montelukast 4 MG Oral Granules

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montelukast

RxCUI: 351246

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.
92.7%
Plan Coverage
4,696
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 237 distinct formulary files spanning 4,696 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 $190,742,362 and an average per-beneficiary annual cost of $62.26. 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
237
Plans covering
4,696
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
$190,742,362
Avg per beneficiary
$62.26

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering montelukast 4 MG Oral Granules

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
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T1 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T1 No $0 NV
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T1 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T1 No $0 UT
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T1 No $0 NV
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T1 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T1 No $0 CO
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T1 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T1 No $0 CO
Select Health Medicare Flex (HMO) SELECTHEALTH, INC. T1 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T1 No $0 CO
Select Health Medicare Active (HMO) SELECTHEALTH, INC. T1 No $0 CO
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T1 No $0 NV
Select Health Medicare Wellness (HMO) SELECTHEALTH, INC. T1 No $0 NV
Florida Complete Care-Duals VIP (HMO-POS D-SNP) HPMP OF FLORIDA, INC. T1 No $0 FL
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
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

Frequently Asked Questions

Is montelukast 4 MG Oral Granules covered by Medicare Part D?

Yes, montelukast 4 MG Oral Granules is covered by 4,696 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 $190,742,362, covering 3,063,882 beneficiaries. The average spend per beneficiary was $62.26.

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