Medicare Part D coverage · montelukast · RxCUI 311759
montelukast 4 MG Chewable Tablet
Per the CMS 2026 Part D formulary file, montelukast 4 MG Chewable Tablet is covered by 5,051 Medicare Part D plans (100% of enrollable products), averaging Tier 1.6, with prior authorization required on 0% of covering formularies.
- 100%
- Plan coverage
- 5,051
- Plans covering
- T1.6
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for montelukast 4 MG Chewable Tablet
Per the CMS 2026 Part D formulary file, montelukast 4 MG Chewable Tablet (RxNorm concept RXCUI 311759, generic name montelukast) appears on 327 distinct formulary files spanning 5,051 Medicare Part D plan offerings - 100% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 1.6.
Real-world access to montelukast 4 MG Chewable Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 16.8% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 3,063,882 Part D beneficiaries filled montelukast 4 MG Chewable Tablet in 2023, with total plan-and-beneficiary spending of $190,737,848 and an average per-beneficiary annual cost of $62.25. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry montelukast 4 MG Chewable Tablet today.
Coverage Details
- Formularies covering
- 327
- Plans covering
- 5,051
- Coverage rate
- 100%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 16.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 3,063,882
- Total spending
- $190,737,848
- Avg per beneficiary
- $62.25
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering montelukast 4 MG Chewable Tablet
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T1 | No | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T1 | No | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering montelukast 4 MG Chewable Tablet
98 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| UHC Dual Complete IA-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | IA |
| UHC Dual Complete MO-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | MO |
| UHC Dual Complete NE-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | NE |
| UHC Dual Complete KS-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | KS |
| UHC Dual Complete MO-S3 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | MO |
| UHC Dual Complete KS-Q1 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T1 | No | $0 | KS |
| UHC Dual Complete TN-S001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T1 | No | $0 | TN |
| UHC Dual Complete TN-Y001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T1 | No | $0 | TN |
| UHC Dual Complete TN-Y2 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T1 | No | $0 | TN |
| AARP Medicare Advantage from UHC MI-0001 (PPO) | Unitedhealthcare Insurance Company | T1 | No | $0 | MI |
| UHC Dual Complete NM-Y1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T1 | No | $0 | NM |
| UHC Dual Complete NM-S1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T1 | No | $0 | NM |
| UHC Dual Complete NM-V1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T1 | No | $0 | NM |
| UHC Dual Complete AZ-S001 (HMO-POS D-SNP) | Arizona Physicians IPA, Inc. | T1 | No | $0 | AZ |
| UHC Dual Complete AZ-Y001 (HMO-POS D-SNP) | Arizona Physicians IPA, Inc. | T1 | No | $0 | AZ |
| UHC Dual Complete VA-Y4 (PPO D-SNP) | Care Improvement Plus South Central Insurance Co. | T1 | No | $0 | VA |
| AARP Medicare Advantage from UHC AL-0001 (HMO-POS) | Unitedhealthcare OF THE Midlands, Inc. | T1 | No | $0 | AL |
| AARP Medicare Advantage from UHC CA-0002 (HMO-POS) | UHC OF California | T1 | No | $0 | CA |
| UHC Sharp Medicare Advantage CA-001P (HMO-POS) | UHC OF California | T1 | No | $0 | CA |
| AARP Medicare Advantage from UHC CA-003P (HMO-POS) | UHC OF California | T1 | No | $0 | CA |
Show the next 30 plans
Showing top 50 of 98 plans.
Frequently Asked Questions
Is montelukast 4 MG Chewable Tablet covered by Medicare Part D?
Yes, montelukast 4 MG Chewable Tablet is covered by 5,051 Medicare Part D plans (100% of all Part D formularies).
What tier is montelukast 4 MG Chewable Tablet on Medicare Part D plans?
montelukast 4 MG Chewable Tablet averages Tier 1.6 across Part D plans, ranging from Tier 1 to Tier 4.
Does montelukast 4 MG Chewable Tablet require prior authorization?
0% of Part D formularies require prior authorization for montelukast 4 MG Chewable Tablet. Step therapy: 0%. Quantity limits: 16.8%.
How much does Medicare spend on montelukast 4 MG Chewable Tablet?
In 2023, total Medicare Part D spending on montelukast 4 MG Chewable Tablet was $190,737,848, covering 3,063,882 beneficiaries. The average spend per beneficiary was $62.25.
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
- clindamycin 150 MG Oral Capsule T1.6
- cromolyn sodium 40 MG/ML Ophthalmic Solution T1.6
- propranolol hydrochloride 60 MG Oral Tablet T1.6
- clindamycin 75 MG Oral Capsule T1.6
- polyethylene glycol 3350 240000 MG / potassium chloride 2980 MG / sodium bicarbonate 6720 MG / sodium chloride 5840 MG / sodium sulfate 22720 MG Powder for Oral Solution [GaviLyte-C] T1.6
- furosemide 8 MG/ML Oral Solution T1.6
Similar prior-authorization rate
- metronidazole 10 MG/ML Topical Cream [Noritate] 0% PA
- 24 HR minocycline 40 MG Extended Release Oral Capsule [Emrosi] 0% PA
- buspirone hydrochloride 10 MG Oral Capsule [Bucapsol] 0% PA
- diflunisal 375 MG Oral Tablet [Dolobid] 0% PA
- hydrocortisone 1 MG/ML Oral Solution [Khindivi] 0% PA
- indomethacin 50 MG Rectal Suppository [Indocin] 0% PA