Medicare Part D coverage · prednisolone · RxCUI 209002
prednisolone 1.2 MG/ML Ophthalmic Suspension [Pred Mild]
Per the CMS 2026 Part D formulary file, prednisolone 1.2 MG/ML Ophthalmic Suspension [Pred Mild] is covered by 1,014 Medicare Part D plans (20.1% of enrollable products), averaging Tier 3.1, with prior authorization required on 0% of covering formularies.
- 20.1%
- Plan coverage
- 1,014
- Plans covering
- T3.1
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for prednisolone 1.2 MG/ML Ophthalmic Suspension [Pred Mild]
Per the CMS 2026 Part D formulary file, prednisolone 1.2 MG/ML Ophthalmic Suspension [Pred Mild] (RxNorm concept RXCUI 209002, generic name prednisolone) appears on 19 distinct formulary files spanning 1,014 Medicare Part D plan offerings - 20.1% 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 prednisolone 1.2 MG/ML Ophthalmic Suspension [Pred Mild] depends on utilization management as much as tier placement: 0% 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 1.2 MG/ML Ophthalmic Suspension [Pred Mild] 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 1.2 MG/ML Ophthalmic Suspension [Pred Mild] today.
Coverage Details
- Formularies covering
- 19
- Plans covering
- 1,014
- Coverage rate
- 20.1%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% 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 1.2 MG/ML Ophthalmic Suspension [Pred Mild]
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 | No | $0 | NY |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| 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 |
| 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 |
| Hamaspik Medicare Select (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $34.50 | NY |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T2 | No | $0 | CA |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T2 | No | $0 | CA |
| HAP Medicare Explore (PPO) | Alliance Health AND Life Insurance Company | T3 | No | $0 | MI |
| HAP Medicare Prime (PPO) | Alliance Health AND Life Insurance Company | T3 | No | $0 | MI |
| HAP Medicare Connect (HMO) | Health Alliance Plan OF Michigan | T3 | No | $0 | MI |
| HAP Medicare Complete Duals (HMO D-SNP) | Health Alliance Plan OF Michigan | T3 | No | $0 | MI |
| HAP Medicare Superior (HMO) | Health Alliance Plan OF Michigan | T3 | No | $0 | MI |
| Henry Ford Select (HMO) | Health Alliance Plan OF Michigan | T3 | No | $0 | MI |
| Kaiser Permanente Senior Advantage LA, Orange Co. (HMO) | Kaiser Foundation HP, Inc. | T3 | No | $0 | CA |
| Kaiser Permanente Senior Advantage Enhanced Solano (HMO) | Kaiser Foundation HP, Inc. | T3 | No | $0 | CA |
Show the next 30 plans
Showing top 50 of 100 plans.
Frequently Asked Questions
Is prednisolone 1.2 MG/ML Ophthalmic Suspension [Pred Mild] covered by Medicare Part D?
Yes, prednisolone 1.2 MG/ML Ophthalmic Suspension [Pred Mild] is covered by 1,014 Medicare Part D plans (20.1% of all Part D formularies).
What tier is prednisolone 1.2 MG/ML Ophthalmic Suspension [Pred Mild] on Medicare Part D plans?
prednisolone 1.2 MG/ML Ophthalmic Suspension [Pred Mild] averages Tier 3.1 across Part D plans, ranging from Tier 1 to Tier 4.
Does prednisolone 1.2 MG/ML Ophthalmic Suspension [Pred Mild] require prior authorization?
0% of Part D formularies require prior authorization for prednisolone 1.2 MG/ML Ophthalmic Suspension [Pred Mild]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on prednisolone 1.2 MG/ML Ophthalmic Suspension [Pred Mild]?
In 2023, total Medicare Part D spending on prednisolone 1.2 MG/ML Ophthalmic Suspension [Pred Mild] 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.