9 HR methylphenidate 1.67 MG/HR Transdermal System
methylphenidate
RxCUI: 753438
What the CMS Formulary Data Shows for 9 HR methylphenidate 1.67 MG/HR Transdermal System
Per the CMS 2026 Part D formulary file, 9 HR methylphenidate 1.67 MG/HR Transdermal System (RxNorm concept RXCUI 753438, generic name methylphenidate) appears on 9 distinct formulary files spanning 67 Medicare Part D plan offerings - 1.3% 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 3.4.
Real-world access to 9 HR methylphenidate 1.67 MG/HR Transdermal System depends on utilization management as much as tier placement: 22.2% of covering formularies require prior authorization. 22.2% require step therapy. 88.9% 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 9 HR methylphenidate 1.67 MG/HR Transdermal System today.
Coverage Details
- Formularies covering
- 9
- Plans covering
- 67
- Coverage rate
- 1.3%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 22.2% of formularies
- Step therapy required
- 22.2% of formularies
- Quantity limits
- 88.9% of formularies
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering 9 HR methylphenidate 1.67 MG/HR Transdermal System
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 | Yes | No | $164.80 | - |
| Blue Rx PDP Plus (PDP) | HM HEALTH INSURANCE COMPANY | T4 | Yes | No | $193.20 | - |
Medicare Advantage Plans (MA-PD) Covering 9 HR methylphenidate 1.67 MG/HR Transdermal System
65 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T1 | Yes | $0 | CA |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T2 | No | $0 | MS |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | NV |
| Select Health Medicare Dual (HMO D-SNP) | SELECTHEALTH, INC. | T4 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | UT |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | NV |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | CO |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | CO |
| Select Health Medicare Flex (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | CO |
| Select Health Medicare Active (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | CO |
| Select Health Medicare Dual (HMO D-SNP) | SELECTHEALTH, INC. | T4 | No | $0 | NV |
| Select Health Medicare Wellness (HMO) | SELECTHEALTH, INC. | T4 | No | $0 | NV |
| Medicare BlueEssential (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Medicare BlueActive (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Medicare BlueVital (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Univera SeniorChoice Basic (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Univera SeniorChoice Extra (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Medicare Blue Choice Core (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $0 | NY |
| Univera Medicare Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T4 | No | $0 | NY |
| Medicare Blue Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T4 | No | $0 | NY |
| Network Health Select (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | No | $0 | WI |
| Network Health Go (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | No | $0 | WI |
| Network Health Anywhere (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | No | $0 | WI |
| Network Health Choice (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | No | $0 | WI |
| Network Health Zero (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | No | $0 | WI |
| CDPHP $0 Medicare Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T4 | No | $0 | NY |
| PacificSource Medicare Essentials Rx 27 (HMO) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | No | $0 | OR |
| PacificSource Medicare MyCare Choice Rx 29 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | No | $0 | MT |
| PacificSource Medicare Essentials Choice Rx 36 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | No | $0 | OR |
| PacificSource Medicare MyCare Rx 40 (HMO) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | No | $0 | OR |
| PacificSource Dual Care (HMO D-SNP) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | No | $0 | OR |
| PacificSource Dual Care Alliance (HMO D-SNP) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | No | $0 | OR |
| PacificSource Medicare MyCare Choice Rx 34 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | No | $19.00 | ID |
| Network Health Cares (PPO D-SNP) | NETWORK HEALTH INSURANCE CORPORATION | T4 | No | $21.10 | WI |
| PacificSource Medicare Essentials Choice Rx 14 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | No | $29.10 | OR |
| Univera SeniorChoice Core (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $33.00 | NY |
| Univera SeniorChoice Advanced (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $36.90 | NY |
| Network Health PlusRx (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T4 | No | $38.60 | WI |
| Medicare BlueClassic (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $51.00 | NY |
| Security Blue HMO-POS Standard (HMO-POS) | HIGHMARK CHOICE COMPANY | T4 | Yes | $51.80 | PA |
| PacificSource Medicare MyCare Choice Rx 24 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | No | $52.00 | ID |
| Univera SeniorChoice Secure (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $54.90 | NY |
| Medicare BlueBalanced (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $55.00 | NY |
| Medicare Blue Choice Prime (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $55.00 | NY |
| Univera SeniorChoice Value Plus (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T4 | No | $58.60 | NY |
| PacificSource Medicare Essentials Rx 41 (HMO) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T4 | No | $69.30 | OR |
Frequently Asked Questions
Is 9 HR methylphenidate 1.67 MG/HR Transdermal System covered by Medicare Part D?
Yes, 9 HR methylphenidate 1.67 MG/HR Transdermal System is covered by 67 Medicare Part D plans (1.3% of all Part D formularies).
What tier is 9 HR methylphenidate 1.67 MG/HR Transdermal System on Medicare Part D plans?
9 HR methylphenidate 1.67 MG/HR Transdermal System averages Tier 3.4 across Part D plans, ranging from Tier 1 to Tier 4.
Does 9 HR methylphenidate 1.67 MG/HR Transdermal System require prior authorization?
22.2% of Part D formularies require prior authorization for 9 HR methylphenidate 1.67 MG/HR Transdermal System. Step therapy: 22.2%. Quantity limits: 88.9%.
Read our methodology - how this data is sourced, computed, and verified.