olopatadine hydrochloride 0.665 MG/ACTUAT Metered Dose Nasal Spray

Verify with CMS →

olopatadine hydrochloride

RxCUI: 1797895

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.
34.2%
Plan Coverage
1,733
Plans Covering
T2.7
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for olopatadine hydrochloride 0.665 MG/ACTUAT Metered Dose Nasal Spray

Per the CMS 2026 Part D formulary file, olopatadine hydrochloride 0.665 MG/ACTUAT Metered Dose Nasal Spray (RxNorm concept RXCUI 1797895, generic name olopatadine hydrochloride) appears on 112 distinct formulary files spanning 1,733 Medicare Part D plan offerings - 34.2% 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 2.7.

Real-world access to olopatadine hydrochloride 0.665 MG/ACTUAT Metered Dose Nasal Spray depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 1.8% require step therapy. 74.1% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 147,406 Part D beneficiaries filled olopatadine hydrochloride 0.665 MG/ACTUAT Metered Dose Nasal Spray in 2023, with total plan-and-beneficiary spending of $13,255,277 and an average per-beneficiary annual cost of $89.92. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry olopatadine hydrochloride 0.665 MG/ACTUAT Metered Dose Nasal Spray today.

Coverage Details

Formularies covering
112
Plans covering
1,733
Coverage rate
34.2%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
0% of formularies
Step therapy required
1.8% of formularies
Quantity limits
74.1% of formularies

2023 Medicare Spending

Beneficiaries
147,406
Total spending
$13,255,277
Avg per beneficiary
$89.92

Tier Distribution Across Plans

61 plans
Tier 1, Preferred Generic
39 plans
Tier 2, Generic

Medicare Advantage Plans (MA-PD) Covering olopatadine hydrochloride 0.665 MG/ACTUAT Metered Dose Nasal Spray

