Medicare Part D coverage · 24 · RxCUI 1043563
24 HR metformin hydrochloride 1000 MG / saxagliptin 2.5 MG Extended Release Oral Tablet
Per the CMS 2026 Part D formulary file, 24 HR metformin hydrochloride 1000 MG / saxagliptin 2.5 MG Extended Release Oral Tablet is covered by 358 Medicare Part D plans (7.1% of enrollable products), averaging Tier 2.1, with prior authorization required on 0% of covering formularies.
- 7.1%
- Plan coverage
- 358
- Plans covering
- T2.1
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for 24 HR metformin hydrochloride 1000 MG / saxagliptin 2.5 MG Extended Release Oral Tablet
Per the CMS 2026 Part D formulary file, 24 HR metformin hydrochloride 1000 MG / saxagliptin 2.5 MG Extended Release Oral Tablet (RxNorm concept RXCUI 1043563, generic name 24) appears on 42 distinct formulary files spanning 358 Medicare Part D plan offerings - 7.1% 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 2.1.
Real-world access to 24 HR metformin hydrochloride 1000 MG / saxagliptin 2.5 MG Extended Release Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 2.4% require step therapy. 78.6% 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 metformin hydrochloride 1000 MG / saxagliptin 2.5 MG Extended Release Oral Tablet today.
Coverage Details
- Formularies covering
- 42
- Plans covering
- 358
- Coverage rate
- 7.1%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 2.4% of formularies
- Quantity limits
- 78.6% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 24 HR metformin hydrochloride 1000 MG / saxagliptin 2.5 MG Extended Release Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
Show the next 30 plans
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T1 | No | $0 | MS |
| MMM Supremo (HMO C-SNP) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Diamante Platino (HMO D-SNP) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Unico (HMO-POS) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Elite (HMO-POS) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Deluxe (HMO-POS) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Dorado Platino (HMO D-SNP) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| PMC Premier Platino (HMO D-SNP) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| PMC Max (HMO-POS) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Plenitud (HMO-POS) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Valioso (HMO-POS) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Combo Platino (HMO D-SNP) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Flexi Platino (HMO D-SNP) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Grandioso (HMO-POS) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Mega Flex (HMO-POS) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Relax Platino (HMO D-SNP) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| MMM Balance (HMO-POS) | MMM Healthcare, LLC | T1 | No | $0 | PR |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| 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 |
| 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 |
| CareOregon Advantage Plus (HMO D-SNP) | Health Plan OF Careoregon, Inc. | T1 | No | $0 | OR |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | No | $4.80 | FL |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Michigan, Inc. | T1 | No | $8.80 | MI |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Illinois, Inc. | T1 | No | $15.20 | IL |
| WellSense Added Value (HMO) | Boston Medical Center Health Plan, Inc. | T1 | No | $21.70 | NH |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 24 HR metformin hydrochloride 1000 MG / saxagliptin 2.5 MG Extended Release Oral Tablet covered by Medicare Part D?
Yes, 24 HR metformin hydrochloride 1000 MG / saxagliptin 2.5 MG Extended Release Oral Tablet is covered by 358 Medicare Part D plans (7.1% of all Part D formularies).
What tier is 24 HR metformin hydrochloride 1000 MG / saxagliptin 2.5 MG Extended Release Oral Tablet on Medicare Part D plans?
24 HR metformin hydrochloride 1000 MG / saxagliptin 2.5 MG Extended Release Oral Tablet averages Tier 2.1 across Part D plans, ranging from Tier 1 to Tier 4.
Does 24 HR metformin hydrochloride 1000 MG / saxagliptin 2.5 MG Extended Release Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for 24 HR metformin hydrochloride 1000 MG / saxagliptin 2.5 MG Extended Release Oral Tablet. Step therapy: 2.4%. Quantity limits: 78.6%.
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
- erythromycin 20 MG/ML Topical Solution T2.1
- {7 (ethinyl estradiol 0.035 MG / norgestimate 0.18 MG Oral Tablet) / 7 (ethinyl estradiol 0.035 MG / norgestimate 0.215 MG Oral Tablet) / 7 (ethinyl estradiol 0.035 MG / norgestimate 0.25 MG Oral Tablet) / 7 (inert ingredients 1 MG Oral Tablet) } Pack [Tri-Sprintec 28 Day] T2.1
- acetaminophen 24 MG/ML / codeine phosphate 2.4 MG/ML Oral Solution T2.1
- {21 (ethinyl estradiol 0.03 MG / levonorgestrel 0.15 MG Oral Tablet) / 7 (inert ingredients 1 MG Oral Tablet) } Pack [Portia 28 Day] T2.1
- {21 (ethinyl estradiol 0.035 MG / norgestimate 0.25 MG Oral Tablet) / 7 (inert ingredients 1 MG Oral Tablet) } Pack [Sprintec 28 Day] T2.1
- {21 (ethinyl estradiol 0.035 MG / norgestimate 0.25 MG Oral Tablet) / 7 (inert ingredients 1 MG Oral Tablet) } Pack T2.1
Similar prior-authorization rate
- metronidazole 10 MG/ML Topical Cream [Noritate] 0% PA
- buspirone hydrochloride 10 MG Oral Capsule [Bucapsol] 0% PA
- diflunisal 375 MG Oral Tablet [Dolobid] 0% PA
- hydrocortisone 1 MG/ML Oral Solution [Khindivi] 0% PA
- indomethacin 50 MG Rectal Suppository [Indocin] 0% PA
- sarecycline 100 MG Oral Tablet [Seysara] 0% PA