Medicare Part D coverage · somatropin · RxCUI 582971
somatropin 12 MG Cartridge [Humatrope]
Per the CMS 2026 Part D formulary file, somatropin 12 MG Cartridge [Humatrope] is covered by 130 Medicare Part D plans (2.6% of enrollable products), averaging Tier 3.7, with prior authorization required on 100% of covering formularies.
- 2.6%
- Plan coverage
- 130
- Plans covering
- T3.7
- Avg tier
- 100%
- Prior auth required
What the CMS Formulary Data Shows for somatropin 12 MG Cartridge [Humatrope]
Per the CMS 2026 Part D formulary file, somatropin 12 MG Cartridge [Humatrope] (RxNorm concept RXCUI 582971, generic name somatropin) appears on 15 distinct formulary files spanning 130 Medicare Part D plan offerings - 2.6% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 3.7.
Real-world access to somatropin 12 MG Cartridge [Humatrope] depends on utilization management as much as tier placement: 100% 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 1,572 Part D beneficiaries filled somatropin 12 MG Cartridge [Humatrope] in 2023, with total plan-and-beneficiary spending of $27,196,427 and an average per-beneficiary annual cost of $17,300.53. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry somatropin 12 MG Cartridge [Humatrope] today.
Coverage Details
- Formularies covering
- 15
- Plans covering
- 130
- Coverage rate
- 2.6%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,572
- Total spending
- $27,196,427
- Avg per beneficiary
- $17,300.53
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering somatropin 12 MG Cartridge [Humatrope]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | Yes | $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 |
| Platino Plus (HMO D-snp) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T2 | Yes | $0 | CA |
| BlueCare Plus (HMO D-SNP) | Volunteer State Health Plan | T4 | Yes | $0 | TN |
| BlueCare Plus Choice (HMO D-SNP) | Volunteer State Health Plan | T4 | Yes | $0 | TN |
| BlueCare Plus Select (HMO D-SNP) | Volunteer State Health Plan | T4 | Yes | $0 | TN |
| BlueAdvantage Sapphire (PPO) | Bluecross Blueshield OF Tennessee, Inc. | T5 | Yes | $0 | TN |
| BlueAdvantage Sapphire (PPO) | Bluecross Blueshield OF Tennessee, Inc. | T5 | Yes | $0 | TN |
| BlueAdvantage Garnet (PPO) | Bluecross Blueshield OF Tennessee, Inc. | T5 | Yes | $0 | TN |
| BlueAdvantage Garnet (PPO) | Bluecross Blueshield OF Tennessee, Inc. | T5 | Yes | $0 | TN |
| BlueAdvantage Sapphire (PPO) | Bluecross Blueshield OF Tennessee, Inc. | T5 | Yes | $0 | TN |
| BlueAdvantage Sapphire (PPO) | Bluecross Blueshield OF Tennessee, Inc. | T5 | Yes | $0 | GA |
| BlueAdvantage Total Heart and Diabetes (PPO C-SNP) | Bluecross Blueshield OF Tennessee, Inc. | T5 | Yes | $0 | GA, TN |
| BlueAdvantage Total Heart and Diabetes (PPO C-SNP) | Bluecross Blueshield OF Tennessee, Inc. | T5 | Yes | $0 | TN |
| Óptimo Plus (PPO) | Triple S Advantage, Inc. | T5 | Yes | $0 | PR |
Show the next 30 plans
| Contigo Plus (HMO C-SNP) | Triple S Advantage, Inc. | T5 | Yes | $0 | PR |
| Brillante (HMO-POS) | Triple S Advantage, Inc. | T5 | Yes | $0 | PR |
