triamterene 100 MG Oral Capsule

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triamterene

RxCUI: 198312

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.
41.3%
Plan Coverage
2,095
Plans Covering
T3.5
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for triamterene 100 MG Oral Capsule

Per the CMS 2026 Part D formulary file, triamterene 100 MG Oral Capsule (RxNorm concept RXCUI 198312, generic name triamterene) appears on 58 distinct formulary files spanning 2,095 Medicare Part D plan offerings - 41.3% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 3.5.

Real-world access to triamterene 100 MG Oral Capsule depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 8.6% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 2,495 Part D beneficiaries filled triamterene 100 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $4,563,861 and an average per-beneficiary annual cost of $1,829.20. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry triamterene 100 MG Oral Capsule today.

Coverage Details

Formularies covering
58
Plans covering
2,095
Coverage rate
41.3%
Tier range
Tier 1 – Tier 6
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
0% of formularies
Step therapy required
0% of formularies
Quantity limits
8.6% of formularies

2023 Medicare Spending

Beneficiaries
2,495
Total spending
$4,563,861
Avg per beneficiary
$1,829.20

Tier Distribution Across Plans

27 plans
Tier 1, Preferred Generic
73 plans
Tier 2, Generic

Medicare Advantage Plans (MA-PD) Covering triamterene 100 MG Oral Capsule

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
NaviCare (HMO D-SNP) FALLON COMMUNITY HEALTH PLAN T1 No $0 MA
Provider Partners Pennsylvania Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC T1 No $0 PA
Provider Partners North Carolina Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA T1 No $0 NC
Provider Partners Indiana Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF INDIANA T1 No $0 IN
Provider Partners Maryland Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN, INC. T1 No $0 MD
Provider Partners Missouri Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. T1 No $0 MO
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 No $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
Tufts Health One Care (HMO D-SNP) TUFTS HEALTH PUBLIC PLANS, INC. T1 No $0 MA
Tufts Health One Care CW (HMO D-SNP) TUFTS HEALTH PUBLIC PLANS, INC. T1 No $0 MA
Tufts Health Plan Senior Care Options (HMO D-SNP) TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION T1 No $0 MA
Tufts Health Plan Senior Care Options CW (HMO D-SNP) TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION T1 No $0 MA
Provider Partners Texas Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC. T1 No $4.80 TX
Provider Partners Illinois Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS T1 No $15.20 IL
Provider Partners Maryland Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN, INC. T1 No $31.20 MD
Provider Partners Maryland Essential Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN, INC. T1 No $31.20 MD
Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC T1 No $32.70 PA
Provider Partners Pennsylvania Essential Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC T1 No $32.70 PA
Provider Partners North Carolina Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA T1 No $36.20 NC
Provider Partners North Carolina Essential Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA T1 No $36.20 NC
Provider Partners Indiana Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF INDIANA T1 No $38.40 IN
Provider Partners Indiana Essential Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF INDIANA T1 No $38.40 IN
Provider Partners Kentucky Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY T1 No $38.40 KY
Provider Partners Missouri Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. T1 No $43.00 MO
Provider Partners Missouri Essential Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. T1 No $43.00 MO
Fallon Medicare Plus Orange (HMO) FALLON COMMUNITY HEALTH PLAN T2 No $0 MA
Healthy Mississippi Premier Advantage (HMO-POS) Healthy Mississippi, Inc. T2 No $0 MS
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Solano (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Inland Empire (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Adv Enhanced Marin San Mateo (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Ventura (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Kern (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Kern (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage San Diego (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Adv Enhanced Santa Clara (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Enhanced Stanis (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Stanis (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic SnJoaq (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Fresno (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Advantage Basic Sac., Sonoma (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Santa Cruz (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Alameda (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic SF (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Adv Basic Contra Costa (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Sr Adv Basic Santa Clara (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic Solano (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA
Kaiser Permanente Senior Advantage Basic San Mateo (HMO) KAISER FOUNDATION HP, INC. T2 No $0 CA

Frequently Asked Questions

Is triamterene 100 MG Oral Capsule covered by Medicare Part D?

Yes, triamterene 100 MG Oral Capsule is covered by 2,095 Medicare Part D plans (41.3% of all Part D formularies).

What tier is triamterene 100 MG Oral Capsule on Medicare Part D plans?

triamterene 100 MG Oral Capsule averages Tier 3.5 across Part D plans, ranging from Tier 1 to Tier 6.

Does triamterene 100 MG Oral Capsule require prior authorization?

0% of Part D formularies require prior authorization for triamterene 100 MG Oral Capsule. Step therapy: 0%. Quantity limits: 8.6%.

How much does Medicare spend on triamterene 100 MG Oral Capsule?

In 2023, total Medicare Part D spending on triamterene 100 MG Oral Capsule was $4,563,861, covering 2,495 beneficiaries. The average spend per beneficiary was $1,829.20.

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