Medicare Part D coverage · mycophenolic acid · RxCUI 616450
mycophenolic acid 180 MG Delayed Release Oral Tablet [Myfortic]
Per the CMS 2026 Part D formulary file, mycophenolic acid 180 MG Delayed Release Oral Tablet [Myfortic] is covered by 104 Medicare Part D plans (2.1% of enrollable products), averaging Tier 3.1, with prior authorization required on 100% of covering formularies.
- 2.1%
- Plan coverage
- 104
- Plans covering
- T3.1
- Avg tier
- 100%
- Prior auth required
What the CMS Formulary Data Shows for mycophenolic acid 180 MG Delayed Release Oral Tablet [Myfortic]
Per the CMS 2026 Part D formulary file, mycophenolic acid 180 MG Delayed Release Oral Tablet [Myfortic] (RxNorm concept RXCUI 616450, generic name mycophenolic acid) appears on 7 distinct formulary files spanning 104 Medicare Part D plan offerings - 2.1% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.1.
Real-world access to mycophenolic acid 180 MG Delayed Release Oral Tablet [Myfortic] 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 215 Part D beneficiaries filled mycophenolic acid 180 MG Delayed Release Oral Tablet [Myfortic] in 2023, with total plan-and-beneficiary spending of $1,330,716 and an average per-beneficiary annual cost of $6,189.38. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry mycophenolic acid 180 MG Delayed Release Oral Tablet [Myfortic] today.
Coverage Details
- Formularies covering
- 7
- Plans covering
- 104
- Coverage rate
- 2.1%
- Tier range
- Tier 1 – Tier 4
- 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
- 215
- Total spending
- $1,330,716
- Avg per beneficiary
- $6,189.38
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering mycophenolic acid 180 MG Delayed Release Oral Tablet [Myfortic]
100 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. | T4 | Yes | $0 | NY |
| Medicare BlueActive (PPO) | Excellus Health Plan, Inc. | T4 | Yes | $0 | NY |
| Medicare BlueVital (PPO) | Excellus Health Plan, Inc. | T4 | Yes | $0 | NY |
| Univera SeniorChoice Basic (HMO) | Excellus Health Plan, Inc. | T4 | Yes | $0 | NY |
| Univera SeniorChoice Extra (HMO) | Excellus Health Plan, Inc. | T4 | Yes | $0 | NY |
| Medicare Blue Choice Core (HMO) | Excellus Health Plan, Inc. | T4 | Yes | $0 | NY |
| Univera Medicare Dual (HMO D-SNP) | Excellus Health Plan Community Care LLC | T4 | Yes | $0 | NY |
| Medicare Blue Dual (HMO D-SNP) | Excellus Health Plan Community Care LLC | T4 | Yes | $0 | NY |
| Óptimo Plus (PPO) | Triple S Advantage, Inc. | T4 | Yes | $0 | PR |
| Contigo Plus (HMO C-SNP) | Triple S Advantage, Inc. | T4 | Yes | $0 | PR |
| Brillante (HMO-POS) | Triple S Advantage, Inc. | T4 | Yes | $0 | PR |
| Enlace Plus (HMO) | Triple S Advantage, Inc. | T4 | Yes | $0 | PR |
| ContigoEnMente (HMO C-SNP) | Triple S Advantage, Inc. | T4 | Yes | $0 | PR |
| Ahorro Plus (HMO) | Triple S Advantage, Inc. | T4 | Yes | $0 | PR |
| CDPHP $0 Medicare Rx (HMO) | Capital District Physicians' Health Plan, Inc. | T4 | Yes | $0 | 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 |
Show the next 30 plans
| 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 |
| 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 |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is mycophenolic acid 180 MG Delayed Release Oral Tablet [Myfortic] covered by Medicare Part D?
Yes, mycophenolic acid 180 MG Delayed Release Oral Tablet [Myfortic] is covered by 104 Medicare Part D plans (2.1% of all Part D formularies).
What tier is mycophenolic acid 180 MG Delayed Release Oral Tablet [Myfortic] on Medicare Part D plans?
mycophenolic acid 180 MG Delayed Release Oral Tablet [Myfortic] averages Tier 3.1 across Part D plans, ranging from Tier 1 to Tier 4.
Does mycophenolic acid 180 MG Delayed Release Oral Tablet [Myfortic] require prior authorization?
100% of Part D formularies require prior authorization for mycophenolic acid 180 MG Delayed Release Oral Tablet [Myfortic]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on mycophenolic acid 180 MG Delayed Release Oral Tablet [Myfortic]?
In 2023, total Medicare Part D spending on mycophenolic acid 180 MG Delayed Release Oral Tablet [Myfortic] was $1,330,716, covering 215 beneficiaries. The average spend per beneficiary was $6,189.38.
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
- aprepitant 125 MG Oral Capsule T3.1
- isotretinoin 30 MG Oral Capsule [Claravis] T3.1
- 3 ML insulin, regular, human 500 UNT/ML Pen Injector [Humulin R] T3.1
- penicillin G sodium 100000 UNT/ML Injectable Solution T3.1
- Abuse-Deterrent 24 HR hydrocodone bitartrate 20 MG Extended Release Oral Tablet T3.1
- magnesium chloride 0.00148 MEQ/ML / potassium chloride 0.00497 MEQ/ML / sodium acetate 0.027 MEQ/ML / sodium chloride 0.0899 MEQ/ML / sodium gluconate 5.02 MG/ML Injectable Solution [Plasmalyte A] T3.1
Similar prior-authorization rate
- sodium phenylbutyrate 0.483 MG/MG Oral Pellet [Pheburane] 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
- eltrombopag 25 MG Oral Tablet [Promacta] 100% PA