mycophenolate mofetil 500 MG Oral Tablet [Cellcept]
mycophenolate mofetil
RxCUI: 616435
What the CMS Formulary Data Shows for mycophenolate mofetil 500 MG Oral Tablet [Cellcept]
Per the CMS 2026 Part D formulary file, mycophenolate mofetil 500 MG Oral Tablet [Cellcept] (RxNorm concept RXCUI 616435, generic name mycophenolate mofetil) appears on 6 distinct formulary files spanning 98 Medicare Part D plan offerings - 1.9% 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 3.7.
Real-world access to mycophenolate mofetil 500 MG Oral Tablet [Cellcept] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 105,503 Part D beneficiaries filled mycophenolate mofetil 500 MG Oral Tablet [Cellcept] in 2023, with total plan-and-beneficiary spending of $66,976,289 and an average per-beneficiary annual cost of $634.83. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry mycophenolate mofetil 500 MG Oral Tablet [Cellcept] today.
Coverage Details
- Formularies covering
- 6
- Plans covering
- 98
- Coverage rate
- 1.9%
- 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
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 105,503
- Total spending
- $66,976,289
- Avg per beneficiary
- $634.83
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering mycophenolate mofetil 500 MG Oral Tablet [Cellcept]
98 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 |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T1 | Yes | $0 | CA |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | Yes | $34.50 | NY |
| Medicare BlueEssential (PPO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Medicare BlueActive (PPO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Medicare BlueVital (PPO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Univera SeniorChoice Basic (HMO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Univera SeniorChoice Extra (HMO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Medicare Blue Choice Core (HMO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Univera Medicare Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T5 | Yes | $0 | NY |
| Medicare Blue Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T5 | Yes | $0 | NY |
| CDPHP $0 Medicare Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| SCAN Connections (HMO D-SNP) | SCAN HEALTH PLAN | T5 | Yes | $0 | CA |
| SCAN Connections at Home (HMO D-SNP) | SCAN HEALTH PLAN | T5 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN NEVADA, INC. | T5 | Yes | $0 | NV |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN NEVADA, INC. | T5 | Yes | $0 | NV |
| SCAN Strive (HMO C-SNP) | SCAN HEALTH PLAN NEVADA, INC. | T5 | Yes | $0 | NV |
| SCAN MyChoice (HMO) | SCAN HEALTH PLAN NEVADA, INC. | T5 | Yes | $0 | NV |
| SCAN Classic (HMO) | SCAN DESERT HEALTH PLAN, INC. | T5 | Yes | $0 | AZ |
| SCAN Balance (HMO C-SNP) | SCAN DESERT HEALTH PLAN, INC. | T5 | Yes | $0 | AZ |
| SCAN Embrace (HMO-POS I-SNP) | SCAN DESERT HEALTH PLAN, INC. | T5 | Yes | $0 | AZ |
| SCAN Strive (HMO C-SNP) | SCAN DESERT HEALTH PLAN, INC. | T5 | Yes | $0 | AZ |
| SCAN MyChoice (HMO) | SCAN DESERT HEALTH PLAN, INC. | T5 | Yes | $0 | AZ |
| SCAN Classic WA (HMO) | SCAN HEALTH PLAN (WA) | T5 | Yes | $0 | WA |
| SCAN MyChoice WA (HMO) | SCAN HEALTH PLAN (WA) | T5 | Yes | $0 | WA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN (NM) | T5 | Yes | $0 | NM |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN (NM) | T5 | Yes | $0 | NM |
| SCAN Strive (HMO C-SNP) | SCAN HEALTH PLAN (NM) | T5 | Yes | $0 | NM |
| SCAN MyChoice (HMO) | SCAN HEALTH PLAN (NM) | T5 | Yes | $0 | NM |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T5 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T5 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T5 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T5 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T5 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T5 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T5 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T5 | Yes | $0 | CA |
| SCAN Prime (HMO) | SCAN HEALTH PLAN | T5 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T5 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T5 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T5 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T5 | Yes | $0 | CA |
| SCAN Alta (HMO) | SCAN HEALTH PLAN | T5 | Yes | $0 | CA |
| SCAN Venture (HMO) | SCAN HEALTH PLAN | T5 | Yes | $0 | CA |
| SCAN Venture (HMO) | SCAN HEALTH PLAN | T5 | Yes | $0 | CA |
| SCAN Embrace (HMO I-SNP) | SCAN HEALTH PLAN | T5 | Yes | $0 | CA |
| SCAN Embrace (HMO I-SNP) | SCAN HEALTH PLAN | T5 | Yes | $0 | CA |
| SCAN Embrace (HMO-POS I-SNP) | SCAN HEALTH PLAN | T5 | Yes | $0 | CA |
| SCAN Affirm partnered with Included LGBTQ+ Health (HMO) | SCAN HEALTH PLAN | T5 | Yes | $0 | CA |
| SCAN Affirm partnered with Included LGBTQ+ Health (HMO) | SCAN HEALTH PLAN | T5 | Yes | $0 | CA |
Frequently Asked Questions
Is mycophenolate mofetil 500 MG Oral Tablet [Cellcept] covered by Medicare Part D?
Yes, mycophenolate mofetil 500 MG Oral Tablet [Cellcept] is covered by 98 Medicare Part D plans (1.9% of all Part D formularies).
What tier is mycophenolate mofetil 500 MG Oral Tablet [Cellcept] on Medicare Part D plans?
mycophenolate mofetil 500 MG Oral Tablet [Cellcept] averages Tier 3.7 across Part D plans, ranging from Tier 1 to Tier 5.
Does mycophenolate mofetil 500 MG Oral Tablet [Cellcept] require prior authorization?
100% of Part D formularies require prior authorization for mycophenolate mofetil 500 MG Oral Tablet [Cellcept]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on mycophenolate mofetil 500 MG Oral Tablet [Cellcept]?
In 2023, total Medicare Part D spending on mycophenolate mofetil 500 MG Oral Tablet [Cellcept] was $66,976,289, covering 105,503 beneficiaries. The average spend per beneficiary was $634.83.
Read our methodology - how this data is sourced, computed, and verified.