testosterone cypionate 200 MG/ML Injectable Solution [Depo-testosterone]

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testosterone cypionate

RxCUI: 835842

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
26.4%
Plan Coverage
1,340
Plans Covering
T2.4
Avg Tier
83.8%
Prior Auth Required

What the CMS Formulary Data Shows for testosterone cypionate 200 MG/ML Injectable Solution [Depo-testosterone]

Per the CMS 2026 Part D formulary file, testosterone cypionate 200 MG/ML Injectable Solution [Depo-testosterone] (RxNorm concept RXCUI 835842, generic name testosterone cypionate) appears on 105 distinct formulary files spanning 1,340 Medicare Part D plan offerings - 26.4% 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 2.4.

Real-world access to testosterone cypionate 200 MG/ML Injectable Solution [Depo-testosterone] depends on utilization management as much as tier placement: 83.8% 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 242,810 Part D beneficiaries filled testosterone cypionate 200 MG/ML Injectable Solution [Depo-testosterone] in 2023, with total plan-and-beneficiary spending of $37,968,692 and an average per-beneficiary annual cost of $156.37. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry testosterone cypionate 200 MG/ML Injectable Solution [Depo-testosterone] today.

Coverage Details

Formularies covering
105
Plans covering
1,340
Coverage rate
26.4%
Tier range
Tier 1 – Tier 4
Average tier
Tier 2, Generic

Restrictions

Prior authorization required
83.8% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

2023 Medicare Spending

Beneficiaries
242,810
Total spending
$37,968,692
Avg per beneficiary
$156.37

Tier Distribution Across Plans

79 plans
Tier 1, Preferred Generic
21 plans
Tier 2, Generic

Medicare Advantage Plans (MA-PD) Covering testosterone cypionate 200 MG/ML Injectable Solution [Depo-testosterone]

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Freedom VIP Care (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Savings (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Savings (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Rewards (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Rewards (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Optimum Diamond Rewards (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Savings (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Rewards (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Freedom Medi-Medi Partial (HMO D-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Medi-Medi Full (HMO D-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Optimum Emerald Partial (HMO D-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Emerald Full (HMO D-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Freedom Medicare Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Medicare Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Savings COPD (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Savings COPD (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Máximo (HMO-POS) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Máximo (HMO-POS) FREEDOM HEALTH, INC. T1 No $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Platinum Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Gold Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Savings COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Gold Plus Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Florida Complete Care-Duals VIP (HMO-POS D-SNP) HPMP OF FLORIDA, INC. T1 Yes $0 FL
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 Yes $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 Yes $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 Yes $0 AZ
Elderplan Plus Long-Term Care (HMO-POS D-SNP) ELDERPLAN, INC. T1 Yes $0 NY
Health Choice Pathway (HMO D-SNP) HEALTH CHOICE ARIZONA, INC. T1 Yes $0 AZ
Healthfirst CompleteCare (HMO D-SNP) HEALTHFIRST HEALTH PLAN, INC. T1 Yes $0 NY
IMCare Classic (HMO D-SNP) ITASCA MEDICAL CARE T1 Yes $0 MN
Johns Hopkins Advantage MD D-SNP (HMO D-SNP) HOPKINS HEALTH ADVANTAGE, INC. T1 Yes $0 MD
MetroPlus UltraCare (HMO D-SNP) METROPLUS HEALTH PLAN, INC. T1 Yes $0 NY
Senior Whole Health SCO (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 Yes $0 MA

Frequently Asked Questions

Is testosterone cypionate 200 MG/ML Injectable Solution [Depo-testosterone] covered by Medicare Part D?

Yes, testosterone cypionate 200 MG/ML Injectable Solution [Depo-testosterone] is covered by 1,340 Medicare Part D plans (26.4% of all Part D formularies).

What tier is testosterone cypionate 200 MG/ML Injectable Solution [Depo-testosterone] on Medicare Part D plans?

testosterone cypionate 200 MG/ML Injectable Solution [Depo-testosterone] averages Tier 2.4 across Part D plans, ranging from Tier 1 to Tier 4.

Does testosterone cypionate 200 MG/ML Injectable Solution [Depo-testosterone] require prior authorization?

83.8% of Part D formularies require prior authorization for testosterone cypionate 200 MG/ML Injectable Solution [Depo-testosterone]. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on testosterone cypionate 200 MG/ML Injectable Solution [Depo-testosterone]?

In 2023, total Medicare Part D spending on testosterone cypionate 200 MG/ML Injectable Solution [Depo-testosterone] was $37,968,692, covering 242,810 beneficiaries. The average spend per beneficiary was $156.37.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial