Medicare Part D coverage · timolol hemihydrate · RxCUI 2702393
timolol hemihydrate 5 MG/ML Ophthalmic Solution
Per the CMS 2026 Part D formulary file, timolol hemihydrate 5 MG/ML Ophthalmic Solution is covered by 1,088 Medicare Part D plans (21.5% of enrollable products), averaging Tier 1.5, with prior authorization required on 0% of covering formularies.
- 21.5%
- Plan coverage
- 1,088
- Plans covering
- T1.5
- Avg tier
- 0%
- Prior auth required
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 73 distinct formulary files spanning 1,088 Medicare Part D plan offerings - 21.5% 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 1.5.
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 $3,132,739 and an average per-beneficiary annual cost of $448.95. 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
- 73
- Plans covering
- 1,088
- Coverage rate
- 21.5%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, 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
- $3,132,739
- Avg per beneficiary
- $448.95
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 |
Show the next 30 plans
| 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 |
Showing top 50 of 100 plans.
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 1,088 Medicare Part D plans (21.5% 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 1.5 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 $3,132,739, covering 6,978 beneficiaries. The average spend per beneficiary was $448.95.
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
Similar prior-authorization rate
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