prednisolone 5 MG Oral Tablet
prednisolone
RxCUI: 198142
What the CMS Formulary Data Shows for prednisolone 5 MG Oral Tablet
Per the CMS 2026 Part D formulary file, prednisolone 5 MG Oral Tablet (RxNorm concept RXCUI 198142, generic name prednisolone) appears on 21 distinct formulary files spanning 307 Medicare Part D plan offerings - 6.1% 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 2.7.
Real-world access to prednisolone 5 MG Oral Tablet depends on utilization management as much as tier placement: 28.6% 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 20,337 Part D beneficiaries filled prednisolone 5 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $1,319,595 and an average per-beneficiary annual cost of $64.89. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry prednisolone 5 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 21
- Plans covering
- 307
- Coverage rate
- 6.1%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 28.6% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 20,337
- Total spending
- $1,319,595
- Avg per beneficiary
- $64.89
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering prednisolone 5 MG Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. | T1 | No | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | No | $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 |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $13.10 | PA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $17.60 | PA |
| Highmark Health Options Duals Select (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | No | $31.20 | DE |
| HAP Medicare Explore (PPO) | ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | T2 | No | $0 | MI |
| HAP Medicare Prime (PPO) | ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | T2 | No | $0 | MI |
| HAP Medicare Connect (HMO) | HEALTH ALLIANCE PLAN OF MICHIGAN | T2 | No | $0 | MI |
| HAP Medicare Complete Duals (HMO D-SNP) | HEALTH ALLIANCE PLAN OF MICHIGAN | T2 | No | $0 | MI |
| HAP Medicare Superior (HMO) | HEALTH ALLIANCE PLAN OF MICHIGAN | T2 | No | $0 | MI |
| Henry Ford Select (HMO) | HEALTH ALLIANCE PLAN OF MICHIGAN | T2 | No | $0 | MI |
| MMM Supremo (HMO C-SNP) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Diamante Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Unico (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Elite (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Deluxe (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Dorado Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| PMC Premier Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| PMC Max (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Plenitud (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Valioso (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Combo Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Flexi Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Grandioso (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Mega Flex (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Relax Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Balance (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| Presbyterian Senior Care Plan 2 with Rx (HMO) | PRESBYTERIAN HEALTH PLAN | T2 | No | $0 | NM |
| Presbyterian Dual Plus (HMO D-SNP) | PRESBYTERIAN HEALTH PLAN | T2 | No | $0 | NM |
| Presbyterian Senior Care Extra Health Plan with Rx (HMO) | PRESBYTERIAN HEALTH PLAN | T2 | No | $0 | NM |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST | T2 | Yes | $0 | NV |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST | T2 | Yes | $0 | NV |
| Prominence Dual (HMO D-SNP) | PROMINENCE HEALTHFIRST | T2 | Yes | $0 | NV |
| Prominence Dual (HMO D-SNP) | PROMINENCE HEALTHFIRST | T2 | Yes | $0 | NV |
| Prominence Giveback (HMO) | PROMINENCE HEALTHFIRST | T2 | Yes | $0 | NV |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST OF FLORIDA INC | T2 | Yes | $0 | FL |
| Prominence Giveback (HMO) | PROMINENCE HEALTHFIRST OF FLORIDA INC | T2 | Yes | $0 | FL |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T2 | Yes | $0 | TX |
| Prominence Plus (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T2 | Yes | $0 | TX |
| Prominence Dual (HMO D-SNP) | PROMINENCE HEALTHFIRST OF TEXAS | T2 | Yes | $0 | TX |
| Prominence Extra Help (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T2 | Yes | $0 | TX |
| Prominence Beyond (HMO) | PROMINENCE HEALTHFIRST OF TEXAS | T2 | Yes | $0 | TX |
Frequently Asked Questions
Is prednisolone 5 MG Oral Tablet covered by Medicare Part D?
Yes, prednisolone 5 MG Oral Tablet is covered by 307 Medicare Part D plans (6.1% of all Part D formularies).
What tier is prednisolone 5 MG Oral Tablet on Medicare Part D plans?
prednisolone 5 MG Oral Tablet averages Tier 2.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does prednisolone 5 MG Oral Tablet require prior authorization?
28.6% of Part D formularies require prior authorization for prednisolone 5 MG Oral Tablet. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on prednisolone 5 MG Oral Tablet?
In 2023, total Medicare Part D spending on prednisolone 5 MG Oral Tablet was $1,319,595, covering 20,337 beneficiaries. The average spend per beneficiary was $64.89.
Read our methodology - how this data is sourced, computed, and verified.