Medicare Part D coverage · triamterene · RxCUI 198312
triamterene 100 MG Oral Capsule
Per the CMS 2026 Part D formulary file, triamterene 100 MG Oral Capsule is covered by 2,081 Medicare Part D plans (41.2% of enrollable products), averaging Tier 3.4, with prior authorization required on 0% of covering formularies.
- 41.2%
- Plan coverage
- 2,081
- Plans covering
- T3.4
- 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 57 distinct formulary files spanning 2,081 Medicare Part D plan offerings - 41.2% 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 3.4.
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. 8.8% 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
- 57
- Plans covering
- 2,081
- Coverage rate
- 41.2%
- 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
- 8.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 2,495
- Total spending
- $4,563,861
- Avg per beneficiary
- $1,829.20
Tier Distribution Across Plans
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 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 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 |
Show the next 30 plans
Showing top 50 of 100 plans.
Frequently Asked Questions
Is triamterene 100 MG Oral Capsule covered by Medicare Part D?
Yes, triamterene 100 MG Oral Capsule is covered by 2,081 Medicare Part D plans (41.2% 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 3.4 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: 8.8%.
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.
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.
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