Medicare Part D coverage · prednisone · RxCUI 205301
prednisone 5 MG/ML Oral Solution
Per the CMS 2026 Part D formulary file, prednisone 5 MG/ML Oral Solution is covered by 4,235 Medicare Part D plans (83.8% of enrollable products), averaging Tier 3.2, with prior authorization required on 41.2% of covering formularies.
- 83.8%
- Plan coverage
- 4,235
- Plans covering
- T3.2
- Avg tier
- 41.2%
- Prior auth required
What the CMS Formulary Data Shows for prednisone 5 MG/ML Oral Solution
Per the CMS 2026 Part D formulary file, prednisone 5 MG/ML Oral Solution (RxNorm concept RXCUI 205301, generic name prednisone) appears on 165 distinct formulary files spanning 4,235 Medicare Part D plan offerings - 83.8% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.2.
Real-world access to prednisone 5 MG/ML Oral Solution depends on utilization management as much as tier placement: 41.2% 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 7,163,637 Part D beneficiaries filled prednisone 5 MG/ML Oral Solution in 2023, with total plan-and-beneficiary spending of $84,293,758 and an average per-beneficiary annual cost of $11.77. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry prednisone 5 MG/ML Oral Solution today.
Coverage Details
- Formularies covering
- 165
- Plans covering
- 4,235
- Coverage rate
- 83.8%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 41.2% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 7,163,637
- Total spending
- $84,293,758
- Avg per beneficiary
- $11.77
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering prednisone 5 MG/ML Oral Solution
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T2 | No | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T2 | No | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering prednisone 5 MG/ML Oral Solution
98 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 |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $0 | FL |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | No | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | No | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | No | $0 | NJ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | Yes | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | Yes | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | Yes | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | Yes | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | Yes | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | Yes | $0 | NY |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | No | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | No | $0 | GA |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
Show the next 30 plans
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | No | $0 | MI |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | No | $0 | CA |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | Yes | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | Yes | $0 | MA |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | No | $0 | CA |
| 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 |
| 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 |
| Florida Complete Care (HMO I-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Florida Complete Care- In The Community (HMO-POS I-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | No | $4.80 | FL |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Michigan, Inc. | T1 | No | $8.80 | MI |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $13.10 | PA |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Illinois, Inc. | T1 | No | $15.20 | IL |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $17.60 | PA |
| WellSense Added Value (HMO) | Boston Medical Center Health Plan, Inc. | T1 | No | $21.70 | NH |
| Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) | Elderplan, Inc. | T1 | Yes | $22.70 | NY |
| VIVA Medicare Extra Value (HMO D-SNP) | Viva Health, Inc. | T1 | Yes | $27.70 | AL |
Showing top 50 of 98 plans.
Frequently Asked Questions
Is prednisone 5 MG/ML Oral Solution covered by Medicare Part D?
Yes, prednisone 5 MG/ML Oral Solution is covered by 4,235 Medicare Part D plans (83.8% of all Part D formularies).
What tier is prednisone 5 MG/ML Oral Solution on Medicare Part D plans?
prednisone 5 MG/ML Oral Solution averages Tier 3.2 across Part D plans, ranging from Tier 1 to Tier 4.
Does prednisone 5 MG/ML Oral Solution require prior authorization?
41.2% of Part D formularies require prior authorization for prednisone 5 MG/ML Oral Solution. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on prednisone 5 MG/ML Oral Solution?
In 2023, total Medicare Part D spending on prednisone 5 MG/ML Oral Solution was $84,293,758, covering 7,163,637 beneficiaries. The average spend per beneficiary was $11.77.
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
- leuprolide acetate 5 MG/ML Injectable Solution T3.2
- tazarotene 0.001 MG/MG Topical Gel T3.2
- 1 ML hydromorphone hydrochloride 10 MG/ML Injection T3.2
- 24 HR hydromorphone hydrochloride 32 MG Extended Release Oral Tablet T3.2
- riluzole 5 MG/ML Oral Suspension [Tiglutik] T3.2
- dexlansoprazole 30 MG Delayed Release Oral Capsule T3.2
Similar prior-authorization rate
- cyclobenzaprine hydrochloride 7.5 MG Oral Tablet 41.2% PA
- lactulose 10000 MG Powder for Oral Solution 41.2% PA
- topiramate 25 MG/ML Oral Solution [Eprontia] 41.4% PA
- isotretinoin 20 MG Oral Capsule 41.4% PA
- isotretinoin 30 MG Oral Capsule 41.4% PA
- 8 HR methylphenidate hydrochloride 10 MG Extended Release Oral Tablet 41% PA