timolol hemihydrate 5 MG/ML Ophthalmic Solution

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timolol hemihydrate

RxCUI: 2702393

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.
4.6%
Plan Coverage
235
Plans Covering
T1.3
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 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

100 plans
Tier 1, Preferred Generic

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.

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