Medicare Part D coverage · tiopronin · RxCUI 198287
tiopronin 100 MG Oral Tablet
Per the CMS 2026 Part D formulary file, tiopronin 100 MG Oral Tablet is covered by 218 Medicare Part D plans (4.3% of enrollable products), averaging Tier 4.2, with prior authorization required on 39.4% of covering formularies.
- 4.3%
- Plan coverage
- 218
- Plans covering
- T4.2
- Avg tier
- 39.4%
- Prior auth required
What the CMS Formulary Data Shows for tiopronin 100 MG Oral Tablet
Per the CMS 2026 Part D formulary file, tiopronin 100 MG Oral Tablet (RxNorm concept RXCUI 198287, generic name tiopronin) appears on 33 distinct formulary files spanning 218 Medicare Part D plan offerings - 4.3% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.2.
Real-world access to tiopronin 100 MG Oral Tablet depends on utilization management as much as tier placement: 39.4% 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 261 Part D beneficiaries filled tiopronin 100 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $23,230,085 and an average per-beneficiary annual cost of $89,004.16. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry tiopronin 100 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 33
- Plans covering
- 218
- Coverage rate
- 4.3%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 39.4% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 261
- Total spending
- $23,230,085
- Avg per beneficiary
- $89,004.16
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering tiopronin 100 MG Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | Yes | $0 | CA |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | Yes | $0 | CA |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | No | $4.80 | FL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | No | $17.00 | AZ |
| PHP (HMO C-snp) | Aids Healthcare Foundation | T4 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T4 | No | $0 | NY |
| VNS Health EasyCare Plus (HMO D-SNP) | VNS Choice | T4 | No | $51.60 | NY |
| Medicare BlueEssential (PPO) | Excellus Health Plan, Inc. | T5 | No | $0 | NY |
| Medicare BlueActive (PPO) | Excellus Health Plan, Inc. | T5 | No | $0 | NY |
| Medicare BlueVital (PPO) | Excellus Health Plan, Inc. | T5 | No | $0 | NY |
| Univera SeniorChoice Basic (HMO) | Excellus Health Plan, Inc. | T5 | No | $0 | NY |
| Univera SeniorChoice Extra (HMO) | Excellus Health Plan, Inc. | T5 | No | $0 | NY |
| Medicare Blue Choice Core (HMO) | Excellus Health Plan, Inc. | T5 | No | $0 | NY |
| Univera Medicare Dual (HMO D-SNP) | Excellus Health Plan Community Care LLC | T5 | No | $0 | NY |
| Medicare Blue Dual (HMO D-SNP) | Excellus Health Plan Community Care LLC | T5 | No | $0 | NY |
| Network Health Select (PPO) | Network Health Insurance Corporation | T5 | Yes | $0 | WI |
Show the next 30 plans
| Network Health Go (PPO) | Network Health Insurance Corporation | T5 | Yes | $0 | WI |
| Network Health Anywhere (PPO) | Network Health Insurance Corporation | T5 | Yes | $0 | WI |
| Network Health Choice (PPO) | Network Health Insurance Corporation | T5 | Yes | $0 | WI |
| Network Health Zero (PPO) | Network Health Insurance Corporation | T5 | Yes | $0 | WI |
| Troy Medicare (HMO) | Troy Health, Inc. | T5 | Yes | $0 | NC |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | Troy Health, Inc. | T5 | Yes | $0 | NC |
| Contra Costa Health Care Plus (HMO D-SNP) | Contra Costa County Medical Service DBA Contra Costa Health | T5 | Yes | $0 | CA |
| SummaCare Medicare Topaz (HMO) | Summacare Inc. | T5 | No | $0 | OH |
| SummaCare Medicare Quartz (HMO) | Summacare Inc. | T5 | No | $0 | OH |
| Keystone First VIP Choice (HMO D-SNP) | Vista Health Plan, Inc. | T5 | Yes | $0 | PA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Vista Health Plan, Inc. | T5 | Yes | $0 | PA |
| First Choice VIP Care (HMO D-SNP) | Select Health OF South Carolina, Inc. | T5 | Yes | $0 | SC |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T5 | Yes | $0 | DE |
| AmeriHealth Caritas VIP Care Choice (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T5 | Yes | $0 | DE |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Amerihealth Caritas Florida, Inc. | T5 | Yes | $0 | FL |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Amerihealth Caritas Louisiana, Inc. | T5 | Yes | $0 | LA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Amerihealth Caritas North Carolina, Inc. | T5 | Yes | $0 | NC |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Amerihealth Michigan, Inc. | T5 | Yes | $0 | MI |
| Gold Heart & Diabetes (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T5 | No | $0 | FL |
| Gold Heart & Diabetes Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T5 | No | $0 | FL |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T5 | No | $0 | FL |
| Gold Health (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T5 | No | $0 | FL |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T5 | No | $0 | FL |
| Gold Heart & Diabetes (HMO-POS C-SNP) | Gold Kidney OF Arizona | T5 | No | $0 | AZ |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | Gold Kidney OF Arizona | T5 | No | $0 | AZ |
| Gold Heart & Diabetes (HMO-POS C-SNP) | Gold Kidney OF Arizona | T5 | No | $0 | AZ |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | Gold Kidney OF Arizona | T5 | No | $0 | AZ |
| VillageCareMAX Medicare Health Advantage Plan (HMO D-SNP) | Village Senior Services Corporation | T5 | No | $0 | NY |
| VillageCareMAX Medicare Total Advantage Plan (HMO D-SNP) | Village Senior Services Corporation | T5 | No | $0 | NY |
| Presbyterian Senior Care Plan 2 with Rx (HMO) | Presbyterian Health Plan | T5 | No | $0 | NM |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is tiopronin 100 MG Oral Tablet covered by Medicare Part D?
Yes, tiopronin 100 MG Oral Tablet is covered by 218 Medicare Part D plans (4.3% of all Part D formularies).
What tier is tiopronin 100 MG Oral Tablet on Medicare Part D plans?
tiopronin 100 MG Oral Tablet averages Tier 4.2 across Part D plans, ranging from Tier 1 to Tier 5.
Does tiopronin 100 MG Oral Tablet require prior authorization?
39.4% of Part D formularies require prior authorization for tiopronin 100 MG Oral Tablet. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on tiopronin 100 MG Oral Tablet?
In 2023, total Medicare Part D spending on tiopronin 100 MG Oral Tablet was $23,230,085, covering 261 beneficiaries. The average spend per beneficiary was $89,004.16.
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
- everolimus 10 MG Oral Tablet T4.2
- {56 (elexacaftor 50 MG / ivacaftor 37.5 MG / tezacaftor 25 MG Oral Tablet) / 28 (ivacaftor 75 MG Oral Tablet) } Pack [Trikafta (50 MG / 37.5 MG / 25 MG; 75 MG)] T4.2
- 1.5 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron] T4.2
- alpha 1-proteinase inhibitor, human 1 MG Injection [Prolastin] T4.2
- ivacaftor 150 MG Oral Tablet [Kalydeco] T4.2
- tenofovir alafenamide 25 MG Oral Tablet [Vemlidy] T4.2
Similar prior-authorization rate
- perampanel 0.5 MG/ML Oral Suspension 39.5% PA
- perampanel 2 MG Oral Tablet 39.6% PA
- perampanel 4 MG Oral Tablet 39.6% PA
- dexmethylphenidate hydrochloride 5 MG Oral Tablet 39.1% PA
- dexmethylphenidate hydrochloride 10 MG Oral Tablet 39.1% PA
- flucytosine 500 MG Oral Capsule 39.9% PA