Medicare Part D coverage · spironolactone · RxCUI 104232
spironolactone 5 MG/ML Oral Suspension
Per the CMS 2026 Part D formulary file, spironolactone 5 MG/ML Oral Suspension is covered by 29 Medicare Part D plans (0.6% of enrollable products), averaging Tier 1.8, with prior authorization required on 0% of covering formularies.
- 0.6%
- Plan coverage
- 29
- Plans covering
- T1.8
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for spironolactone 5 MG/ML Oral Suspension
Per the CMS 2026 Part D formulary file, spironolactone 5 MG/ML Oral Suspension (RxNorm concept RXCUI 104232, generic name spironolactone) appears on 11 distinct formulary files spanning 29 Medicare Part D plan offerings - 0.6% 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 1.8.
Real-world access to spironolactone 5 MG/ML Oral Suspension depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 54.5% require step therapy. 54.5% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 2,081,937 Part D beneficiaries filled spironolactone 5 MG/ML Oral Suspension in 2023, with total plan-and-beneficiary spending of $101,773,696 and an average per-beneficiary annual cost of $48.88. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry spironolactone 5 MG/ML Oral Suspension today.
Coverage Details
- Formularies covering
- 11
- Plans covering
- 29
- Coverage rate
- 0.6%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 54.5% of formularies
- Quantity limits
- 54.5% of formularies
2023 Medicare Spending
- Beneficiaries
- 2,081,937
- Total spending
- $101,773,696
- Avg per beneficiary
- $48.88
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering spironolactone 5 MG/ML Oral Suspension
29 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| PHP (HMO C-snp) | Aids Healthcare Foundation | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | No | $0 | NY |
| 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 |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | No | $4.80 | FL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | No | $17.00 | AZ |
| VNS Health EasyCare Plus (HMO D-SNP) | VNS Choice | T1 | No | $51.60 | NY |
| Gold Heart & Diabetes (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T2 | No | $0 | FL |
| Gold Heart & Diabetes Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T2 | No | $0 | FL |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T2 | No | $0 | FL |
| Gold Health (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T2 | No | $0 | FL |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T2 | No | $0 | FL |
| Gold Heart & Diabetes (HMO-POS C-SNP) | Gold Kidney OF Arizona | T2 | No | $0 | AZ |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | Gold Kidney OF Arizona | T2 | No | $0 | AZ |
| Gold Heart & Diabetes (HMO-POS C-SNP) | Gold Kidney OF Arizona | T2 | No | $0 | AZ |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | Gold Kidney OF Arizona | T2 | No | $0 | AZ |
| VillageCareMAX Medicare Health Advantage Plan (HMO D-SNP) | Village Senior Services Corporation | T2 | No | $0 | NY |
| VillageCareMAX Medicare Total Advantage Plan (HMO D-SNP) | Village Senior Services Corporation | T2 | No | $0 | NY |
| Mass General Brigham Advantage (PPO) | Mass General Brigham Health Plan, Inc. | T3 | No | $0 | MA |
Show the next 9 plans
| Mass General Brigham Advantage Secure (HMO-POS) | Mass General Brigham Health Plan, Inc. | T3 | No | $62.00 | MA |
| Mass General Brigham Advantage Premier (PPO) | Mass General Brigham Health Plan, Inc. | T3 | No | $79.70 | MA |
| Mass General Brigham Advantage Signature (PPO) | Mass General Brigham Health Plan, Inc. | T3 | No | $147.20 | MA |
| SummaCare Medicare Topaz (HMO) | Summacare Inc. | T4 | No | $0 | OH |
| SummaCare Medicare Quartz (HMO) | Summacare Inc. | T4 | No | $0 | OH |
| SummaCare Medicare Garnet (HMO) | Summacare Inc. | T4 | No | $35.00 | OH |
| SummaCare Medicare Ruby (HMO) | Summacare Inc. | T4 | No | $50.00 | OH |
| SummaCare Medicare Sapphire (HMO-POS) | Summacare Inc. | T4 | No | $83.00 | OH |
| SummaCare Medicare Emerald (HMO-POS) | Summacare Inc. | T4 | No | $100.80 | OH |
Frequently Asked Questions
Is spironolactone 5 MG/ML Oral Suspension covered by Medicare Part D?
Yes, spironolactone 5 MG/ML Oral Suspension is covered by 29 Medicare Part D plans (0.6% of all Part D formularies).
What tier is spironolactone 5 MG/ML Oral Suspension on Medicare Part D plans?
spironolactone 5 MG/ML Oral Suspension averages Tier 1.8 across Part D plans, ranging from Tier 1 to Tier 4.
Does spironolactone 5 MG/ML Oral Suspension require prior authorization?
0% of Part D formularies require prior authorization for spironolactone 5 MG/ML Oral Suspension. Step therapy: 54.5%. Quantity limits: 54.5%.
How much does Medicare spend on spironolactone 5 MG/ML Oral Suspension?
In 2023, total Medicare Part D spending on spironolactone 5 MG/ML Oral Suspension was $101,773,696, covering 2,081,937 beneficiaries. The average spend per beneficiary was $48.88.
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
- fluconazole 50 MG Oral Tablet T1.8
- Smoking Cessation 12 HR bupropion hydrochloride 150 MG Extended Release Oral Tablet T1.8
- metolazone 5 MG Oral Tablet T1.8
- doxycycline monohydrate 50 MG Oral Capsule T1.8
- trihexyphenidyl hydrochloride 2 MG Oral Tablet T1.8
- Microencapsulated potassium chloride 15 MEQ Extended Release Oral Tablet [Klor-Con] T1.8
Similar prior-authorization rate
- metronidazole 10 MG/ML Topical Cream [Noritate] 0% PA
- 24 HR minocycline 40 MG Extended Release Oral Capsule [Emrosi] 0% PA
- buspirone hydrochloride 10 MG Oral Capsule [Bucapsol] 0% PA
- diflunisal 375 MG Oral Tablet [Dolobid] 0% PA
- hydrocortisone 1 MG/ML Oral Solution [Khindivi] 0% PA
- indomethacin 50 MG Rectal Suppository [Indocin] 0% PA