Medicare Part D coverage · triptorelin · RxCUI 905059
triptorelin 3.75 MG Injection [Trelstar]
Per the CMS 2026 Part D formulary file, triptorelin 3.75 MG Injection [Trelstar] is covered by 2,221 Medicare Part D plans (44% of enrollable products), averaging Tier 3.3, with prior authorization required on 78.9% of covering formularies.
- 44%
- Plan coverage
- 2,221
- Plans covering
- T3.3
- Avg tier
- 78.9%
- Prior auth required
What the CMS Formulary Data Shows for triptorelin 3.75 MG Injection [Trelstar]
Per the CMS 2026 Part D formulary file, triptorelin 3.75 MG Injection [Trelstar] (RxNorm concept RXCUI 905059, generic name triptorelin) appears on 204 distinct formulary files spanning 2,221 Medicare Part D plan offerings - 44% 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 3.3.
Real-world access to triptorelin 3.75 MG Injection [Trelstar] depends on utilization management as much as tier placement: 78.9% of covering formularies require prior authorization. 2.9% require step therapy. 22.1% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 2,074 Part D beneficiaries filled triptorelin 3.75 MG Injection [Trelstar] in 2023, with total plan-and-beneficiary spending of $14,231,107 and an average per-beneficiary annual cost of $6,861.67. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry triptorelin 3.75 MG Injection [Trelstar] today.
Coverage Details
- Formularies covering
- 204
- Plans covering
- 2,221
- Coverage rate
- 44%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 78.9% of formularies
- Step therapy required
- 2.9% of formularies
- Quantity limits
- 22.1% of formularies
2023 Medicare Spending
- Beneficiaries
- 2,074
- Total spending
- $14,231,107
- Avg per beneficiary
- $6,861.67
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering triptorelin 3.75 MG Injection [Trelstar]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 |
| 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 |
| 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 | No | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | No | $0 | AL |
| 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 |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | Yes | $0 | CA |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | Yes | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | Yes | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
Show the next 30 plans
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | Yes | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | 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 |
| Platino Blindao (HMO D-SNP) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Enlace (HMO D-SNP) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Advance (HMO D-snp) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Plus (HMO D-snp) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| 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 | 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 |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Senior Care (HMO I-SNP) | Align Senior Care Florida, Inc. | T1 | No | $4.80 | FL |
| ProCare Advantage (HMO-POS I-SNP) | Procare Advantage, LLC | T1 | No | $4.80 | TX |
| ProCare Advantage - Kidney Care (HMO-POS C-SNP) | Procare Advantage, LLC | T1 | No | $4.80 | TX |
| American Health Advantage of Florida (HMO I-SNP) | American Health Plan OF FL, Inc. | T1 | No | $4.80 | FL |
| SECUR Advantage (HMO I-SNP) | Secur Inc | T1 | Yes | $4.80 | FL |
| SECUR Enhanced (HMO I-SNP) | Secur Inc | T1 | Yes | $4.80 | FL |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Hcsc Insurance Services Company | T1 | Yes | $4.80 | TX |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | Yes | $4.80 | FL |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | Yes | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | Yes | $4.80 | TX |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS Insurance Company | T1 | Yes | $5.00 | OK |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Michigan, Inc. | T1 | Yes | $8.80 | MI |
| Senior Care (HMO I-SNP) | Align Senior Care MI, LLC | T1 | No | $8.80 | MI |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is triptorelin 3.75 MG Injection [Trelstar] covered by Medicare Part D?
Yes, triptorelin 3.75 MG Injection [Trelstar] is covered by 2,221 Medicare Part D plans (44% of all Part D formularies).
What tier is triptorelin 3.75 MG Injection [Trelstar] on Medicare Part D plans?
triptorelin 3.75 MG Injection [Trelstar] averages Tier 3.3 across Part D plans, ranging from Tier 1 to Tier 4.
Does triptorelin 3.75 MG Injection [Trelstar] require prior authorization?
78.9% of Part D formularies require prior authorization for triptorelin 3.75 MG Injection [Trelstar]. Step therapy: 2.9%. Quantity limits: 22.1%.
How much does Medicare spend on triptorelin 3.75 MG Injection [Trelstar]?
In 2023, total Medicare Part D spending on triptorelin 3.75 MG Injection [Trelstar] was $14,231,107, covering 2,074 beneficiaries. The average spend per beneficiary was $6,861.67.
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
- 0.25 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Eligard] T3.3
- 0.375 ML leuprolide acetate 120 MG/ML Prefilled Syringe [Eligard] T3.3
- alanine 27.6 MG/ML / arginine 19.6 MG/ML / aspartate 6 MG/ML / glutamate 10.2 MG/ML / glycine 20.6 MG/ML / histidine 11.8 MG/ML / isoleucine 10.8 MG/ML / leucine 10.8 MG/ML / lysine 13.5 MG/ML / methionine 7.6 MG/ML / phenylalanine 10 MG/ML / proline 13.4 MG/ML / serine 10.2 MG/ML / threonine 9.8 MG/ML / tryptophan 3.2 MG/ML / tyrosine 0.5 MG/ML / valine 14.4 MG/ML Injectable Solution [Prosol] T3.3
- bazedoxifene 20 MG / estrogens, conjugated (USP) 0.45 MG Oral Tablet [Duavee] T3.3
- dextroamphetamine sulfate 10 MG Oral Tablet [Zenzedi] T3.3
- naftifine hydrochloride 0.02 MG/MG Topical Gel T3.3
Similar prior-authorization rate
- tazarotene 0.0005 MG/MG Topical Gel 78.9% PA
- 72 HR fentanyl 0.0375 MG/HR Transdermal System 79% PA
- tazarotene 0.001 MG/MG Topical Gel 79% PA
- 72 HR fentanyl 0.0875 MG/HR Transdermal System 79.1% PA
- 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Glatopa] 79.5% PA
- stiripentol 250 MG Oral Capsule [Diacomit] 79.6% PA