Medicare Part D coverage · tretinoin · RxCUI 313453
tretinoin 0.001 MG/MG Topical Gel
Per the CMS 2026 Part D formulary file, tretinoin 0.001 MG/MG Topical Gel is covered by 1,206 Medicare Part D plans (23.9% of enrollable products), averaging Tier 3.5, with prior authorization required on 81.8% of covering formularies.
- 23.9%
- Plan coverage
- 1,206
- Plans covering
- T3.5
- Avg tier
- 81.8%
- Prior auth required
What the CMS Formulary Data Shows for tretinoin 0.001 MG/MG Topical Gel
Per the CMS 2026 Part D formulary file, tretinoin 0.001 MG/MG Topical Gel (RxNorm concept RXCUI 313453, generic name tretinoin) appears on 22 distinct formulary files spanning 1,206 Medicare Part D plan offerings - 23.9% 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 3.5.
Real-world access to tretinoin 0.001 MG/MG Topical Gel depends on utilization management as much as tier placement: 81.8% of covering formularies require prior authorization. 9.1% require step therapy. 27.3% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 91,688 Part D beneficiaries filled tretinoin 0.001 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 0.001 MG/MG Topical Gel today.
Coverage Details
- Formularies covering
- 22
- Plans covering
- 1,206
- Coverage rate
- 23.9%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 81.8% of formularies
- Step therapy required
- 9.1% of formularies
- Quantity limits
- 27.3% of formularies
2023 Medicare Spending
- Beneficiaries
- 91,688
- Total spending
- $22,910,407
- Avg per beneficiary
- $249.87
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering tretinoin 0.001 MG/MG Topical Gel
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T4 | Yes | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T4 | Yes | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering tretinoin 0.001 MG/MG Topical Gel
98 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| Freedom VIP Care (HMO C-SNP) | Freedom Health, Inc. | T2 | Yes | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | Freedom Health, Inc. | T2 | Yes | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | Freedom Health, Inc. | T2 | Yes | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | Freedom Health, Inc. | T2 | Yes | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | Freedom Health, Inc. | T2 | Yes | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | Optimum Healthcare, Inc. | T2 | Yes | $0 | FL |
| Optimum Diamond Savings (HMO C-SNP) | Optimum Healthcare, Inc. | T2 | Yes | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | Optimum Healthcare, Inc. | T2 | Yes | $0 | FL |
| Optimum Diamond (HMO C-SNP) | Optimum Healthcare, Inc. | T2 | Yes | $0 | FL |
| Freedom Medi-Medi Partial (HMO D-SNP) | Freedom Health, Inc. | T2 | Yes | $0 | FL |
| Freedom Medi-Medi Full (HMO D-SNP) | Freedom Health, Inc. | T2 | Yes | $0 | FL |
| Optimum Emerald Partial (HMO D-SNP) | Optimum Healthcare, Inc. | T2 | Yes | $0 | FL |
| Optimum Emerald Full (HMO D-SNP) | Optimum Healthcare, Inc. | T2 | Yes | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | Freedom Health, Inc. | T2 | Yes | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | Freedom Health, Inc. | T2 | Yes | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | Freedom Health, Inc. | T2 | Yes | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | Freedom Health, Inc. | T2 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T2 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T2 | Yes | $0 | FL |
Show the next 30 plans
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T2 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T2 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T2 | Yes | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T2 | Yes | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T2 | Yes | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T2 | Yes | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T2 | Yes | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T2 | Yes | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T2 | Yes | $0 | FL |
| Freedom Máximo (HMO-POS) | Freedom Health, Inc. | T2 | Yes | $0 | FL |
| Freedom Máximo (HMO-POS) | Freedom Health, Inc. | T2 | Yes | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T2 | Yes | $0 | FL |
| Optimum Platinum Plan (HMO) | Optimum Healthcare, Inc. | T2 | Yes | $0 | FL |
| Optimum Gold Plan (HMO) | Optimum Healthcare, Inc. | T2 | Yes | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T2 | Yes | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T2 | Yes | $0 | FL |
| Optimum Diamond Rewards COPD (HMO C-SNP) | Optimum Healthcare, Inc. | T2 | Yes | $0 | FL |
| Optimum Diamond Savings COPD (HMO C-SNP) | Optimum Healthcare, Inc. | T2 | Yes | $0 | FL |
| Optimum Gold Plus Plan (HMO) | Optimum Healthcare, Inc. | T2 | Yes | $0 | FL |
| Optimum Diamond Rewards COPD (HMO C-SNP) | Optimum Healthcare, Inc. | T2 | Yes | $0 | FL |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T2 | No | $0 | MS |
| UHC Dual Complete IA-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | Yes | $0 | IA |
| UHC Dual Complete MO-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | Yes | $0 | MO |
| UHC Dual Complete NE-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | Yes | $0 | NE |
| UHC Dual Complete KS-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | Yes | $0 | KS |
| UHC Dual Complete MO-S3 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | Yes | $0 | MO |
| UHC Dual Complete KS-Q1 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | Yes | $0 | KS |
| UHC Dual Complete TN-S001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T4 | Yes | $0 | TN |
| UHC Dual Complete TN-Y001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T4 | Yes | $0 | TN |
| UHC Dual Complete TN-Y2 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T4 | Yes | $0 | TN |
Showing top 50 of 98 plans.
Frequently Asked Questions
Is tretinoin 0.001 MG/MG Topical Gel covered by Medicare Part D?
Yes, tretinoin 0.001 MG/MG Topical Gel is covered by 1,206 Medicare Part D plans (23.9% of all Part D formularies).
What tier is tretinoin 0.001 MG/MG Topical Gel on Medicare Part D plans?
tretinoin 0.001 MG/MG Topical Gel averages Tier 3.5 across Part D plans, ranging from Tier 1 to Tier 4.
Does tretinoin 0.001 MG/MG Topical Gel require prior authorization?
81.8% of Part D formularies require prior authorization for tretinoin 0.001 MG/MG Topical Gel. Step therapy: 9.1%. Quantity limits: 27.3%.
How much does Medicare spend on tretinoin 0.001 MG/MG Topical Gel?
In 2023, total Medicare Part D spending on tretinoin 0.001 MG/MG Topical Gel was $22,910,407, covering 91,688 beneficiaries. The average spend per beneficiary was $249.87.
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
- lomustine 40 MG Oral Capsule T3.5
- 1 ML denosumab 60 MG/ML Prefilled Syringe [Prolia] T3.5
- ethacrynic acid 25 MG Oral Tablet T3.5
- daridorexant 25 MG Oral Tablet [Quviviq] T3.5
- 24 HR canagliflozin 150 MG / metformin hydrochloride 1000 MG Extended Release Oral Tablet [Invokamet] T3.5
- canagliflozin 150 MG / metformin hydrochloride 1000 MG Oral Tablet [Invokamet] T3.5
Similar prior-authorization rate
- amphotericin B liposomal 50 MG Injection [AmBisome] 81.8% PA
- nitisinone 2 MG Oral Tablet [Harliku] 81.8% PA
- Twice-Daily diclofenac epolamine 0.013 MG/MG Medicated Patch 81.7% PA
- vorinostat 100 MG Oral Capsule [Zolinza] 81.4% PA
- ondansetron 4 MG Oral Tablet 82.3% PA
- ondansetron 8 MG Oral Tablet 82.3% PA