12 HR clonidine hydrochloride 0.1 MG Extended Release Oral Tablet
clonidine hydrochloride
RxCUI: 1013930
What the CMS Formulary Data Shows for 12 HR clonidine hydrochloride 0.1 MG Extended Release Oral Tablet
Per the CMS 2026 Part D formulary file, 12 HR clonidine hydrochloride 0.1 MG Extended Release Oral Tablet (RxNorm concept RXCUI 1013930, generic name clonidine hydrochloride) appears on 140 distinct formulary files spanning 1,612 Medicare Part D plan offerings - 31.8% 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 2.4.
Real-world access to 12 HR clonidine hydrochloride 0.1 MG Extended Release Oral Tablet depends on utilization management as much as tier placement: 4.3% of covering formularies require prior authorization. 0% require step therapy. 41.4% 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 12 HR clonidine hydrochloride 0.1 MG Extended Release Oral Tablet today.
Coverage Details
- Formularies covering
- 140
- Plans covering
- 1,612
- Coverage rate
- 31.8%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 4.3% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 41.4% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 12 HR clonidine hydrochloride 0.1 MG Extended Release Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T1 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T1 | No | $0 | NV |
| Select Health Medicare Dual (HMO D-SNP) | SELECTHEALTH, INC. | T1 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T1 | No | $0 | UT |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T1 | No | $0 | NV |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T1 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T1 | No | $0 | CO |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T1 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T1 | No | $0 | CO |
| Select Health Medicare Flex (HMO) | SELECTHEALTH, INC. | T1 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T1 | No | $0 | CO |
| Select Health Medicare Active (HMO) | SELECTHEALTH, INC. | T1 | No | $0 | CO |
| Select Health Medicare Dual (HMO D-SNP) | SELECTHEALTH, INC. | T1 | No | $0 | NV |
| Select Health Medicare Wellness (HMO) | SELECTHEALTH, INC. | T1 | No | $0 | NV |
| ElderServe MAP (HMO D-SNP) | ELDERSERVE HEALTH, INC. | T1 | No | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | GROUP HEALTH COOPERATIVE OF EAU CLAIRE | T1 | No | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP | T1 | No | $0 | NJ |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | UPPER PENINSULA HEALTH PLAN, LLC | T1 | No | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | CARESOURCE GEORGIA CO. | T1 | No | $0 | GA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP CARESOURCE | T1 | No | $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 |
| CareAdvantage (HMO D-SNP) | SAN MATEO HEALTH COMMISSION | T1 | No | $0 | CA |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | No | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | HORIZON HEALTHCARE OF NEW JERSEY, INC. | T1 | No | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | No | $0 | MN |
| AbilityCare (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | No | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | ALAMEDA ALLIANCE FOR HEALTH | T1 | No | $0 | CA |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T1 | No | $0 | MS |
| PHP (HMO C-SNP) | AIDS HEALTHCARE FOUNDATION | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS CHOICE | T1 | No | $0 | NY |
| Platino Blindao (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| Platino Enlace (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| PLATINO ADVANCE (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| PLATINO PLUS (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| 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 |
| Leon MediExtra (HMO) | LEON HEALTH, INC. | T1 | No | $0 | FL |
| Leon MediDual (HMO D-SNP) | LEON HEALTH, INC. | T1 | No | $0 | FL |
| Leon MediMore (HMO) | LEON HEALTH, INC. | T1 | No | $0 | FL |
| Leon MediMax (HMO D-SNP) | LEON HEALTH, INC. | T1 | No | $0 | FL |
Frequently Asked Questions
Is 12 HR clonidine hydrochloride 0.1 MG Extended Release Oral Tablet covered by Medicare Part D?
Yes, 12 HR clonidine hydrochloride 0.1 MG Extended Release Oral Tablet is covered by 1,612 Medicare Part D plans (31.8% of all Part D formularies).
What tier is 12 HR clonidine hydrochloride 0.1 MG Extended Release Oral Tablet on Medicare Part D plans?
12 HR clonidine hydrochloride 0.1 MG Extended Release Oral Tablet averages Tier 2.4 across Part D plans, ranging from Tier 1 to Tier 4.
Does 12 HR clonidine hydrochloride 0.1 MG Extended Release Oral Tablet require prior authorization?
4.3% of Part D formularies require prior authorization for 12 HR clonidine hydrochloride 0.1 MG Extended Release Oral Tablet. Step therapy: 0%. Quantity limits: 41.4%.
Read our methodology - how this data is sourced, computed, and verified.