testosterone undecanoate 158 MG Oral Capsule [Jatenzo]

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testosterone undecanoate

RxCUI: 2201640

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.
0.1%
Plan Coverage
6
Plans Covering
T4
Avg Tier
100%
Prior Auth Required

What the CMS Formulary Data Shows for testosterone undecanoate 158 MG Oral Capsule [Jatenzo]

Per the CMS 2026 Part D formulary file, testosterone undecanoate 158 MG Oral Capsule [Jatenzo] (RxNorm concept RXCUI 2201640, generic name testosterone undecanoate) appears on 1 distinct formulary file spanning 6 Medicare Part D plan offerings - 0.1% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 4 to Tier 4, with a cross-plan average of Tier 4.

Real-world access to testosterone undecanoate 158 MG Oral Capsule [Jatenzo] depends on utilization management as much as tier placement: 100% 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 1,079 Part D beneficiaries filled testosterone undecanoate 158 MG Oral Capsule [Jatenzo] in 2023, with total plan-and-beneficiary spending of $4,591,544 and an average per-beneficiary annual cost of $4,255.37. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry testosterone undecanoate 158 MG Oral Capsule [Jatenzo] today.

Coverage Details

Formularies covering
1
Plans covering
6
Coverage rate
0.1%
Tier range
Tier 4, Non-Preferred
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
100% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

2023 Medicare Spending

Beneficiaries
1,079
Total spending
$4,591,544
Avg per beneficiary
$4,255.37

Tier Distribution Across Plans

6 plans
Tier 4, Non-Preferred

Medicare Advantage Plans (MA-PD) Covering testosterone undecanoate 158 MG Oral Capsule [Jatenzo]

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

Plan Insurer Tier PA Premium States
Keystone 65 Select Rx (HMO) KEYSTONE HEALTH PLAN EAST, INC. T4 Yes $47.00 PA
Keystone 65 Preferred Rx (HMO) KEYSTONE HEALTH PLAN EAST, INC. T4 Yes $59.70 PA
Keystone 65 Select Rx (HMO) KEYSTONE HEALTH PLAN EAST, INC. T4 Yes $63.50 PA
Keystone 65 Preferred Rx (HMO) KEYSTONE HEALTH PLAN EAST, INC. T4 Yes $79.70 PA
Personal Choice 65 Rx (PPO) QCC INSURANCE COMPANY T4 Yes $102.20 PA
Personal Choice 65 Rx (PPO) QCC INSURANCE COMPANY T4 Yes $112.70 PA

Frequently Asked Questions

Is testosterone undecanoate 158 MG Oral Capsule [Jatenzo] covered by Medicare Part D?

Yes, testosterone undecanoate 158 MG Oral Capsule [Jatenzo] is covered by 6 Medicare Part D plans (0.1% of all Part D formularies).

What tier is testosterone undecanoate 158 MG Oral Capsule [Jatenzo] on Medicare Part D plans?

testosterone undecanoate 158 MG Oral Capsule [Jatenzo] averages Tier 4 across Part D plans, ranging from Tier 4 to Tier 4.

Does testosterone undecanoate 158 MG Oral Capsule [Jatenzo] require prior authorization?

100% of Part D formularies require prior authorization for testosterone undecanoate 158 MG Oral Capsule [Jatenzo]. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on testosterone undecanoate 158 MG Oral Capsule [Jatenzo]?

In 2023, total Medicare Part D spending on testosterone undecanoate 158 MG Oral Capsule [Jatenzo] was $4,591,544, covering 1,079 beneficiaries. The average spend per beneficiary was $4,255.37.

Read our methodology - how this data is sourced, computed, and verified.

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