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
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
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.
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
- ceftriaxone 250 MG Injection T2.7
- 3 ML insulin, regular, human 100 UNT/ML Pen Injector [Novolin R] T2.7
- tretinoin 0.25 MG/ML Topical Cream T2.7
- tobramycin 10 MG/ML Injectable Solution T2.7
- tretinoin 1 MG/ML Topical Cream T2.7
- 24 HR amphetamine aspartate 2.5 MG / amphetamine sulfate 2.5 MG / dextroamphetamine saccharate 2.5 MG / dextroamphetamine sulfate 2.5 MG Extended Release Oral Capsule T2.7
Similar prior-authorization rate
- acetaminophen 325 MG / butalbital 50 MG / caffeine 40 MG Oral Tablet 35.9% PA
- isotretinoin 30 MG Oral Capsule [Zenatane] 35.9% PA
- isotretinoin 10 MG Oral Capsule [Zenatane] 35.9% PA
- 168 HR buprenorphine 0.01 MG/HR Transdermal System 34.8% PA
- Sprinkle duloxetine 40 MG Delayed Release Oral Capsule [Drizalma] 36.1% PA
- 12 HR orphenadrine citrate 100 MG Extended Release Oral Tablet 36.2% PA