 No $0 MN
Prime Health Complete (HMO D-SNP) PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE T1 No $0 MN
DualConnect (HMO D-SNP) SANTA CLARA COUNTY HEALTH AUTHORITY T1 No $0 CA
VNS Health Total (HMO D-SNP) VNS CHOICE T1 No $0 NY
Alterwood Advantage Dual Secure (HMO D-SNP) ALTERWOOD ADVANTAGE, INC. T1 No $0 MD
Nascentia Dual Advantage (HMO D-SNP) VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK T1 No $0 NY
Provider Partners Pennsylvania Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC T1 No $0 PA
Provider Partners North Carolina Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA T1 No $0 NC
Provider Partners Indiana Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF INDIANA T1 No $0 IN
Provider Partners Maryland Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN, INC. T1 No $0 MD
Provider Partners Missouri Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. T1 No $0 MO
Abilis Health Community (HMO I-SNP) SIGNATURE ADVANTAGE, LLC T1 No $0 KY, TN
Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) ARKANSAS SUPERIOR SELECT, INC. T1 No $0 AR
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
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 No $0 PA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 No $0 PA
Highmark Health Options Duals (HMO D-SNP) HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. T1 No $0 WV
Highmark Health Options Duals (HMO D-SNP) HIGHMARK BCBSD, INC. T1 No $0 DE
Tufts Health One Care (HMO D-SNP) TUFTS HEALTH PUBLIC PLANS, INC. T1 No $0 MA
Tufts Health One Care CW (HMO D-SNP) TUFTS HEALTH PUBLIC PLANS, INC. T1 No $0 MA
Tufts Health Plan Senior Care Options (HMO D-SNP) TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION T1 No $0 MA

Frequently Asked Questions

Is mometasone furoate 0.05 MG/ACTUAT Metered Dose Nasal Spray covered by Medicare Part D?

Yes, mometasone furoate 0.05 MG/ACTUAT Metered Dose Nasal Spray is covered by 4,195 Medicare Part D plans (82.8% of all Part D formularies).

What tier is mometasone furoate 0.05 MG/ACTUAT Metered Dose Nasal Spray on Medicare Part D plans?

mometasone furoate 0.05 MG/ACTUAT Metered Dose Nasal Spray averages Tier 2.8 across Part D plans, ranging from Tier 1 to Tier 4.

Does mometasone furoate 0.05 MG/ACTUAT Metered Dose Nasal Spray require prior authorization?

0.5% of Part D formularies require prior authorization for mometasone furoate 0.05 MG/ACTUAT Metered Dose Nasal Spray. Step therapy: 1.4%. Quantity limits: 85.7%.

How much does Medicare spend on mometasone furoate 0.05 MG/ACTUAT Metered Dose Nasal Spray?

In 2023, total Medicare Part D spending on mometasone furoate 0.05 MG/ACTUAT Metered Dose Nasal Spray was $54,728,321, covering 490,025 beneficiaries. The average spend per beneficiary was $111.68.

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