Medicare Part D coverage · ticagrelor · RxCUI 1116639
ticagrelor 90 MG Oral Tablet [Brilinta]
Per the CMS 2026 Part D formulary file, ticagrelor 90 MG Oral Tablet [Brilinta] is covered by 114 Medicare Part D plans (2.3% of enrollable products), averaging Tier 3, with prior authorization required on 0% of covering formularies.
- 2.3%
- Plan coverage
- 114
- Plans covering
- T3
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for ticagrelor 90 MG Oral Tablet [Brilinta]
Per the CMS 2026 Part D formulary file, ticagrelor 90 MG Oral Tablet [Brilinta] (RxNorm concept RXCUI 1116639, generic name ticagrelor) appears on 25 distinct formulary files spanning 114 Medicare Part D plan offerings - 2.3% 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 3.
Real-world access to ticagrelor 90 MG Oral Tablet [Brilinta] depends on utilization management as much as tier placement: 0% 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 234,770 Part D beneficiaries filled ticagrelor 90 MG Oral Tablet [Brilinta] in 2023, with total plan-and-beneficiary spending of $691,725,954 and an average per-beneficiary annual cost of $2,946.40. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry ticagrelor 90 MG Oral Tablet [Brilinta] today.
Coverage Details
- Formularies covering
- 25
- Plans covering
- 114
- Coverage rate
- 2.3%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 234,770
- Total spending
- $691,725,954
- Avg per beneficiary
- $2,946.40
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering ticagrelor 90 MG Oral Tablet [Brilinta]
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 | No | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | No | $0 | CA |
| Hamaspik Medicare Select (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $34.50 | NY |
| BlueCare Plus (HMO D-SNP) | Volunteer State Health Plan | T2 | No | $0 | TN |
| BlueCare Plus Choice (HMO D-SNP) | Volunteer State Health Plan | T2 | No | $0 | TN |
| BlueCare Plus Select (HMO D-SNP) | Volunteer State Health Plan | T2 | No | $0 | TN |
| BlueAdvantage Sapphire (PPO) | Bluecross Blueshield OF Tennessee, Inc. | T3 | No | $0 | TN |
| BlueAdvantage Sapphire (PPO) | Bluecross Blueshield OF Tennessee, Inc. | T3 | No | $0 | TN |
| BlueAdvantage Garnet (PPO) | Bluecross Blueshield OF Tennessee, Inc. | T3 | No | $0 | TN |
| BlueAdvantage Garnet (PPO) | Bluecross Blueshield OF Tennessee, Inc. | T3 | No | $0 | TN |
| BlueAdvantage Sapphire (PPO) | Bluecross Blueshield OF Tennessee, Inc. | T3 | No | $0 | TN |
| BlueAdvantage Sapphire (PPO) | Bluecross Blueshield OF Tennessee, Inc. | T3 | No | $0 | GA |
| BlueAdvantage Total Heart and Diabetes (PPO C-SNP) | Bluecross Blueshield OF Tennessee, Inc. | T3 | No | $0 | GA, TN |
| BlueAdvantage Total Heart and Diabetes (PPO C-SNP) | Bluecross Blueshield OF Tennessee, Inc. | T3 | No | $0 | TN |
| Personal Choice 65 Achieve Rx (PPO) | QCC Insurance Company | T3 | No | $0 | PA |
| Keystone 65 Focus Rx (HMO-POS) | Keystone Health Plan East, Inc. | T3 | No | $0 | PA |
Show the next 30 plans
| Keystone 65 Focus Rx (HMO-POS) | Keystone Health Plan East, Inc. | T3 | No | $0 | PA |
| Keystone 65 Basic Rx (HMO) | Keystone Health Plan East, Inc. | T3 | No | $0 | PA |
| AmeriHealth Medicare Core (PPO) | Amerihealth Insurance Company OF NEW Jersey | T3 | No | $0 | NJ |
| AmeriHealth Medicare Ultimate (PPO) | Amerihealth Insurance Company OF NEW Jersey | T3 | No | $0 | NJ |
