Medicare Part D coverage · tretinoin · RxCUI 313450

tretinoin 0.0001 MG/MG Topical Gel

Per the CMS 2026 Part D formulary file, tretinoin 0.0001 MG/MG Topical Gel is covered by 4,798 Medicare Part D plans (95% of enrollable products), averaging Tier 2.8, with prior authorization required on 91% of covering formularies.

95%
Plan coverage
4,798
Plans covering
T2.8
Avg tier
91%
Prior auth required

Verify with CMS →

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.

What the CMS Formulary Data Shows for tretinoin 0.0001 MG/MG Topical Gel

Per the CMS 2026 Part D formulary file, tretinoin 0.0001 MG/MG Topical Gel (RxNorm concept RXCUI 313450, generic name tretinoin) appears on 268 distinct formulary files spanning 4,798 Medicare Part D plan offerings - 95% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.8.

Real-world access to tretinoin 0.0001 MG/MG Topical Gel depends on utilization management as much as tier placement: 91% of covering formularies require prior authorization. 0% require step therapy. 67.2% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 91,688 Part D beneficiaries filled tretinoin 0.0001 MG/MG Topical Gel in 2023, with total plan-and-beneficiary spending of $22,910,407 and an average per-beneficiary annual cost of $249.87. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry tretinoin 0.0001 MG/MG Topical Gel today.

Coverage Details

Formularies covering
268
Plans covering
4,798
Coverage rate
95%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
91% of formularies
Step therapy required
0% of formularies
Quantity limits
67.2% of formularies

2023 Medicare Spending

Beneficiaries
91,688
Total spending
$22,910,407
Avg per beneficiary
$249.87

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering tretinoin 0.0001 MG/MG Topical Gel

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 Yes $0 VA
Sentara Community Complete (HMO D-SNP) Sentara Health Plans T1 Yes $0 VA
Florida Complete Care-Duals VIP (HMO-POS D-SNP) Hpmp OF Florida, Inc. T1 Yes $0 FL
ElderServe MAP (HMO D-SNP) Elderserve Health, Inc. T1 Yes $0 NY
Cooperative Advantage (HMO D-SNP) Group Health Cooperative OF EAU Claire T1 Yes $0 WI
Longevity Health Plan (PPO I-SNP) Longevity Health Plan OF NEW Jersey Insurance Comp T1 Yes $0 NJ
Mercy Care Advantage (HMO D-SNP) Mercy Care T1 Yes $0 AZ
Mercy Care Advantage (HMO D-SNP) Mercy Care T1 Yes $0 AZ
Mercy Care Advantage (HMO D-SNP) Mercy Care T1 Yes $0 AZ
Elderplan Plus Long-Term Care (HMO-POS D-SNP) Elderplan, Inc. T1 Yes $0 NY
Health Choice Pathway (HMO D-SNP) Health Choice Arizona, Inc. T1 Yes $0 AZ
Healthfirst CompleteCare (HMO D-SNP) Healthfirst Health Plan, Inc. T1 Yes $0 NY
IMCare Classic (HMO D-SNP) Itasca Medical Care T1 Yes $0 MN
Johns Hopkins Advantage MD D-SNP (HMO D-SNP) Hopkins Health Advantage, Inc. T1 Yes $0 MD
MetroPlus UltraCare (HMO D-SNP) Metroplus Health Plan, Inc. T1 Yes $0 NY
Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) Upper Peninsula Health Plan, LLC T1 Yes $0 MI
CareSource Dual Advantage (HMO D-SNP) Caresource Georgia Co. T1 Yes $0 GA
Senior Whole Health SCO (HMO D-SNP) Senior Whole Health, LLC T1 Yes $0 MA
Senior Whole Health SCO NHC (HMO D-SNP) Senior Whole Health, LLC T1 Yes $0 MA
Molina One Care (HMO D-SNP) Senior Whole Health, LLC T1 Yes $0 MA
Show the next 30 plans
HAP CareSource MI Coordinated Health (HMO D-SNP) HAP Caresource T1 Yes $0 MI
PruittHealth Premier D-SNP (HMO D-SNP) Pruitthealth Premier, Inc. T1 Yes $0 GA
Simpra Advantage Dual Care (PPO D-SNP) Simpra Advantage, Inc. T1 Yes $0 AL
CareAdvantage (HMO D-SNP) SAN Mateo Health Commission T1 Yes $0 CA
Gold Coast Health Plan Total Care Advantage (HMO D-SNP) Ventura County Medi-Cal Managed Care Commission T1 Yes $0 CA
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) Health Care Service Corporation T1 Yes $0 NM
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) Health Care Service Corporation T1 Yes $0 NM
Horizon NJ TotalCare (HMO D-SNP) Horizon Healthcare OF NEW Jersey, Inc. T1 Yes $0 NJ
SecureBlue (HMO D-SNP) HMO Minnesota T1 Yes $0 MN
NaviCare (HMO D-SNP) Fallon Community Health Plan T1 No $0 MA
Hamaspik Medicare Choice (HMO D-SNP) Hamaspik, Inc. T1 Yes $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
PHP (HMO C-snp) Aids Healthcare Foundation T1 Yes $0 CA
CCA One Care (HMO D-SNP) Commonwealth Care Alliance, Inc. T1 Yes $0 MA
CCA Senior Care Options (HMO D-SNP) Commonwealth Care Alliance, Inc. T1 Yes $0 MA
VNS Health Total (HMO D-SNP) VNS Choice T1 Yes $0 NY
Abilis Health Community (HMO I-SNP) Signature Advantage, LLC T1 Yes $0 KY, TN
Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) Arkansas Superior Select, Inc. T1 Yes $0 AR
Community Care's Partnership Program (HMO D-SNP) Community Care Health Plan, Inc. T1 No $0 WI
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 Yes $0 MA
Mass General Brigham One Care (HMO D-SNP) Mass General Brigham Health Plan, Inc T1 Yes $0 MA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) Gateway Health Plan, Inc. T1 No $0 PA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) Gateway Health Plan, Inc. T1 No $0 PA
Highmark Health Options Duals (HMO D-SNP) Highmark Health Options West Virginia Inc. T1 No $0 WV
Highmark Health Options Duals (HMO D-SNP) Highmark Bcbsd, Inc. T1 No $0 DE
Leon MediExtra (HMO) Leon Health, Inc. T1 No $0 FL
Leon MediDual (HMO D-SNP) Leon Health, Inc. T1 No $0 FL

Showing top 50 of 100 plans.

Frequently Asked Questions

Is tretinoin 0.0001 MG/MG Topical Gel covered by Medicare Part D?

Yes, tretinoin 0.0001 MG/MG Topical Gel is covered by 4,798 Medicare Part D plans (95% of all Part D formularies).

What tier is tretinoin 0.0001 MG/MG Topical Gel on Medicare Part D plans?

tretinoin 0.0001 MG/MG Topical Gel averages Tier 2.8 across Part D plans, ranging from Tier 1 to Tier 4.

Does tretinoin 0.0001 MG/MG Topical Gel require prior authorization?

91% of Part D formularies require prior authorization for tretinoin 0.0001 MG/MG Topical Gel. Step therapy: 0%. Quantity limits: 67.2%.

How much does Medicare spend on tretinoin 0.0001 MG/MG Topical Gel?

In 2023, total Medicare Part D spending on tretinoin 0.0001 MG/MG Topical Gel was $22,910,407, covering 91,688 beneficiaries. The average spend per beneficiary was $249.87.

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.

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