Medicare Part D coverage · promethazine hydrochloride · RxCUI 992459

promethazine hydrochloride 25 MG Rectal Suppository [Promethegan]

Per the CMS 2026 Part D formulary file, promethazine hydrochloride 25 MG Rectal Suppository [Promethegan] is covered by 1,687 Medicare Part D plans (33.4% of enrollable products), averaging Tier 2.7, with prior authorization required on 35.4% of covering formularies.

33.4%
Plan coverage
1,687
Plans covering
T2.7
Avg tier
35.4%
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 25 MG Rectal Suppository [Promethegan]

Per the CMS 2026 Part D formulary file, promethazine hydrochloride 25 MG Rectal Suppository [Promethegan] (RxNorm concept RXCUI 992459, generic name promethazine hydrochloride) appears on 130 distinct formulary files spanning 1,687 Medicare Part D plan offerings - 33.4% 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 2.7.

Real-world access to promethazine hydrochloride 25 MG Rectal Suppository [Promethegan] depends on utilization management as much as tier placement: 35.4% 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 523,738 Part D beneficiaries filled promethazine hydrochloride 25 MG Rectal Suppository [Promethegan] 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 25 MG Rectal Suppository [Promethegan] today.

Coverage Details

Formularies covering
130
Plans covering
1,687
Coverage rate
33.4%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
35.4% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

2023 Medicare Spending

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

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering promethazine hydrochloride 25 MG Rectal Suppository [Promethegan]

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

Plan Insurer Tier PA Premium States
Freedom VIP Care (HMO C-SNP) Freedom Health, Inc. T1 Yes $0 FL
Freedom VIP Savings (HMO C-SNP) Freedom Health, Inc. T1 Yes $0 FL
Freedom VIP Savings (HMO C-SNP) Freedom Health, Inc. T1 Yes $0 FL
Freedom VIP Rewards (HMO C-SNP) Freedom Health, Inc. T1 Yes $0 FL
Freedom VIP Rewards (HMO C-SNP) Freedom Health, Inc. T1 Yes $0 FL
Optimum Diamond Rewards (HMO C-SNP) Optimum Healthcare, Inc. T1 Yes $0 FL
Optimum Diamond Savings (HMO C-SNP) Optimum Healthcare, Inc. T1 Yes $0 FL
Optimum Diamond Rewards (HMO C-SNP) Optimum Healthcare, Inc. T1 Yes $0 FL
Optimum Diamond (HMO C-SNP) Optimum Healthcare, Inc. T1 Yes $0 FL
Freedom Medi-Medi Partial (HMO D-SNP) Freedom Health, Inc. T1 Yes $0 FL
Freedom Medi-Medi Full (HMO D-SNP) Freedom Health, Inc. T1 Yes $0 FL
Optimum Emerald Partial (HMO D-SNP) Optimum Healthcare, Inc. T1 Yes $0 FL
Optimum Emerald Full (HMO D-SNP) Optimum Healthcare, Inc. T1 Yes $0 FL
Freedom Medicare Plan Rx (HMO) Freedom Health, Inc. T1 Yes $0 FL
Freedom Medicare Plan Rx (HMO) Freedom Health, Inc. T1 Yes $0 FL
Freedom VIP Savings COPD (HMO C-SNP) Freedom Health, Inc. T1 Yes $0 FL
Freedom VIP Savings COPD (HMO C-SNP) Freedom Health, Inc. T1 Yes $0 FL
Freedom Platinum Plan Rx (HMO) Freedom Health, Inc. T1 Yes $0 FL
Freedom Platinum Plan Rx (HMO) Freedom Health, Inc. T1 Yes $0 FL
Freedom Platinum Plan Rx (HMO) Freedom Health, Inc. T1 Yes $0 FL
Show the next 30 plans
Freedom Platinum Plan Rx (HMO) Freedom Health, Inc. T1 Yes $0 FL
Freedom Platinum Plan Rx (HMO) Freedom Health, Inc. T1 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) Freedom Health, Inc. T1 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) Freedom Health, Inc. T1 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) Freedom Health, Inc. T1 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) Freedom Health, Inc. T1 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) Freedom Health, Inc. T1 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) Freedom Health, Inc. T1 Yes $0 FL
Freedom Máximo (HMO-POS) Freedom Health, Inc. T1 Yes $0 FL
Freedom Máximo (HMO-POS) Freedom Health, Inc. T1 Yes $0 FL
Optimum Gold Rewards Plan (HMO) Optimum Healthcare, Inc. T1 Yes $0 FL
Optimum Platinum Plan (HMO) Optimum Healthcare, Inc. T1 Yes $0 FL
Optimum Gold Plan (HMO) Optimum Healthcare, Inc. T1 Yes $0 FL
Optimum Gold Rewards Plan (HMO) Optimum Healthcare, Inc. T1 Yes $0 FL
Optimum Gold Rewards Plan (HMO) Optimum Healthcare, Inc. T1 Yes $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) Optimum Healthcare, Inc. T1 Yes $0 FL
Optimum Diamond Savings COPD (HMO C-SNP) Optimum Healthcare, Inc. T1 Yes $0 FL
Optimum Gold Plus Plan (HMO) Optimum Healthcare, Inc. T1 Yes $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) Optimum Healthcare, Inc. T1 Yes $0 FL
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
PHP (HMO C-snp) Aids Healthcare Foundation T1 Yes $0 CA
Elevate Medicare Choice (HMO D-SNP) Denver Health Medical Plan, Inc. T1 No $0 CO
AllCare Advantage Redwood Rx (HMO D-SNP) Allcare Health Plan, Inc. T1 Yes $0 OR
PrimeWest Senior Health Complete (HMO D-SNP) Primewest Rural MN Health Care Access Initiative T1 Yes $0 MN

Showing top 50 of 100 plans.

Frequently Asked Questions

Is promethazine hydrochloride 25 MG Rectal Suppository [Promethegan] covered by Medicare Part D?

Yes, promethazine hydrochloride 25 MG Rectal Suppository [Promethegan] is covered by 1,687 Medicare Part D plans (33.4% of all Part D formularies).

What tier is promethazine hydrochloride 25 MG Rectal Suppository [Promethegan] on Medicare Part D plans?

promethazine hydrochloride 25 MG Rectal Suppository [Promethegan] averages Tier 2.7 across Part D plans, ranging from Tier 1 to Tier 4.

Does promethazine hydrochloride 25 MG Rectal Suppository [Promethegan] require prior authorization?

35.4% of Part D formularies require prior authorization for promethazine hydrochloride 25 MG Rectal Suppository [Promethegan]. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on promethazine hydrochloride 25 MG Rectal Suppository [Promethegan]?

In 2023, total Medicare Part D spending on promethazine hydrochloride 25 MG Rectal Suppository [Promethegan] 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