Medicare Part D coverage · mycophenolate mofetil · RxCUI 616447
mycophenolate mofetil 250 MG Oral Capsule [Cellcept]
Per the CMS 2026 Part D formulary file, mycophenolate mofetil 250 MG Oral Capsule [Cellcept] is covered by 98 Medicare Part D plans (1.9% of enrollable products), averaging Tier 3.5, with prior authorization required on 100% of covering formularies.
- 1.9%
- Plan coverage
- 98
- Plans covering
- T3.5
- Avg tier
- 100%
- Prior auth required
What the CMS Formulary Data Shows for mycophenolate mofetil 250 MG Oral Capsule [Cellcept]
Per the CMS 2026 Part D formulary file, mycophenolate mofetil 250 MG Oral Capsule [Cellcept] (RxNorm concept RXCUI 616447, 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 3.5.
Real-world access to mycophenolate mofetil 250 MG Oral Capsule [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 250 MG Oral Capsule [Cellcept] in 2023, with total plan-and-beneficiary spending of $66,554,791 and an average per-beneficiary annual cost of $630.83. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry mycophenolate mofetil 250 MG Oral Capsule [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
- $66,554,791
- Avg per beneficiary
- $630.83
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering mycophenolate mofetil 250 MG Oral Capsule [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 |
| SCAN Connections (HMO D-SNP) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Connections at Home (HMO D-SNP) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | Scan Health Plan Nevada, Inc. | T4 | Yes | $0 | NV |
| SCAN Balance (HMO C-SNP) | Scan Health Plan Nevada, Inc. | T4 | Yes | $0 | NV |
| SCAN Strive (HMO C-SNP) | Scan Health Plan Nevada, Inc. | T4 | Yes | $0 | NV |
| SCAN MyChoice (HMO) | Scan Health Plan Nevada, Inc. | T4 | Yes | $0 | NV |
| SCAN Classic (HMO) | Scan Desert Health Plan, Inc. | T4 | Yes | $0 | AZ |
| SCAN Balance (HMO C-SNP) | Scan Desert Health Plan, Inc. | T4 | Yes | $0 | AZ |
| SCAN Embrace (HMO-POS I-SNP) | Scan Desert Health Plan, Inc. | T4 | Yes | $0 | AZ |
| SCAN Strive (HMO C-SNP) | Scan Desert Health Plan, Inc. | T4 | Yes | $0 | AZ |
| SCAN MyChoice (HMO) | Scan Desert Health Plan, Inc. | T4 | Yes | $0 | AZ |
| SCAN Classic WA (HMO) | Scan Health Plan (WA) | T4 | Yes | $0 | WA |
| SCAN MyChoice WA (HMO) | Scan Health Plan (WA) | T4 | Yes | $0 | WA |
| SCAN Classic (HMO) | Scan Health Plan (NM) | T4 | Yes | $0 | NM |
| SCAN Balance (HMO C-SNP) | Scan Health Plan (NM) | T4 | Yes | $0 | NM |
| SCAN Strive (HMO C-SNP) | Scan Health Plan (NM) | T4 | Yes | $0 | NM |
| SCAN MyChoice (HMO) | Scan Health Plan (NM) | T4 | Yes | $0 | NM |
Show the next 30 plans
| SCAN Classic (HMO) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Prime (HMO) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Alta (HMO) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Venture (HMO) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Venture (HMO) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Embrace (HMO I-SNP) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Embrace (HMO I-SNP) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Embrace (HMO-POS I-SNP) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Affirm partnered with Included LGBTQ+ Health (HMO) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Affirm partnered with Included LGBTQ+ Health (HMO) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Strive (HMO C-SNP) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Strive (HMO C-SNP) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Inspired by women for women (HMO) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Affirm partnered with Included LGBTQ+ Health (HMO) | Scan Health Plan | T4 | Yes | $0 | CA |
Showing top 50 of 98 plans.
Frequently Asked Questions
Is mycophenolate mofetil 250 MG Oral Capsule [Cellcept] covered by Medicare Part D?
Yes, mycophenolate mofetil 250 MG Oral Capsule [Cellcept] is covered by 98 Medicare Part D plans (1.9% of all Part D formularies).
What tier is mycophenolate mofetil 250 MG Oral Capsule [Cellcept] on Medicare Part D plans?
mycophenolate mofetil 250 MG Oral Capsule [Cellcept] averages Tier 3.5 across Part D plans, ranging from Tier 1 to Tier 5.
Does mycophenolate mofetil 250 MG Oral Capsule [Cellcept] require prior authorization?
100% of Part D formularies require prior authorization for mycophenolate mofetil 250 MG Oral Capsule [Cellcept]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on mycophenolate mofetil 250 MG Oral Capsule [Cellcept]?
In 2023, total Medicare Part D spending on mycophenolate mofetil 250 MG Oral Capsule [Cellcept] was $66,554,791, covering 105,503 beneficiaries. The average spend per beneficiary was $630.83.
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
- lomustine 40 MG Oral Capsule T3.5
- 1 ML denosumab 60 MG/ML Prefilled Syringe [Prolia] T3.5
- tretinoin 0.001 MG/MG Topical Gel T3.5
- ethacrynic acid 25 MG Oral Tablet T3.5
- daridorexant 25 MG Oral Tablet [Quviviq] T3.5
- 24 HR canagliflozin 150 MG / metformin hydrochloride 1000 MG Extended Release Oral Tablet [Invokamet] T3.5
Similar prior-authorization rate
- sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane] 100% PA
- azathioprine 50 MG Oral Tablet 100% PA
- formoterol fumarate 0.01 MG/ML Inhalation Solution [Perforomist] 100% PA
- lusutrombopag 3 MG Oral Tablet [Mulpleta] 100% PA
- 12 HR tapentadol 100 MG Extended Release Oral Tablet [Nucynta] 100% PA
- {14 (24 HR lamotrigine 100 MG Extended Release Oral Tablet [Lamictal]) / 7 (24 HR lamotrigine 200 MG Extended Release Oral Tablet [Lamictal]) / 14 (24 HR lamotrigine 50 MG Extended Release Oral Tablet [Lamictal]) } Pack [Lamictal XR Green Patient Titration Kit (for Patients Taking Carbamazepine, Phenytoin, Phenobarbital, or Primidone, and Not Taking Valproate)] 100% PA