Medicare Part D coverage · teriflunomide · RxCUI 1310533
teriflunomide 7 MG Oral Tablet
Per the CMS 2026 Part D formulary file, teriflunomide 7 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 7 MG Oral Tablet
Per the CMS 2026 Part D formulary file, teriflunomide 7 MG Oral Tablet (RxNorm concept RXCUI 1310533, 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 7 MG Oral Tablet depends on utilization management as much as tier placement: 63.3% of covering formularies require prior authorization. 0% require step therapy. 92.2% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 6,565 Part D beneficiaries filled teriflunomide 7 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 7 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
- 92.2% 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 7 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 7 MG Oral Tablet covered by Medicare Part D?
Yes, teriflunomide 7 MG Oral Tablet is covered by 3,937 Medicare Part D plans (77.9% of all Part D formularies).
What tier is teriflunomide 7 MG Oral Tablet on Medicare Part D plans?
teriflunomide 7 MG Oral Tablet averages Tier 3.4 across Part D plans, ranging from Tier 1 to Tier 5.
Does teriflunomide 7 MG Oral Tablet require prior authorization?
63.3% of Part D formularies require prior authorization for teriflunomide 7 MG Oral Tablet. Step therapy: 0%. Quantity limits: 92.2%.
How much does Medicare spend on teriflunomide 7 MG Oral Tablet?
In 2023, total Medicare Part D spending on teriflunomide 7 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