timolol hemihydrate 5 MG/ML Ophthalmic Solution
timolol hemihydrate
RxCUI: 2702393
What the CMS Formulary Data Shows for timolol hemihydrate 5 MG/ML Ophthalmic Solution
Per the CMS 2026 Part D formulary file, timolol hemihydrate 5 MG/ML Ophthalmic Solution (RxNorm concept RXCUI 2702393, generic name timolol hemihydrate) appears on 66 distinct formulary files spanning 235 Medicare Part D plan offerings - 4.6% 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 1.3.
Real-world access to timolol hemihydrate 5 MG/ML Ophthalmic Solution 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 6,978 Part D beneficiaries filled timolol hemihydrate 5 MG/ML Ophthalmic Solution in 2023, with total plan-and-beneficiary spending of $4,906,851 and an average per-beneficiary annual cost of $703.19. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry timolol hemihydrate 5 MG/ML Ophthalmic Solution today.
Coverage Details
- Formularies covering
- 66
- Plans covering
- 235
- Coverage rate
- 4.6%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 1, Preferred Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 6,978
- Total spending
- $4,906,851
- Avg per beneficiary
- $703.19
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering timolol hemihydrate 5 MG/ML Ophthalmic Solution
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Geisinger Gold Preferred Complete Rx (PPO) | GEISINGER INDEMNITY INSURANCE COMPANY | T1 | No | $0 | PA |
| Geisinger Gold Secure Rx (HMO D-SNP) | GEISINGER HEALTH PLAN | T1 | No | $0 | PA |
| Geisinger Gold Classic 360 Rx (HMO) | GEISINGER HEALTH PLAN | T1 | No | $0 | PA |
| Geisinger Gold Classic Essential Rx (HMO) | GEISINGER HEALTH PLAN | T1 | No | $0 | PA |
| DrMax (HMO) | DOCTORS HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| DrExtraCare (HMO C-SNP) | DOCTORS HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| DrSelect (HMO) | DOCTORS HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| DrSelect-CFL (HMO) | DOCTORS HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| DrPlatinum-CFL (HMO D-SNP) | DOCTORS HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| DrTotalCare-CFL (HMO C-SNP) | DOCTORS HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| DrElite-SFL (HMO) | DOCTORS HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| MCS Classicare RxMax (HMO) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Platino Ideal (HMO D-SNP) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Efectivo (HMO) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Essential (HMO-POS) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Platino Progreso (HMO D-SNP) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Primero (HMO C-SNP) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Firme (HMO) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare En Tu Hogar (HMO) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Hero (HMO) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Platino Total (HMO D-SNP) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare InteliCare (HMO) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Platino Maximo (HMO D-SNP) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Excede (HMO) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Estrella (HMO) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Platino Superior (HMO D-SNP) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Platino 185 (HMO D-SNP) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| CenCal CareConnect (HMO D-SNP) | SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA | T1 | No | $0 | CA |
| SummaCare Medicare Topaz (HMO) | SUMMACARE INC. | T1 | No | $0 | OH |
| SummaCare Medicare Quartz (HMO) | SUMMACARE INC. | T1 | No | $0 | OH |
| IEHP DualChoice (HMO D-SNP) | Inland Empire Health Plan | T1 | No | $0 | CA |
| PHP (HMO C-SNP) | AIDS HEALTHCARE FOUNDATION | T1 | No | $0 | CA |
| Astiva Health Savings Plan (HMO) | ASTIVA HEALTH, INC. | T1 | No | $0 | CA |
| Astiva Health C-SNP Deluxe (HMO C-SNP) | ASTIVA HEALTH, INC. | T1 | No | $0 | CA |
| Astiva Health Savings Plan - NorCal (HMO) | ASTIVA HEALTH, INC. | T1 | No | $0 | CA |
| Astiva Health Premier Plan - NorCal (HMO) | ASTIVA HEALTH, INC. | T1 | No | $0 | CA |
| Astiva Health Premier Plan (HMO) | ASTIVA HEALTH, INC. | T1 | No | $0 | CA |
| ATRIO Prime Rx (HMO) | ATRIO HEALTH PLANS | T1 | No | $0 | OR |
| ATRIO Choice Rx (PPO) | ATRIO HEALTH PLANS | T1 | No | $0 | OR |
| ATRIO Choice Rx (PPO) | ATRIO HEALTH PLANS | T1 | No | $0 | OR |
| ATRIO Prime Rx (PPO) | ATRIO HEALTH PLANS | T1 | No | $0 | OR |
| ATRIO Prime Rx (PPO) | ATRIO HEALTH PLANS | T1 | No | $0 | OR |
| ATRIO Prime Rx (PPO) | ATRIO HEALTH PLANS | T1 | No | $0 | OR |
| ATRIO Choice Rx (PPO) | ATRIO HEALTH PLANS | T1 | No | $0 | OR |
| ATRIO Choice Rx (PPO) | ATRIO HEALTH PLANS | T1 | No | $0 | OR |
| ATRIO Support Rx (PPO C-SNP) | ATRIO HEALTH PLANS | T1 | No | $0 | OR |
| BayCarePlus Complete (HMO) | BAYCARE SELECT HEALTH PLANS, INC. | T1 | No | $0 | FL |
| BayCarePlus Rewards (HMO) | BAYCARE SELECT HEALTH PLANS, INC. | T1 | No | $0 | FL |
| BayCarePlus Premier (HMO) | BAYCARE SELECT HEALTH PLANS, INC. | T1 | No | $0 | FL |
| TotalCare (HMO D-SNP) | SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDIC | T1 | No | $0 | CA |
Frequently Asked Questions
Is timolol hemihydrate 5 MG/ML Ophthalmic Solution covered by Medicare Part D?
Yes, timolol hemihydrate 5 MG/ML Ophthalmic Solution is covered by 235 Medicare Part D plans (4.6% of all Part D formularies).
What tier is timolol hemihydrate 5 MG/ML Ophthalmic Solution on Medicare Part D plans?
timolol hemihydrate 5 MG/ML Ophthalmic Solution averages Tier 1.3 across Part D plans, ranging from Tier 1 to Tier 4.
Does timolol hemihydrate 5 MG/ML Ophthalmic Solution require prior authorization?
0% of Part D formularies require prior authorization for timolol hemihydrate 5 MG/ML Ophthalmic Solution. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on timolol hemihydrate 5 MG/ML Ophthalmic Solution?
In 2023, total Medicare Part D spending on timolol hemihydrate 5 MG/ML Ophthalmic Solution was $4,906,851, covering 6,978 beneficiaries. The average spend per beneficiary was $703.19.
Read our methodology - how this data is sourced, computed, and verified.