Medicare Part D coverage · montelukast · RxCUI 351246
montelukast 4 MG Oral Granules
Per the CMS 2026 Part D formulary file, montelukast 4 MG Oral Granules is covered by 4,682 Medicare Part D plans (92.7% of enrollable products), averaging Tier 2.8, with prior authorization required on 0% of covering formularies.
- 92.7%
- Plan coverage
- 4,682
- Plans covering
- T2.8
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for montelukast 4 MG Oral Granules
Per the CMS 2026 Part D formulary file, montelukast 4 MG Oral Granules (RxNorm concept RXCUI 351246, generic name montelukast) appears on 236 distinct formulary files spanning 4,682 Medicare Part D plan offerings - 92.7% 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 montelukast 4 MG Oral Granules depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 18.6% 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 Oral Granules 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 Oral Granules today.
Coverage Details
- Formularies covering
- 236
- Plans covering
- 4,682
- Coverage rate
- 92.7%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 18.6% of formularies
2023 Medicare Spending
- Beneficiaries
- 3,063,882
- Total spending
- $190,737,848
- Avg per beneficiary
- $62.25
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering montelukast 4 MG Oral Granules
100 Medicare Advantage plans with Part D drug coverage include this drug.
Show the next 30 plans
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | No | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | No | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | No | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | No | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | No | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | No | $0 | NY |
| 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 |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | No | $0 | MI |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| 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 |
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare OF NEW Jersey, Inc. | T1 | No | $0 | NJ |
| 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 |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T1 | No | $0 | MS |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $0 | PA |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is montelukast 4 MG Oral Granules covered by Medicare Part D?
Yes, montelukast 4 MG Oral Granules is covered by 4,682 Medicare Part D plans (92.7% of all Part D formularies).
What tier is montelukast 4 MG Oral Granules on Medicare Part D plans?
montelukast 4 MG Oral Granules averages Tier 2.8 across Part D plans, ranging from Tier 1 to Tier 4.
Does montelukast 4 MG Oral Granules require prior authorization?
0% of Part D formularies require prior authorization for montelukast 4 MG Oral Granules. Step therapy: 0%. Quantity limits: 18.6%.
How much does Medicare spend on montelukast 4 MG Oral Granules?
In 2023, total Medicare Part D spending on montelukast 4 MG Oral Granules 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
- fosfomycin 3000 MG Granules for Oral Solution T2.8
- hydrocortisone 1.67 MG/ML Enema T2.8
- pilocarpine hydrochloride 7.5 MG Oral Tablet T2.8
- colestipol hydrochloride 5000 MG Granules for Oral Suspension T2.8
- timolol 0.0025 MG/MG Ophthalmic Gel T2.8
- 1000 ML glucose 50 MG/ML / potassium chloride 0.02 MEQ/ML Injection T2.8
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