Medicare Part D coverage · teriflunomide · RxCUI 1310525
teriflunomide 14 MG Oral Tablet
Per the CMS 2026 Part D formulary file, teriflunomide 14 MG Oral Tablet is covered by 3,937 Medicare Part D plans (77.9% of enrollable products), averaging Tier 3.4, with prior authorization required on 63.3% of covering formularies.
- 77.9%
- Plan coverage
- 3,937
- Plans covering
- T3.4
- Avg tier
- 63.3%
- Prior auth required
What the CMS Formulary Data Shows for teriflunomide 14 MG Oral Tablet
Per the CMS 2026 Part D formulary file, teriflunomide 14 MG Oral Tablet (RxNorm concept RXCUI 1310525, generic name teriflunomide) appears on 166 distinct formulary files spanning 3,937 Medicare Part D plan offerings - 77.9% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 3.4.
Real-world access to teriflunomide 14 MG Oral Tablet depends on utilization management as much as tier placement: 63.3% of covering formularies require prior authorization. 0% require step therapy. 90.4% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 6,565 Part D beneficiaries filled teriflunomide 14 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $353,934,133 and an average per-beneficiary annual cost of $53,912.28. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry teriflunomide 14 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 166
- Plans covering
- 3,937
- Coverage rate
- 77.9%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 63.3% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 90.4% of formularies
2023 Medicare Spending
- Beneficiaries
- 6,565
- Total spending
- $353,934,133
- Avg per beneficiary
- $53,912.28
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering teriflunomide 14 MG Oral Tablet
100 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 | Yes | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | Yes | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | Yes | $0 | NJ |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | Yes | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | Yes | $0 | GA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | Yes | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | No | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | No | $0 | AL |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | Yes | $0 | CA |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | Yes | $0 | MA |
| 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 |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| Platino Blindao (HMO D-SNP) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Enlace (HMO D-SNP) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Advance (HMO D-snp) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Plus (HMO D-snp) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
Show the next 30 plans
| FHCP Medicare Classic (HMO) | Florida Blue Medicare, Inc. | T1 | Yes | $0 | FL |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | Yes | $0 | CA |
| 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 |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | Yes | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | Yes | $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 | Yes | $4.80 | FL |
| Senior Care (HMO I-SNP) | Align Senior Care Florida, Inc. | T1 | No | $4.80 | FL |
| ProCare Advantage (HMO-POS I-SNP) | Procare Advantage, LLC | T1 | No | $4.80 | TX |
| ProCare Advantage - Kidney Care (HMO-POS C-SNP) | Procare Advantage, LLC | T1 | No | $4.80 | TX |
| American Health Advantage of Florida (HMO I-SNP) | American Health Plan OF FL, Inc. | T1 | No | $4.80 | FL |
| SECUR Advantage (HMO I-SNP) | Secur Inc | T1 | No | $4.80 | FL |
| SECUR Enhanced (HMO I-SNP) | Secur Inc | T1 | No | $4.80 | FL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | Yes | $4.80 | FL |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Michigan, Inc. | T1 | Yes | $8.80 | MI |
| Senior Care (HMO I-SNP) | Align Senior Care MI, LLC | T1 | No | $8.80 | MI |
| AgeRight Advantage Health Plan (HMO I-SNP) | Marquis Advantage, Inc. | T1 | No | $10.50 | OR, WA |
| Senior Care (HMO I-SNP) | Align Senior Care California Inc. | T1 | No | $12.00 | CA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $13.10 | PA |
| Liberty Medicare Dual Plan (HMO D-SNP) | Liberty Advantage, LLC | T1 | No | $14.70 | NC |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Illinois, Inc. | T1 | Yes | $15.20 | IL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | Yes | $17.00 | AZ |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $17.60 | PA |
| WellSense Added Value (HMO) | Boston Medical Center Health Plan, Inc. | T1 | Yes | $21.70 | NH |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is teriflunomide 14 MG Oral Tablet covered by Medicare Part D?
Yes, teriflunomide 14 MG Oral Tablet is covered by 3,937 Medicare Part D plans (77.9% of all Part D formularies).
What tier is teriflunomide 14 MG Oral Tablet on Medicare Part D plans?
teriflunomide 14 MG Oral Tablet averages Tier 3.4 across Part D plans, ranging from Tier 1 to Tier 5.
Does teriflunomide 14 MG Oral Tablet require prior authorization?
63.3% of Part D formularies require prior authorization for teriflunomide 14 MG Oral Tablet. Step therapy: 0%. Quantity limits: 90.4%.
How much does Medicare spend on teriflunomide 14 MG Oral Tablet?
In 2023, total Medicare Part D spending on teriflunomide 14 MG Oral Tablet was $353,934,133, covering 6,565 beneficiaries. The average spend per beneficiary was $53,912.28.
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
- 1 ML penicillin G benzathine 600000 UNT/ML Prefilled Syringe [Bicillin L-A] T3.4
- levetiracetam 250 MG Tablet for Oral Suspension [Spritam] T3.4
- 24 HR rotigotine 0.0417 MG/HR Transdermal System [Neupro] T3.4
- 24 HR rotigotine 0.0833 MG/HR Transdermal System [Neupro] T3.4
- auranofin 3 MG Oral Capsule [Ridaura] T3.4
- colistin 75 MG/ML Injectable Solution T3.4
Similar prior-authorization rate
- tiopronin 100 MG Delayed Release Oral Tablet 63.3% PA
- lactulose 20000 MG Powder for Oral Solution [Kristalose] 63.6% PA
- ivermectin 3 MG Oral Tablet 63.7% PA
- alosetron 1 MG Oral Tablet 62.8% PA
- alosetron 0.5 MG Oral Tablet 62.8% PA
- deferiprone 1000 MG Oral Tablet [Ferriprox] 62.5% PA