12 HR desloratadine 2.5 MG / pseudoephedrine sulfate 120 MG Extended Release Oral Tablet [Clarinex-D]

Verify with CMS →

desloratadine

RxCUI: 1112250

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.
1.1%
Plan Coverage
55
Plans Covering
T3.4
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for 12 HR desloratadine 2.5 MG / pseudoephedrine sulfate 120 MG Extended Release Oral Tablet [Clarinex-D]

Per the CMS 2026 Part D formulary file, 12 HR desloratadine 2.5 MG / pseudoephedrine sulfate 120 MG Extended Release Oral Tablet [Clarinex-D] (RxNorm concept RXCUI 1112250, generic name desloratadine) appears on 5 distinct formulary files spanning 55 Medicare Part D plan offerings - 1.1% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 3 to Tier 4, with a cross-plan average of Tier 3.4.

Real-world access to 12 HR desloratadine 2.5 MG / pseudoephedrine sulfate 120 MG Extended Release Oral Tablet [Clarinex-D] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 80% require step therapy. 20% 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 desloratadine 2.5 MG / pseudoephedrine sulfate 120 MG Extended Release Oral Tablet [Clarinex-D] today.

Coverage Details

Formularies covering
5
Plans covering
55
Coverage rate
1.1%
Tier range
Tier 3 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
0% of formularies
Step therapy required
80% of formularies
Quantity limits
20% of formularies

Tier Distribution Across Plans

39 plans
Tier 3, Preferred Brand
16 plans
Tier 4, Non-Preferred

Standalone Drug Plans (PDP) Covering 12 HR desloratadine 2.5 MG / pseudoephedrine sulfate 120 MG Extended Release Oral Tablet [Clarinex-D]

2 standalone prescription drug plans include this drug.

Plan Insurer Tier PA ST Premium States
Blue Rx PDP Complete (PDP) HM HEALTH INSURANCE COMPANY T4 No No $164.80 -
Blue Rx PDP Plus (PDP) HM HEALTH INSURANCE COMPANY T4 No No $193.20 -

Medicare Advantage Plans (MA-PD) Covering 12 HR desloratadine 2.5 MG / pseudoephedrine sulfate 120 MG Extended Release Oral Tablet [Clarinex-D]

53 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Freedom VIP Care (HMO C-SNP) FREEDOM HEALTH, INC. T3 No $0 FL
Freedom VIP Savings (HMO C-SNP) FREEDOM HEALTH, INC. T3 No $0 FL
Freedom VIP Savings (HMO C-SNP) FREEDOM HEALTH, INC. T3 No $0 FL
Freedom VIP Rewards (HMO C-SNP) FREEDOM HEALTH, INC. T3 No $0 FL
Freedom VIP Rewards (HMO C-SNP) FREEDOM HEALTH, INC. T3 No $0 FL
Optimum Diamond Rewards (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T3 No $0 FL
Optimum Diamond Savings (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T3 No $0 FL
Optimum Diamond Rewards (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T3 No $0 FL
Optimum Diamond (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T3 No $0 FL
Freedom Medi-Medi Partial (HMO D-SNP) FREEDOM HEALTH, INC. T3 No $0 FL
Freedom Medi-Medi Full (HMO D-SNP) FREEDOM HEALTH, INC. T3 No $0 FL
Optimum Emerald Partial (HMO D-SNP) OPTIMUM HEALTHCARE, INC. T3 No $0 FL
Optimum Emerald Full (HMO D-SNP) OPTIMUM HEALTHCARE, INC. T3 No $0 FL
Freedom Medicare Plan Rx (HMO) FREEDOM HEALTH, INC. T3 No $0 FL
Freedom Medicare Plan Rx (HMO) FREEDOM HEALTH, INC. T3 No $0 FL
Freedom VIP Savings COPD (HMO C-SNP) FREEDOM HEALTH, INC. T3 No $0 FL
Freedom VIP Savings COPD (HMO C-SNP) FREEDOM HEALTH, INC. T3 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T3 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T3 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T3 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T3 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T3 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T3 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T3 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T3 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T3 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T3 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T3 No $0 FL
Freedom Máximo (HMO-POS) FREEDOM HEALTH, INC. T3 No $0 FL
Freedom Máximo (HMO-POS) FREEDOM HEALTH, INC. T3 No $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T3 No $0 FL
Optimum Platinum Plan (HMO) OPTIMUM HEALTHCARE, INC. T3 No $0 FL
Optimum Gold Plan (HMO) OPTIMUM HEALTHCARE, INC. T3 No $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T3 No $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T3 No $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T3 No $0 FL
Optimum Diamond Savings COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T3 No $0 FL
Optimum Gold Plus Plan (HMO) OPTIMUM HEALTHCARE, INC. T3 No $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T3 No $0 FL
Óptimo Plus (PPO) TRIPLE S ADVANTAGE, INC. T4 No $0 PR
Contigo Plus (HMO C-SNP) TRIPLE S ADVANTAGE, INC. T4 No $0 PR
Brillante (HMO-POS) TRIPLE S ADVANTAGE, INC. T4 No $0 PR
Enlace Plus (HMO) TRIPLE S ADVANTAGE, INC. T4 No $0 PR
ContigoEnMente (HMO C-SNP) TRIPLE S ADVANTAGE, INC. T4 No $0 PR
Ahorro Plus (HMO) TRIPLE S ADVANTAGE, INC. T4 No $0 PR
Security Blue HMO-POS Standard (HMO-POS) HIGHMARK CHOICE COMPANY T4 No $51.80 PA
Freedom Blue PPO Select (PPO) HIGHMARK SENIOR HEALTH COMPANY T4 No $95.70 PA
Security Blue HMO-POS Deluxe (HMO-POS) HIGHMARK CHOICE COMPANY T4 No $95.90 PA
Freedom Blue PPO Standard (PPO) HIGHMARK SENIOR HEALTH COMPANY T4 No $98.20 PA
Freedom Blue PPO Select (PPO) HIGHMARK SENIOR HEALTH COMPANY T4 No $115.70 PA

Frequently Asked Questions

Is 12 HR desloratadine 2.5 MG / pseudoephedrine sulfate 120 MG Extended Release Oral Tablet [Clarinex-D] covered by Medicare Part D?

Yes, 12 HR desloratadine 2.5 MG / pseudoephedrine sulfate 120 MG Extended Release Oral Tablet [Clarinex-D] is covered by 55 Medicare Part D plans (1.1% of all Part D formularies).

What tier is 12 HR desloratadine 2.5 MG / pseudoephedrine sulfate 120 MG Extended Release Oral Tablet [Clarinex-D] on Medicare Part D plans?

12 HR desloratadine 2.5 MG / pseudoephedrine sulfate 120 MG Extended Release Oral Tablet [Clarinex-D] averages Tier 3.4 across Part D plans, ranging from Tier 3 to Tier 4.

Does 12 HR desloratadine 2.5 MG / pseudoephedrine sulfate 120 MG Extended Release Oral Tablet [Clarinex-D] require prior authorization?

0% of Part D formularies require prior authorization for 12 HR desloratadine 2.5 MG / pseudoephedrine sulfate 120 MG Extended Release Oral Tablet [Clarinex-D]. Step therapy: 80%. Quantity limits: 20%.

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