| Enlace Plus (HMO) | Triple S Advantage, Inc. | T5 | Yes | $0 | PR |
| ContigoEnMente (HMO C-SNP) | Triple S Advantage, Inc. | T5 | Yes | $0 | PR |
| Ahorro Plus (HMO) | Triple S Advantage, Inc. | T5 | Yes | $0 | PR |
| Mass General Brigham Advantage (PPO) | Mass General Brigham Health Plan, Inc. | T5 | Yes | $0 | MA |
| SCAN Connections (HMO D-SNP) | Scan Health Plan | T5 | Yes | $0 | CA |
| SCAN Connections at Home (HMO D-SNP) | Scan Health Plan | T5 | Yes | $0 | CA |
| SCAN Classic (HMO) | Scan Health Plan Nevada, Inc. | T5 | Yes | $0 | NV |
| SCAN Balance (HMO C-SNP) | Scan Health Plan Nevada, Inc. | T5 | Yes | $0 | NV |
| SCAN Strive (HMO C-SNP) | Scan Health Plan Nevada, Inc. | T5 | Yes | $0 | NV |
| SCAN MyChoice (HMO) | Scan Health Plan Nevada, Inc. | T5 | Yes | $0 | NV |
| SCAN Classic (HMO) | Scan Desert Health Plan, Inc. | T5 | Yes | $0 | AZ |
| SCAN Balance (HMO C-SNP) | Scan Desert Health Plan, Inc. | T5 | Yes | $0 | AZ |
| SCAN Embrace (HMO-POS I-SNP) | Scan Desert Health Plan, Inc. | T5 | Yes | $0 | AZ |
| SCAN Strive (HMO C-SNP) | Scan Desert Health Plan, Inc. | T5 | Yes | $0 | AZ |
| SCAN MyChoice (HMO) | Scan Desert Health Plan, Inc. | T5 | Yes | $0 | AZ |
| SCAN Classic WA (HMO) | Scan Health Plan (WA) | T5 | Yes | $0 | WA |
| SCAN MyChoice WA (HMO) | Scan Health Plan (WA) | T5 | Yes | $0 | WA |
| SCAN Classic (HMO) | Scan Health Plan (NM) | T5 | Yes | $0 | NM |
| SCAN Balance (HMO C-SNP) | Scan Health Plan (NM) | T5 | Yes | $0 | NM |
| SCAN Strive (HMO C-SNP) | Scan Health Plan (NM) | T5 | Yes | $0 | NM |
| SCAN MyChoice (HMO) | Scan Health Plan (NM) | T5 | Yes | $0 | NM |
| SCAN Classic (HMO) | Scan Health Plan | T5 | Yes | $0 | CA |
| SCAN Classic (HMO) | Scan Health Plan | T5 | Yes | $0 | CA |
| SCAN Classic (HMO) | Scan Health Plan | T5 | Yes | $0 | CA |
| SCAN Classic (HMO) | Scan Health Plan | T5 | Yes | $0 | CA |
| SCAN Classic (HMO) | Scan Health Plan | T5 | Yes | $0 | CA |
| SCAN Classic (HMO) | Scan Health Plan | T5 | Yes | $0 | CA |
| SCAN Classic (HMO) | Scan Health Plan | T5 | Yes | $0 | CA |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is somatropin 12 MG Cartridge [Humatrope] covered by Medicare Part D?
Yes, somatropin 12 MG Cartridge [Humatrope] is covered by 130 Medicare Part D plans (2.6% of all Part D formularies).
What tier is somatropin 12 MG Cartridge [Humatrope] on Medicare Part D plans?
somatropin 12 MG Cartridge [Humatrope] averages Tier 3.7 across Part D plans, ranging from Tier 1 to Tier 5.
Does somatropin 12 MG Cartridge [Humatrope] require prior authorization?
100% of Part D formularies require prior authorization for somatropin 12 MG Cartridge [Humatrope]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on somatropin 12 MG Cartridge [Humatrope]?
In 2023, total Medicare Part D spending on somatropin 12 MG Cartridge [Humatrope] was $27,196,427, covering 1,572 beneficiaries. The average spend per beneficiary was $17,300.53.
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
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Similar prior-authorization rate
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