Medicare does cover Anucort-HC for most beneficiaries, but through Part D prescription drug plans rather than Part B. Because Anucort-HC is a rectal suppository you use at home, it is treated as a self-administered prescription drug, and your actual coverage, tier, and out-of-pocket cost depend on the specific Part D or Medicare Advantage drug plan you are enrolled in.
Why Anucort-HC Is a Part D Drug
Part B covers outpatient drugs that a provider administers to you, not drugs you take on your own. CMS treats suppositories, along with oral, topical, and inhaled medications, as usually self-administered, which puts them outside Part B.1CMS. Self-Administered Drug Exclusion Criteria Anucort-HC, a hydrocortisone acetate suppository used for inflamed hemorrhoids, ulcerative proctitis, ulcerative colitis, cryptitis, and anal itching, fits that category and is covered through Part D.2WebMD. Hydrocortisone Rectal It is also prescription-only, which matters because Part D does not pay for over-the-counter products even when a doctor recommends them.3Center for Medicare Advocacy. Medicare Part D
How To Confirm Your Plan Covers It
Every Part D plan has its own formulary, and formularies change from year to year. The quickest way to check is the Plan Finder at medicare.gov/plan-compare, where you enter your medications and zip code to see which plans cover Anucort-HC and what you would pay.4Medicare.gov. What Drug Plans Cover A free MyMedicare account lets you save your drug list for later comparisons.5Contra Costa County HICAP. Using PlanFinder Call the plan directly before filling the prescription to confirm, because the online data is not always perfectly current.6Medicare Rights Center. Use Medicare Plan Finder
What You Might Pay
Tier placement drives your copay, and Anucort-HC lands in very different spots across plans. One Medicare-affiliated formulary places it on Tier 1 alongside generic hydrocortisone acetate suppositories, which is the lowest copay level.7Formulary Navigator. Anorectal Glucocorticoids Formulary Listing One insurer puts it on a non-preferred tier with a quantity limit.8UPMC Health Plan. Anucort-HC Formulary Detail Another classifies it as Tier 3.9Blue Cross Blue Shield of Massachusetts. Anucort-HC Medication Detail
Without insurance, a box of 12 Anucort-HC 25 mg suppositories averages around $294, with pharmacy prices ranging widely.10GoodRx. Anucort-HC Pricing With a Part D plan, what you actually pay depends on your plan’s copay or coinsurance at the assigned tier and whether you have met your deductible. In 2026, every Part D plan carries a $2,100 annual out-of-pocket cap on covered drug costs; once you hit that, the plan pays 100 percent for the rest of the year.11GoodRx. Anucort-HC Medicare Coverage
Prior Authorization and Step Therapy
Some plans add hurdles before paying for a drug. Prior authorization means the plan must approve the prescription in advance. Step therapy means you have to try a cheaper option first. In one formulary reviewed, Anucort-HC had neither restriction.12Formulary Navigator. Anorectal Glucocorticoids Formulary Search Under one major insurer’s step therapy policy, Anucort-HC is a Step 1 product, meaning you can try it first rather than having to fail something else before getting it.13Cigna. Hydrocortisone Acetate Suppository Step Therapy Coverage Position Criteria Your plan’s rules may differ, so check the formulary notes next to the drug.
If Your Plan Does Not Cover It
Ask for a Formulary Exception
You, your representative, or your prescriber can ask the plan to cover a non-formulary drug. Your doctor needs to submit a supporting statement explaining that the plan’s covered alternatives would not work as well for you, would cause harmful side effects, or both.14Medicare.gov. Plan Rules The statement can be verbal or written, though plans may require a written follow-up.15CMS. Part D Exceptions
The plan has to answer within 72 hours of receiving the statement, or within 24 hours if you or your doctor requests an expedited decision because your health could be at risk.15CMS. Part D Exceptions An approved exception lasts the rest of the plan year as long as you stay in the plan and your doctor keeps prescribing the drug.16Triage Cancer. Medicare Drug Exception Request Quick Guide A denial notice will explain how to appeal.
Use a Transition Fill
If you just enrolled in a new plan or are at the start of a new plan year and were already using Anucort-HC, you may qualify for a one-time 30-day transition supply while you pursue an exception or switch drugs.14Medicare.gov. Plan Rules
Switch to a Generic or Alternative
Generic hydrocortisone acetate suppositories contain the same active ingredient in the same 25 mg and 30 mg strengths. On some formularies they sit on Tier 1 alongside Anucort-HC itself.7Formulary Navigator. Anorectal Glucocorticoids Formulary Listing Combination products that pair hydrocortisone with a local anesthetic such as pramoxine or lidocaine are another prescription option.17Formulary Navigator. Hemorrhoidal Rectal Glucocorticoid-Local Anesthetic Combinations Over-the-counter products like Preparation H use different active ingredients and are not covered by Part D at all.18Drugs.com. Anucort-HC Drug Comparisons
Extra Help for Low-Income Beneficiaries
If your income and resources are limited, Medicare’s Extra Help program (also called the Low-Income Subsidy) can cut Anucort-HC costs sharply. In 2026, qualifying beneficiaries pay no Part D premium or deductible. Copays are capped at $5.10 for generics and $12.65 for brand-name drugs, and once your out-of-pocket spending reaches $2,100 for the year, copays drop to $0.19Medicare.gov. Get Help With Drug Costs If you also have Medicaid and income under $1,350 a month, copays fall further to $1.60 for generics and $4.90 for brand-name drugs.20Medicare Interactive. Drug Costs Under Extra Help
For 2026, the individual limits are generally income below $23,940 and resources below $18,090; for a married couple, $32,460 in income and $36,100 in resources.19Medicare.gov. Get Help With Drug Costs People who have full Medicaid, Supplemental Security Income, or help with Part B premiums through a Medicare Savings Program are enrolled automatically. Everyone else can apply through the Social Security Administration.