Medicare Part D coverage · tenofovir alafenamide · RxCUI 1858267
tenofovir alafenamide 25 MG Oral Tablet [Vemlidy]
Per the CMS 2026 Part D formulary file, tenofovir alafenamide 25 MG Oral Tablet [Vemlidy] is covered by 2,892 Medicare Part D plans (57.2% of enrollable products), averaging Tier 4.2, with prior authorization required on 14.1% of covering formularies.
- 57.2%
- Plan coverage
- 2,892
- Plans covering
- T4.2
- Avg tier
- 14.1%
- Prior auth required
What the CMS Formulary Data Shows for tenofovir alafenamide 25 MG Oral Tablet [Vemlidy]
Per the CMS 2026 Part D formulary file, tenofovir alafenamide 25 MG Oral Tablet [Vemlidy] (RxNorm concept RXCUI 1858267, generic name tenofovir alafenamide) appears on 156 distinct formulary files spanning 2,892 Medicare Part D plan offerings - 57.2% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 4.2.
Real-world access to tenofovir alafenamide 25 MG Oral Tablet [Vemlidy] depends on utilization management as much as tier placement: 14.1% of covering formularies require prior authorization. 1.3% require step therapy. 59% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 13,612 Part D beneficiaries filled tenofovir alafenamide 25 MG Oral Tablet [Vemlidy] in 2023, with total plan-and-beneficiary spending of $187,858,704 and an average per-beneficiary annual cost of $13,800.96. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry tenofovir alafenamide 25 MG Oral Tablet [Vemlidy] today.
Coverage Details
- Formularies covering
- 156
- Plans covering
- 2,892
- Coverage rate
- 57.2%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 14.1% of formularies
- Step therapy required
- 1.3% of formularies
- Quantity limits
- 59% of formularies
2023 Medicare Spending
- Beneficiaries
- 13,612
- Total spending
- $187,858,704
- Avg per beneficiary
- $13,800.96
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering tenofovir alafenamide 25 MG Oral Tablet [Vemlidy]
5 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | No | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T5 | No | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering tenofovir alafenamide 25 MG Oral Tablet [Vemlidy]
95 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | Sentara Health Plans | T1 | Yes | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | Yes | $0 | VA |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | No | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | No | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | No | $0 | NJ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | No | $0 | NY |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | No | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | No | $0 | GA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | No | $0 | MI |
| 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 |
| 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 | No | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | No | $0 | NY |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | No | $0 | AR |
Show the next 30 plans
| 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 |
| 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 |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | No | $4.80 | FL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | No | $4.80 | FL |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Michigan, Inc. | T1 | No | $8.80 | MI |
| Tribute Select (HMO-POS I-SNP) | Arkansas Superior Select, Inc. | T1 | No | $8.90 | AR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | No | $10.50 | OR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | No | $10.50 | OR |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $13.10 | PA |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Illinois, Inc. | 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 |
| WellSense Added Value (HMO) | Boston Medical Center Health Plan, Inc. | T1 | No | $21.70 | NH |
| Alterwood Advantage Dual Value (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $31.20 | MD |
| Highmark Health Options Duals Select (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $31.20 | DE |
| Valor Health Plan (HMO I-SNP) | TSG Guard, Inc. | T1 | No | $31.40 | OH |
| WV Senior Advantage (HMO I-SNP) | West Virginia Senior Advantage, Inc. | T1 | No | $32.70 | WV |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Colorado, Inc. | T1 | No | $35.20 | CO |
| Abilis Health (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $35.90 | KY, TN |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF North Carolina, Inc. | T1 | No | $36.20 | NC |
Showing top 50 of 95 plans.
Frequently Asked Questions
Is tenofovir alafenamide 25 MG Oral Tablet [Vemlidy] covered by Medicare Part D?
Yes, tenofovir alafenamide 25 MG Oral Tablet [Vemlidy] is covered by 2,892 Medicare Part D plans (57.2% of all Part D formularies).
What tier is tenofovir alafenamide 25 MG Oral Tablet [Vemlidy] on Medicare Part D plans?
tenofovir alafenamide 25 MG Oral Tablet [Vemlidy] averages Tier 4.2 across Part D plans, ranging from Tier 1 to Tier 6.
Does tenofovir alafenamide 25 MG Oral Tablet [Vemlidy] require prior authorization?
14.1% of Part D formularies require prior authorization for tenofovir alafenamide 25 MG Oral Tablet [Vemlidy]. Step therapy: 1.3%. Quantity limits: 59%.
How much does Medicare spend on tenofovir alafenamide 25 MG Oral Tablet [Vemlidy]?
In 2023, total Medicare Part D spending on tenofovir alafenamide 25 MG Oral Tablet [Vemlidy] was $187,858,704, covering 13,612 beneficiaries. The average spend per beneficiary was $13,800.96.
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
- everolimus 10 MG Oral Tablet T4.2
- {56 (elexacaftor 50 MG / ivacaftor 37.5 MG / tezacaftor 25 MG Oral Tablet) / 28 (ivacaftor 75 MG Oral Tablet) } Pack [Trikafta (50 MG / 37.5 MG / 25 MG; 75 MG)] T4.2
- 1.5 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron] T4.2
- alpha 1-proteinase inhibitor, human 1 MG Injection [Prolastin] T4.2
- ivacaftor 150 MG Oral Tablet [Kalydeco] T4.2
- 1 ML darbepoetin alfa 0.2 MG/ML Injection [Aranesp] T4.2
Similar prior-authorization rate
- omega-3 acid ethyl esters (USP) 1000 MG Oral Capsule 14.1% PA
- ceftaroline fosamil 600 MG Injection [Teflaro] 14.1% PA
- haloperidol 5 MG/ML Injectable Solution 14% PA
- 1 ML haloperidol decanoate 100 MG/ML Injection 14.2% PA
- haloperidol decanoate 50 MG/ML Injectable Solution 14.2% PA
- tigecycline 50 MG Injection 14% PA