trientine hydrochloride 500 MG Oral Capsule

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trientine hydrochloride

RxCUI: 2619912

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.
53.3%
Plan Coverage
2,699
Plans Covering
T4.5
Avg Tier
62.5%
Prior Auth Required

What the CMS Formulary Data Shows for trientine hydrochloride 500 MG Oral Capsule

Per the CMS 2026 Part D formulary file, trientine hydrochloride 500 MG Oral Capsule (RxNorm concept RXCUI 2619912, generic name trientine hydrochloride) appears on 56 distinct formulary files spanning 2,699 Medicare Part D plan offerings - 53.3% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.5.

Real-world access to trientine hydrochloride 500 MG Oral Capsule depends on utilization management as much as tier placement: 62.5% of covering formularies require prior authorization. 5.4% require step therapy. 46.4% apply quantity limits.

Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry trientine hydrochloride 500 MG Oral Capsule today.

Coverage Details

Formularies covering
56
Plans covering
2,699
Coverage rate
53.3%
Tier range
Tier 1 – Tier 5
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
62.5% of formularies
Step therapy required
5.4% of formularies
Quantity limits
46.4% of formularies

Tier Distribution Across Plans

14 plans
Tier 1, Preferred Generic
86 plans
Tier 4, Non-Preferred

Standalone Drug Plans (PDP) Covering trientine hydrochloride 500 MG Oral Capsule

5 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 -
AARP Medicare Rx Saver from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T4 Yes No $0 -
AARP Medicare Rx Saver from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T4 Yes No $0 -
AARP Medicare Rx Saver from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T4 Yes No $0 -

Medicare Advantage Plans (MA-PD) Covering trientine hydrochloride 500 MG Oral Capsule

95 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
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
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $0 PA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $0 PA
Highmark Health Options Duals (HMO D-SNP) HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. T1 Yes $0 WV
Highmark Health Options Duals (HMO D-SNP) HIGHMARK BCBSD, INC. T1 Yes $0 DE
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
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $13.10 PA
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $17.60 PA
Highmark Health Options Duals Select (HMO D-SNP) HIGHMARK BCBSD, INC. T1 Yes $31.20 DE
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
AARP Medicare Advantage from UHC MI-0001 (PPO) UNITEDHEALTHCARE INSURANCE COMPANY T4 Yes $0 MI
UHC Dual Complete NM-Y1 (PPO D-SNP) UNITEDHEALTHCARE INSURANCE COMPANY T4 Yes $0 NM
UHC Dual Complete NM-S1 (PPO D-SNP) UNITEDHEALTHCARE INSURANCE COMPANY T4 Yes $0 NM
UHC Dual Complete NM-V1 (PPO D-SNP) UNITEDHEALTHCARE INSURANCE COMPANY T4 Yes $0 NM
UHC Dual Complete AZ-S001 (HMO-POS D-SNP) ARIZONA PHYSICIANS IPA, INC. T4 Yes $0 AZ
UHC Dual Complete AZ-Y001 (HMO-POS D-SNP) ARIZONA PHYSICIANS IPA, INC. T4 Yes $0 AZ
UHC Dual Complete VA-Y4 (PPO D-SNP) CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. T4 Yes $0 VA
AARP Medicare Advantage from UHC AL-0001 (HMO-POS) UNITEDHEALTHCARE OF THE MIDLANDS, INC. T4 Yes $0 AL
AARP Medicare Advantage from UHC CA-0002 (HMO-POS) UHC OF CALIFORNIA T4 Yes $0 CA
UHC Sharp Medicare Advantage CA-001P (HMO-POS) UHC OF CALIFORNIA T4 Yes $0 CA
AARP Medicare Advantage from UHC CA-003P (HMO-POS) UHC OF CALIFORNIA T4 Yes $0 CA
AARP Medicare Advantage from UHC CA-0012 (HMO-POS) UHC OF CALIFORNIA T4 Yes $0 CA
AARP Medicare Advantage from UHC CA-004P (HMO-POS) UHC OF CALIFORNIA T4 Yes $0 CA
AARP Medicare Advantage from UHC CA-005P (HMO-POS) UHC OF CALIFORNIA T4 Yes $0 CA
AARP Medicare Advantage from UHC CA-006P (HMO-POS) UHC OF CALIFORNIA T4 Yes $0 CA
AARP Medicare Advantage from UHC CA-10 (HMO-POS) UHC OF CALIFORNIA T4 Yes $0 CA
UHC Sharp Medicare Advantage ValueRx CA-12P (HMO-POS) UHC OF CALIFORNIA T4 Yes $0 CA
AARP Medicare Advantage from UHC CA-021P (HMO-POS) UHC OF CALIFORNIA T4 Yes $0 CA
AARP Medicare Advantage from UHC CA-022P (HMO-POS) UHC OF CALIFORNIA T4 Yes $0 CA
AARP Medicare Advantage from UHC CA-023P (HMO-POS) UHC OF CALIFORNIA T4 Yes $0 CA
AARP Medicare Advantage from UHC CA-026P (HMO-POS) UHC OF CALIFORNIA T4 Yes $0 CA
AARP Medicare Advantage Giveback from UHC CA-19 (HMO-POS) UHC OF CALIFORNIA T4 Yes $0 CA
AARP Medicare Advantage Giveback from UHC CA-20 (HMO-POS) UHC OF CALIFORNIA T4 Yes $0 CA
AARP Medicare Advantage Giveback from UHC CA-21 (HMO-POS) UHC OF CALIFORNIA T4 Yes $0 CA
AARP Medicare Advantage Essentials from UHC CO-2 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T4 Yes $0 CO
AARP Medicare Advantage Essentials from UHC AZ-1 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T4 Yes $0 AZ
AARP Medicare Advantage Essentials from UHC AZ-2 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T4 Yes $0 AZ

Frequently Asked Questions

Is trientine hydrochloride 500 MG Oral Capsule covered by Medicare Part D?

Yes, trientine hydrochloride 500 MG Oral Capsule is covered by 2,699 Medicare Part D plans (53.3% of all Part D formularies).

What tier is trientine hydrochloride 500 MG Oral Capsule on Medicare Part D plans?

trientine hydrochloride 500 MG Oral Capsule averages Tier 4.5 across Part D plans, ranging from Tier 1 to Tier 5.

Does trientine hydrochloride 500 MG Oral Capsule require prior authorization?

62.5% of Part D formularies require prior authorization for trientine hydrochloride 500 MG Oral Capsule. Step therapy: 5.4%. Quantity limits: 46.4%.

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