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Glycopyrrolate and formoterol fumarate 4.8 ug/1 / 9 ug/1 Medicare Part D Coverage

Brand name: BEVESPI AEROSPHERE
Dosage form
AEROSOL, METERED
Route
RESPIRATORY (INHALATION)
Drug class
Bronchodilators
35%
of Medicare Part D plans
cover Glycopyrrolate and formoterol fumarate
1,923 of 5,530 plans
2.9
Avg. formulary tier
$0.00
Median 30-day copay
$0.00–$0.00
Copay range

Formulary Tier Distribution

How Medicare Part D plans classify Glycopyrrolate and formoterol fumarate. Lower tiers = lower copays.

Tier 1 - Preferred Generic 4%
68 plans • avg $0.00/mo
Tier 2 - Generic 0%
4 plans • avg $15.00/mo
Tier 3 - Preferred Brand 95%
1,833 plans • avg $5.03/mo
Tier 4 - Non-Preferred Drug 1%
18 plans • avg $19.29/mo

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Glycopyrrolate and formoterol fumarate Medicare Coverage by State

Coverage rates and average costs vary significantly by state. Click a state to see the specific plans available there.

Alabama 100% Arizona 100% Arkansas 100% California 100% Colorado 100% Connecticut 100% Delaware 100% District of Columbia 100% Florida 100% Georgia 100% Hawaii 100% Idaho 100% Illinois 100% Indiana 100% Iowa 100% Kansas 100% Kentucky 100% Louisiana 100% Maine 100% Maryland 100% Massachusetts 100% Michigan 100% Minnesota 100% Mississippi 100% Missouri 100% Nebraska 100% Nevada 100% New Hampshire 100% New Jersey 100% New Mexico 100% New York 100% North Carolina 100% North Dakota 100% Ohio 100% Oklahoma 100% Oregon 100% Pennsylvania 100% Puerto Rico 100% Rhode Island 100% South Carolina 100% South Dakota 100% Tennessee 100% Texas 100% Utah 100% Virginia 100% Washington 100% West Virginia 100% Wisconsin 100%

Alternative Medications in the Same Drug Class

Other drugs in the Bronchodilators that Medicare Part D plans also cover.

tiotropium bromide inhalation spray Avg Tier 3.3 $0.00/mo 5,529 plans Ipratropium Bromide Avg Tier 1.9 $15.00/mo 5,529 plans fluticasone furoate, umeclidinium bromide and vilanterol trifenatate Avg Tier 3.0 $44.00/mo 5,529 plans ipratropium bromide and albuterol Avg Tier 3.5 $0.00/mo 5,529 plans Albuterol Sulfate Avg Tier 2.2 $15.00/mo 5,512 plans fluticasone furoate, umeclidinium bromide and vilanterol trifenatate Avg Tier 2.9 $44.00/mo 5,414 plans ipratropium bromide Avg Tier 3.8 $44.00/mo 5,312 plans fluticasone propionate and salmeterol Avg Tier 2.5 $11.00/mo 5,138 plans

Frequently Asked Questions about Glycopyrrolate and formoterol fumarate

35% of Medicare Part D plans cover Glycopyrrolate and formoterol fumarate. It is most commonly placed on Tier 3. Coverage varies by plan and geographic area.

The median 30-day copay for Glycopyrrolate and formoterol fumarate on Medicare Part D is $0.00 at a preferred pharmacy. Costs range from $0.00 to $0.00 depending on the plan.

Glycopyrrolate and formoterol fumarate is placed on Tier 3 by most Medicare Part D plans. Lower tier numbers generally mean lower copays.

0% of plans require prior authorization for Glycopyrrolate and formoterol fumarate. Prior authorization means your doctor must confirm the drug is medically necessary before the plan will cover it.

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Coverage statistics based on CMS formulary data for plan year 2026. Data updated regularly. Methodology →