mycophenolate mofetil 200 MG/ML Oral Suspension [Cellcept]

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mycophenolate mofetil

RxCUI: 616444

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.
1.6%
Plan Coverage
83
Plans Covering
T3
Avg Tier
100%
Prior Auth Required

What the CMS Formulary Data Shows for mycophenolate mofetil 200 MG/ML Oral Suspension [Cellcept]

Per the CMS 2026 Part D formulary file, mycophenolate mofetil 200 MG/ML Oral Suspension [Cellcept] (RxNorm concept RXCUI 616444, generic name mycophenolate mofetil) appears on 4 distinct formulary files spanning 83 Medicare Part D plan offerings - 1.6% 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.

Real-world access to mycophenolate mofetil 200 MG/ML Oral Suspension [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 200 MG/ML Oral Suspension [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 200 MG/ML Oral Suspension [Cellcept] today.

Coverage Details

Formularies covering
4
Plans covering
83
Coverage rate
1.6%
Tier range
Tier 1 – Tier 5
Average tier
Tier 3, Preferred Brand

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

3 plans
Tier 1, Preferred Generic
80 plans
Tier 5, Specialty

Medicare Advantage Plans (MA-PD) Covering mycophenolate mofetil 200 MG/ML Oral Suspension [Cellcept]

83 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
Óptimo Plus (PPO) TRIPLE S ADVANTAGE, INC. T5 Yes $0 PR
Contigo Plus (HMO C-SNP) TRIPLE S ADVANTAGE, INC. T5 Yes $0 PR
Brillante (HMO-POS) TRIPLE S ADVANTAGE, INC. T5 Yes $0 PR
Enlace Plus (HMO) TRIPLE S ADVANTAGE, INC. T5 Yes $0 PR
ContigoEnMente (HMO C-SNP) TRIPLE S ADVANTAGE, INC. T5 Yes $0 PR
Ahorro Plus (HMO) TRIPLE S ADVANTAGE, INC. T5 Yes $0 PR
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
SCAN Strive (HMO C-SNP) SCAN HEALTH PLAN T5 Yes $0 CA
SCAN Strive (HMO C-SNP) SCAN HEALTH PLAN T5 Yes $0 CA
SCAN Inspired by women for women (HMO) SCAN HEALTH PLAN T5 Yes $0 CA

Frequently Asked Questions

Is mycophenolate mofetil 200 MG/ML Oral Suspension [Cellcept] covered by Medicare Part D?

Yes, mycophenolate mofetil 200 MG/ML Oral Suspension [Cellcept] is covered by 83 Medicare Part D plans (1.6% of all Part D formularies).

What tier is mycophenolate mofetil 200 MG/ML Oral Suspension [Cellcept] on Medicare Part D plans?

mycophenolate mofetil 200 MG/ML Oral Suspension [Cellcept] averages Tier 3 across Part D plans, ranging from Tier 1 to Tier 5.

Does mycophenolate mofetil 200 MG/ML Oral Suspension [Cellcept] require prior authorization?

100% of Part D formularies require prior authorization for mycophenolate mofetil 200 MG/ML Oral Suspension [Cellcept]. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on mycophenolate mofetil 200 MG/ML Oral Suspension [Cellcept]?

In 2023, total Medicare Part D spending on mycophenolate mofetil 200 MG/ML Oral Suspension [Cellcept] was $66,976,289, covering 105,503 beneficiaries. The average spend per beneficiary was $634.83.

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