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
PruittHealth Premier D-SNP (HMO D-SNP) PRUITTHEALTH PREMIER, INC. T1 No $0 GA
Simpra Advantage Dual Care (PPO D-SNP) SIMPRA ADVANTAGE, INC. T1 No $0 AL
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
SecureBlue (HMO D-SNP) HMO Minnesota T1 No $0 MN
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 No $0 NY
PHP (HMO C-SNP) AIDS HEALTHCARE FOUNDATION T1 No $0 CA
VNS Health Total (HMO D-SNP) VNS CHOICE T1 No $0 NY
Mass General Brigham SCO (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 No $0 MA
Mass General Brigham One Care (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 No $0 MA
Leon MediExtra (HMO) LEON HEALTH, INC. T1 No $0 FL
Leon MediDual (HMO D-SNP) LEON HEALTH, INC. T1 No $0 FL
Leon MediMore (HMO) LEON HEALTH, INC. T1 No $0 FL
Leon MediMax (HMO D-SNP) LEON HEALTH, INC. T1 No $0 FL
Senior Care (HMO I-SNP) ALIGN SENIOR CARE FLORIDA, INC. T1 No $4.80 FL
ProCare Advantage (HMO-POS I-SNP) PROCARE ADVANTAGE, LLC T1 No $4.80 TX
ProCare Advantage - Kidney Care (HMO-POS C-SNP) PROCARE ADVANTAGE, LLC T1 No $4.80 TX
American Health Advantage of Florida (HMO I-SNP) AMERICAN HEALTH PLAN OF FL, INC. T1 No $4.80 FL
SECUR Advantage (HMO I-SNP) SECUR INC T1 No $4.80 FL
SECUR Enhanced (HMO I-SNP) SECUR INC T1 No $4.80 FL
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) HCSC INSURANCE SERVICES COMPANY T1 No $4.80 TX
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T1 No $4.80 FL
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) GHS INSURANCE COMPANY T1 No $5.00 OK
Senior Care (HMO I-SNP) ALIGN SENIOR CARE MI, LLC T1 No $8.80 MI
AgeRight Advantage Health Plan (HMO I-SNP) MARQUIS ADVANTAGE, INC. T1 No $10.50 OR, WA
Senior Care (HMO I-SNP) ALIGN SENIOR CARE CALIFORNIA INC. T1 No $12.00 CA
Liberty Medicare Dual Plan (HMO D-SNP) LIBERTY ADVANTAGE, LLC T1 No $14.70 NC
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF ARIZONA T1 No $17.00 AZ
KeyCare Advantage (HMO I-SNP) ISNP VENTURES, LLC T1 No $23.20 MD
American Health Advantage of Mississippi (HMO I-SNP) AMERICAN HEALTH PLAN OF MS, INC. T1 No $23.80 MS
Senior Care (HMO I-SNP) LIFEWORKS ADVANTAGE, LLC T1 No $24.60 VA
PruittHealth Premier (HMO I-SNP) PRUITTHEALTH PREMIER, INC. T1 No $25.40 GA
Georgia Health Advantage (HMO I-SNP) GEORGIA ASSURANCE, INC. T1 No $25.40 GA
Georgia Health Advantage Choice (HMO I-SNP) GEORGIA ASSURANCE, INC. T1 No $25.40 GA
American Health Advantage of Tennessee (HMO I-SNP) AMERICAN HEALTH PLAN, INC. T1 No $27.70 TN
Simpra Advantage Nursing Home Plan (PPO I-SNP) SIMPRA ADVANTAGE, INC. T1 No $27.70 AL
American Health Advantage of Oklahoma (HMO I-SNP) OKLAHOMA SUPERIOR SELECT, INC. T1 No $28.20 OK
NHC Advantage (HMO I-SNP) NHC ADVANTAGE, LLC T1 No $31.00 MO, NC, SC, TN
Perennial Advantage Strive (HMO I-SNP) PERENNIAL ADVANTAGE OF OHIO, INC. T1 No $31.40 OH
Perennial Advantage Strive (HMO I-SNP) PERENNIAL ADVANTAGE OF COLORADO, INC. T1 No $32.70 PA
American Health Advantage of Pennsylvania (HMO I-SNP) AMERICAN HEALTH PLAN OF PENNSYLVANIA INC T1 No $32.70 PA
Lagniappe Advantage (PPO I-SNP) LAGNIAPPE ADVANTAGE INSURANCE COMPANY T1 No $32.90 LA
American Health Advantage of Louisiana (HMO I-SNP) DIGNITY CARE CORPORATION T1 No $32.90 LA
Hamaspik Medicare Select (HMO D-SNP) HAMASPIK, INC. T1 No $34.50 NY
Perennial Advantage Strive (HMO I-SNP) PERENNIAL ADVANTAGE OF COLORADO, INC. T1 No $35.20 CO
PruittHealth Premier (HMO I-SNP) PRUITTHEALTH PREMIER NORTH CAROLINA, LLC T1 No $35.70 SC
PruittHealth Premier (HMO I-SNP) PRUITTHEALTH PREMIER NORTH CAROLINA, LLC T1 No $36.20 NC

Frequently Asked Questions

Is olopatadine hydrochloride 0.665 MG/ACTUAT Metered Dose Nasal Spray covered by Medicare Part D?

Yes, olopatadine hydrochloride 0.665 MG/ACTUAT Metered Dose Nasal Spray is covered by 1,733 Medicare Part D plans (34.2% of all Part D formularies).

What tier is olopatadine hydrochloride 0.665 MG/ACTUAT Metered Dose Nasal Spray on Medicare Part D plans?

olopatadine hydrochloride 0.665 MG/ACTUAT Metered Dose Nasal Spray averages Tier 2.7 across Part D plans, ranging from Tier 1 to Tier 4.

Does olopatadine hydrochloride 0.665 MG/ACTUAT Metered Dose Nasal Spray require prior authorization?

0% of Part D formularies require prior authorization for olopatadine hydrochloride 0.665 MG/ACTUAT Metered Dose Nasal Spray. Step therapy: 1.8%. Quantity limits: 74.1%.

How much does Medicare spend on olopatadine hydrochloride 0.665 MG/ACTUAT Metered Dose Nasal Spray?

In 2023, total Medicare Part D spending on olopatadine hydrochloride 0.665 MG/ACTUAT Metered Dose Nasal Spray was $13,255,277, covering 147,406 beneficiaries. The average spend per beneficiary was $89.92.

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