| Health New England Medicare Compass (PPO) | Health NEW England, Inc. | T3 | No | $0 | MA |
| Health New England Medicare Value (HMO) | Health NEW England, Inc. | T3 | No | $0 | MA |
| IEHP DualChoice (HMO D-SNP) | Inland Empire Health Plan | T3 | No | $0 | CA |
| Jefferson Health Plans Choice (PPO) | Partners Insurance Company OF NEW Jersey Inc | T3 | No | $0 | NJ |
| Jefferson Health Plans Complete (HMO) | Health Partners Plans, Inc. | T3 | No | $0 | PA |
| Jefferson Health Plans Silver (HMO) | Health Partners Plans, Inc. | T3 | No | $0 | NJ |
| Jefferson Health Plans Elite (HMO) | Health Partners Plans, Inc. | T3 | No | $0 | NJ |
| Jefferson Health Plans Special (HMO D-SNP) | Health Partners Plans, Inc. | T3 | No | $0 | PA |
| Jefferson Health Plans Dual Pearl (HMO D-SNP) | Health Partners Plans, Inc. | T3 | No | $0 | PA |
| Jefferson Health Plans Select (HMO D-SNP) | Health Partners Plans, Inc. | T3 | No | $0 | PA |
| Jefferson Health Plans Flex (PPO) | Partners Insurance Company Inc | T3 | No | $0 | PA |
| Jefferson Health Plans Giveback (HMO) | Health Partners Plans, Inc. | T3 | No | $0 | PA |
| Health First Rewards H1099-014 (HMO) | Health First Health Plans | T3 | No | $0 | FL |
| Health First SunSaver H1099-016 (HMO) | Health First Health Plans | T3 | No | $0 | FL |
| Health First Complete Care H1099-023 (HMO) | Health First Health Plans | T3 | No | $0 | FL |
| Health First Emerald Plus H1099-024 (HMO) | Health First Health Plans | T3 | No | $0 | FL |
| Health First Premier Access H1099-025 (HMO-POS) | Health First Health Plans | T3 | No | $0 | FL |
| Health First Emerald Plus H1099-026 (HMO) | Health First Health Plans | T3 | No | $0 | FL |
| Health First Premier Access H1099-027 (HMO-POS) | Health First Health Plans | T3 | No | $0 | FL |
| Health First Emerald Plus H1099-028 (HMO) | Health First Health Plans | T3 | No | $0 | FL |
| Gundersen Quartz Med Advantage Basic D (w/Rx) (HMO) | Quartz Health Plan Corporation | T3 | No | $0 | IA, WI |
| UW Health Quartz Med Advantage Basic D (w/Rx) (HMO) | Quartz Health Plan Corporation | T3 | No | $0 | WI |
| Gundersen MN Quartz Med Advantage Basic D (w/Rx) (HMO) | Quartz Health Plan MN Corporation | T3 | No | $0 | MN |
| Gundersen MN Quartz Med Advantage Core D (w/Rx) (HMO) | Quartz Health Plan MN Corporation | T3 | No | $8.20 | MN |
| Health First Value H1099-006 (HMO) | Health First Health Plans | T3 | No | $15.00 | FL |
| Health New England Medicare Premium (HMO) | Health NEW England, Inc. | T3 | No | $15.80 | MA |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is ticagrelor 90 MG Oral Tablet [Brilinta] covered by Medicare Part D?
Yes, ticagrelor 90 MG Oral Tablet [Brilinta] is covered by 114 Medicare Part D plans (2.3% of all Part D formularies).
What tier is ticagrelor 90 MG Oral Tablet [Brilinta] on Medicare Part D plans?
ticagrelor 90 MG Oral Tablet [Brilinta] averages Tier 3 across Part D plans, ranging from Tier 1 to Tier 4.
Does ticagrelor 90 MG Oral Tablet [Brilinta] require prior authorization?
0% of Part D formularies require prior authorization for ticagrelor 90 MG Oral Tablet [Brilinta]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on ticagrelor 90 MG Oral Tablet [Brilinta]?
In 2023, total Medicare Part D spending on ticagrelor 90 MG Oral Tablet [Brilinta] was $691,725,954, covering 234,770 beneficiaries. The average spend per beneficiary was $2,946.40.
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.