Medicare Part D coverage · prednisolone · RxCUI 198142
prednisolone 5 MG Oral Tablet
Per the CMS 2026 Part D formulary file, prednisolone 5 MG Oral Tablet is covered by 323 Medicare Part D plans (6.4% of enrollable products), averaging Tier 2.6, with prior authorization required on 26.1% of covering formularies.
- 6.4%
- Plan coverage
- 323
- Plans covering
- T2.6
- Avg tier
- 26.1%
- Prior auth required
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 23 distinct formulary files spanning 323 Medicare Part D plan offerings - 6.4% 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 2.6.
Real-world access to prednisolone 5 MG Oral Tablet depends on utilization management as much as tier placement: 26.1% 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
- 23
- Plans covering
- 323
- Coverage rate
- 6.4%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 26.1% 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 |
| MCS Classicare RxMax (HMO) | MCS Advantage, Inc. | T2 | No | $0 | PR |
Show the next 30 plans
| MCS Classicare Platino Ideal (HMO D-SNP) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Efectivo (HMO) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Essential (HMO-POS) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Platino Progreso (HMO D-SNP) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Primero (HMO C-SNP) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Firme (HMO) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare En Tu Hogar (HMO) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Hero (HMO) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Platino Total (HMO D-SNP) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare InteliCare (HMO) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Platino Maximo (HMO D-SNP) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Excede (HMO) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Estrella (HMO) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Platino Superior (HMO D-SNP) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Platino 185 (HMO D-SNP) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| 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 |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is prednisolone 5 MG Oral Tablet covered by Medicare Part D?
Yes, prednisolone 5 MG Oral Tablet is covered by 323 Medicare Part D plans (6.4% 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 2.6 across Part D plans, ranging from Tier 1 to Tier 4.
Does prednisolone 5 MG Oral Tablet require prior authorization?
26.1% 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.
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
- 0.65 ML medroxyprogesterone acetate 160 MG/ML Prefilled Syringe [depo-subQ provera] T2.6
- 100 ML ciprofloxacin 2 MG/ML Injection T2.6
- {42 (rivaroxaban 15 MG Oral Tablet [Xarelto]) / 9 (rivaroxaban 20 MG Oral Tablet [Xarelto]) } Pack [Xarelto Kit] T2.6
- clonazepam 2 MG Disintegrating Oral Tablet T2.6
- etonogestrel 68 MG Drug Implant [Nexplanon] T2.6
- haloperidol decanoate 100 MG/ML Injectable Solution T2.6
Similar prior-authorization rate
- paricalcitol 0.001 MG Oral Capsule 26.1% PA
- thioguanine 40 MG Oral Tablet [Tabloid] 26.2% PA
- paricalcitol 0.004 MG Oral Capsule 26.3% PA
- paricalcitol 0.002 MG Oral Capsule 26.3% PA
- {2 (0.1 ML) (diazepam 100 MG/ML Nasal Spray [Valtoco]) } Pack [Valtoco 20 MG Dose Kit] 25.9% PA
- {1 (0.1 ML) (diazepam 100 MG/ML Nasal Spray [Valtoco]) } Pack [Valtoco 10 MG Dose Kit] 25.9% PA