Medicare Part D coverage · 24 · RxCUI 899511
24 HR dexmethylphenidate hydrochloride 5 MG Extended Release Oral Capsule
Per the CMS 2026 Part D formulary file, 24 HR dexmethylphenidate hydrochloride 5 MG Extended Release Oral Capsule is covered by 1,932 Medicare Part D plans (38.2% of enrollable products), averaging Tier 2.9, with prior authorization required on 1.9% of covering formularies.
- 38.2%
- Plan coverage
- 1,932
- Plans covering
- T2.9
- Avg tier
- 1.9%
- Prior auth required
What the CMS Formulary Data Shows for 24 HR dexmethylphenidate hydrochloride 5 MG Extended Release Oral Capsule
Per the CMS 2026 Part D formulary file, 24 HR dexmethylphenidate hydrochloride 5 MG Extended Release Oral Capsule (RxNorm concept RXCUI 899511, generic name 24) appears on 54 distinct formulary files spanning 1,932 Medicare Part D plan offerings - 38.2% 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 2.9.
Real-world access to 24 HR dexmethylphenidate hydrochloride 5 MG Extended Release Oral Capsule depends on utilization management as much as tier placement: 1.9% of covering formularies require prior authorization. 0% require step therapy. 81.5% 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 24 HR dexmethylphenidate hydrochloride 5 MG Extended Release Oral Capsule today.
Coverage Details
- Formularies covering
- 54
- Plans covering
- 1,932
- Coverage rate
- 38.2%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 1.9% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 81.5% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 24 HR dexmethylphenidate hydrochloride 5 MG Extended Release Oral Capsule
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| 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 |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | No | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $0 | DE |
| 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 |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $13.10 | PA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $17.60 | PA |
| Highmark Health Options Duals Select (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $31.20 | DE |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediMax (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
Show the next 30 plans
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediSun Plus (HMO D-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediSun Extra (HMO D-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediSun Full Dual Plus (HMO D-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediSun Full Dual Extra (HMO D-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Extra (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Extra Platinum (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply More Platinum (HMO) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Complete Platinum (HMO D-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | Simply Healthcare Plans, Inc. | T2 | No | $0 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 24 HR dexmethylphenidate hydrochloride 5 MG Extended Release Oral Capsule covered by Medicare Part D?
Yes, 24 HR dexmethylphenidate hydrochloride 5 MG Extended Release Oral Capsule is covered by 1,932 Medicare Part D plans (38.2% of all Part D formularies).
What tier is 24 HR dexmethylphenidate hydrochloride 5 MG Extended Release Oral Capsule on Medicare Part D plans?
24 HR dexmethylphenidate hydrochloride 5 MG Extended Release Oral Capsule averages Tier 2.9 across Part D plans, ranging from Tier 1 to Tier 4.
Does 24 HR dexmethylphenidate hydrochloride 5 MG Extended Release Oral Capsule require prior authorization?
1.9% of Part D formularies require prior authorization for 24 HR dexmethylphenidate hydrochloride 5 MG Extended Release Oral Capsule. Step therapy: 0%. Quantity limits: 81.5%.
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
Similar prior-authorization rate
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