Medicare Part D coverage · promethazine hydrochloride · RxCUI 992441

promethazine hydrochloride 12.5 MG Rectal Suppository

Per the CMS 2026 Part D formulary file, promethazine hydrochloride 12.5 MG Rectal Suppository is covered by 2,166 Medicare Part D plans (42.9% of enrollable products), averaging Tier 3.1, with prior authorization required on 18.3% of covering formularies.

42.9%
Plan coverage
2,166
Plans covering
T3.1
Avg tier
18.3%
Prior auth required

Verify with CMS →

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.

What the CMS Formulary Data Shows for promethazine hydrochloride 12.5 MG Rectal Suppository

Per the CMS 2026 Part D formulary file, promethazine hydrochloride 12.5 MG Rectal Suppository (RxNorm concept RXCUI 992441, generic name promethazine hydrochloride) appears on 104 distinct formulary files spanning 2,166 Medicare Part D plan offerings - 42.9% 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 promethazine hydrochloride 12.5 MG Rectal Suppository depends on utilization management as much as tier placement: 18.3% of covering formularies require prior authorization. 0% require step therapy. 10.6% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 523,738 Part D beneficiaries filled promethazine hydrochloride 12.5 MG Rectal Suppository in 2023, with total plan-and-beneficiary spending of $16,549,733 and an average per-beneficiary annual cost of $31.60. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry promethazine hydrochloride 12.5 MG Rectal Suppository today.

Coverage Details

Formularies covering
104
Plans covering
2,166
Coverage rate
42.9%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
18.3% of formularies
Step therapy required
0% of formularies
Quantity limits
10.6% of formularies

2023 Medicare Spending

Beneficiaries
523,738
Total spending
$16,549,733
Avg per beneficiary
$31.60

Tier Distribution Across Plans

67 plans
Tier 1, Preferred Generic
33 plans
Tier 2, Generic

Medicare Advantage Plans (MA-PD) Covering promethazine hydrochloride 12.5 MG Rectal Suppository

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

Plan Insurer Tier PA Premium States
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 No $0 CA
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) Health Care Service Corporation T1 No $0 NM
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) Health Care Service Corporation T1 No $0 NM
SecureBlue (HMO D-SNP) HMO Minnesota T1 No $0 MN
NaviCare (HMO D-SNP) Fallon Community Health Plan T1 No $0 MA
Hamaspik Medicare Choice (HMO D-SNP) Hamaspik, Inc. T1 No $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
PHP (HMO C-snp) Aids Healthcare Foundation T1 Yes $0 CA
VNS Health Total (HMO D-SNP) VNS Choice T1 No $0 NY
Provider Partners Pennsylvania Community Plan (HMO I-SNP) Provider Partners Health Plan OF Pennsylvania, Inc T1 No $0 PA
Provider Partners North Carolina Community Plan (HMO I-SNP) Provider Partners Health Plan OF North Carolina T1 No $0 NC
Provider Partners Indiana Community Plan (HMO I-SNP) Provider Partners Health Plan OF Indiana T1 No $0 IN
Provider Partners Missouri Community Plan (HMO I-SNP) Provider Partners Health Plan OF Missouri, Inc. T1 No $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
Show the next 30 plans
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 No $0 CA
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
American Health Advantage of Florida (HMO I-SNP) American Health Plan OF FL, Inc. T1 No $4.80 FL
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) Hcsc Insurance Services Company T1 No $4.80 TX
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) Gold Kidney OF Florida Inc T1 No $4.80 FL
Provider Partners Texas Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF Texas, Inc. T1 No $4.80 TX
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) GHS Insurance Company T1 No $5.00 OK
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) Gateway Health Plan, Inc. T1 No $13.10 PA
Provider Partners Illinois Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF Illinois T1 No $15.20 IL
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) Gold Kidney OF Arizona T1 No $17.00 AZ
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) Gateway Health Plan, Inc. T1 No $17.60 PA
American Health Advantage of Mississippi (HMO I-SNP) American Health Plan OF MS, Inc. T1 No $23.80 MS
Georgia Health Advantage (HMO I-SNP) Georgia Assurance, Inc. T1 No $25.40 GA
Georgia Health Advantage Choice (HMO I-SNP) Georgia Assurance, Inc. T1 No $25.40 GA
American Health Advantage of Tennessee (HMO I-SNP) American Health Plan, Inc. T1 No $27.70 TN
American Health Advantage of Oklahoma (HMO I-SNP) Oklahoma Superior Select, Inc. T1 No $28.20 OK
Highmark Health Options Duals Select (HMO D-SNP) Highmark Bcbsd, Inc. T1 No $31.20 DE
American Health Advantage of Pennsylvania (HMO I-SNP) American Health Plan OF Pennsylvania Inc T1 No $32.70 PA
Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF Pennsylvania, Inc T1 No $32.70 PA
Provider Partners Pennsylvania Essential Plan (HMO I-SNP) Provider Partners Health Plan OF Pennsylvania, Inc T1 No $32.70 PA
American Health Advantage of Louisiana (HMO I-SNP) Dignity Care Corporation T1 No $32.90 LA
Hamaspik Medicare Select (HMO D-SNP) Hamaspik, Inc. T1 No $34.50 NY

Showing top 50 of 100 plans.

Frequently Asked Questions

Is promethazine hydrochloride 12.5 MG Rectal Suppository covered by Medicare Part D?

Yes, promethazine hydrochloride 12.5 MG Rectal Suppository is covered by 2,166 Medicare Part D plans (42.9% of all Part D formularies).

What tier is promethazine hydrochloride 12.5 MG Rectal Suppository on Medicare Part D plans?

promethazine hydrochloride 12.5 MG Rectal Suppository averages Tier 3.1 across Part D plans, ranging from Tier 1 to Tier 4.

Does promethazine hydrochloride 12.5 MG Rectal Suppository require prior authorization?

18.3% of Part D formularies require prior authorization for promethazine hydrochloride 12.5 MG Rectal Suppository. Step therapy: 0%. Quantity limits: 10.6%.

How much does Medicare spend on promethazine hydrochloride 12.5 MG Rectal Suppository?

In 2023, total Medicare Part D spending on promethazine hydrochloride 12.5 MG Rectal Suppository was $16,549,733, covering 523,738 beneficiaries. The average spend per beneficiary was $31.60.

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.

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