posaconazole 40 MG/ML Oral Suspension

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posaconazole

RxCUI: 665019

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.
55.7%
Plan Coverage
2,821
Plans Covering
T4
Avg Tier
88.1%
Prior Auth Required

What the CMS Formulary Data Shows for posaconazole 40 MG/ML Oral Suspension

Per the CMS 2026 Part D formulary file, posaconazole 40 MG/ML Oral Suspension (RxNorm concept RXCUI 665019, generic name posaconazole) appears on 185 distinct formulary files spanning 2,821 Medicare Part D plan offerings - 55.7% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 4.

Real-world access to posaconazole 40 MG/ML Oral Suspension depends on utilization management as much as tier placement: 88.1% of covering formularies require prior authorization. 0% require step therapy. 38.9% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 8,353 Part D beneficiaries filled posaconazole 40 MG/ML Oral Suspension in 2023, with total plan-and-beneficiary spending of $79,744,497 and an average per-beneficiary annual cost of $9,546.81. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry posaconazole 40 MG/ML Oral Suspension today.

Coverage Details

Formularies covering
185
Plans covering
2,821
Coverage rate
55.7%
Tier range
Tier 1 – Tier 6
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
88.1% of formularies
Step therapy required
0% of formularies
Quantity limits
38.9% of formularies

2023 Medicare Spending

Beneficiaries
8,353
Total spending
$79,744,497
Avg per beneficiary
$9,546.81

Tier Distribution Across Plans

93 plans
Tier 1, Preferred Generic
7 plans
Tier 2, Generic

Medicare Advantage Plans (MA-PD) Covering posaconazole 40 MG/ML Oral Suspension

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
PruittHealth Premier D-SNP (HMO D-SNP) PRUITTHEALTH PREMIER, INC. T1 Yes $0 GA
Simpra Advantage Dual Care (PPO D-SNP) SIMPRA ADVANTAGE, INC. T1 Yes $0 AL
CareAdvantage (HMO D-SNP) SAN MATEO HEALTH COMMISSION T1 No $0 CA
Gold Coast Health Plan Total Care Advantage (HMO D-SNP) Ventura County Medi-Cal Managed Care Commission T1 Yes $0 CA
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) Health Care Service Corporation T1 Yes $0 NM
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) Health Care Service Corporation T1 Yes $0 NM
Horizon NJ TotalCare (HMO D-SNP) HORIZON HEALTHCARE OF NEW JERSEY, INC. T1 Yes $0 NJ
SecureBlue (HMO D-SNP) HMO Minnesota T1 Yes $0 MN
NaviCare (HMO D-SNP) FALLON COMMUNITY HEALTH PLAN T1 Yes $0 MA
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 Yes $0 NY
SeniorCare Complete (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 Yes $0 MN
AbilityCare (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 Yes $0 MN
Alameda Alliance Wellness (HMO D-SNP) ALAMEDA ALLIANCE FOR HEALTH T1 Yes $0 CA
Provider Partners Pennsylvania Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC T1 Yes $0 PA
Provider Partners North Carolina Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA T1 Yes $0 NC
Provider Partners Indiana Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF INDIANA T1 Yes $0 IN
Provider Partners Maryland Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN, INC. T1 Yes $0 MD
Provider Partners Missouri Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. T1 Yes $0 MO
Community Care's Partnership Program (HMO D-SNP) COMMUNITY CARE HEALTH PLAN, INC. T1 No $0 WI
Platino Blindao (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
Platino Enlace (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
PLATINO ADVANCE (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
PLATINO PLUS (HMO D-SNP) TRIPLE S ADVANTAGE, INC. T1 Yes $0 PR
CalOptima Health OneCare Complete (HMO D-SNP) ORANGE COUNTY HEALTH AUTHORITY T1 Yes $0 CA
Mass General Brigham SCO (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 Yes $0 MA
Mass General Brigham One Care (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 Yes $0 MA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $0 PA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $0 PA
Highmark Health Options Duals (HMO D-SNP) HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. T1 Yes $0 WV
Highmark Health Options Duals (HMO D-SNP) HIGHMARK BCBSD, INC. T1 Yes $0 DE
Tufts Health One Care (HMO D-SNP) TUFTS HEALTH PUBLIC PLANS, INC. T1 No $0 MA
Tufts Health One Care CW (HMO D-SNP) TUFTS HEALTH PUBLIC PLANS, INC. T1 No $0 MA
Tufts Health Plan Senior Care Options (HMO D-SNP) TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION T1 No $0 MA
Tufts Health Plan Senior Care Options CW (HMO D-SNP) TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION T1 No $0 MA
Senior Care (HMO I-SNP) ALIGN SENIOR CARE FLORIDA, INC. T1 Yes $4.80 FL
ProCare Advantage (HMO-POS I-SNP) PROCARE ADVANTAGE, LLC T1 Yes $4.80 TX
ProCare Advantage - Kidney Care (HMO-POS C-SNP) PROCARE ADVANTAGE, LLC T1 Yes $4.80 TX
American Health Advantage of Florida (HMO I-SNP) AMERICAN HEALTH PLAN OF FL, INC. T1 Yes $4.80 FL
SECUR Advantage (HMO I-SNP) SECUR INC T1 Yes $4.80 FL
SECUR Enhanced (HMO I-SNP) SECUR INC T1 Yes $4.80 FL
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) HCSC INSURANCE SERVICES COMPANY T1 Yes $4.80 TX
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T1 Yes $4.80 FL
Provider Partners Texas Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC. T1 Yes $4.80 TX
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) GHS INSURANCE COMPANY T1 Yes $5.00 OK
Senior Care (HMO I-SNP) ALIGN SENIOR CARE MI, LLC T1 Yes $8.80 MI
AgeRight Advantage Health Plan (HMO I-SNP) MARQUIS ADVANTAGE, INC. T1 Yes $10.50 OR, WA
Senior Care (HMO I-SNP) ALIGN SENIOR CARE CALIFORNIA INC. T1 Yes $12.00 CA
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $13.10 PA
Liberty Medicare Dual Plan (HMO D-SNP) LIBERTY ADVANTAGE, LLC T1 Yes $14.70 NC
Provider Partners Illinois Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS T1 Yes $15.20 IL

Frequently Asked Questions

Is posaconazole 40 MG/ML Oral Suspension covered by Medicare Part D?

Yes, posaconazole 40 MG/ML Oral Suspension is covered by 2,821 Medicare Part D plans (55.7% of all Part D formularies).

What tier is posaconazole 40 MG/ML Oral Suspension on Medicare Part D plans?

posaconazole 40 MG/ML Oral Suspension averages Tier 4 across Part D plans, ranging from Tier 1 to Tier 6.

Does posaconazole 40 MG/ML Oral Suspension require prior authorization?

88.1% of Part D formularies require prior authorization for posaconazole 40 MG/ML Oral Suspension. Step therapy: 0%. Quantity limits: 38.9%.

How much does Medicare spend on posaconazole 40 MG/ML Oral Suspension?

In 2023, total Medicare Part D spending on posaconazole 40 MG/ML Oral Suspension was $79,744,497, covering 8,353 beneficiaries. The average spend per beneficiary was $9,546.81.

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