Abuse-Deterrent oxycodone hydrochloride 30 MG Oral Tablet
Abuse-Deterrent oxycodone hydrochloride
RxCUI: 1944538
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.
4.4%
Plan Coverage
221
Plans Covering
T3.5
Avg Tier
0%
Prior Auth Required
What the CMS Formulary Data Shows for Abuse-Deterrent oxycodone hydrochloride 30 MG Oral Tablet
Per the CMS 2026 Part D formulary file, Abuse-Deterrent oxycodone hydrochloride 30 MG Oral Tablet (RxNorm concept RXCUI 1944538, generic name Abuse-Deterrent oxycodone hydrochloride) appears on 6 distinct formulary files spanning 221 Medicare Part D plan offerings - 4.4% 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 3.5.
Real-world access to Abuse-Deterrent oxycodone hydrochloride 30 MG Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 100% 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 Abuse-Deterrent oxycodone hydrochloride 30 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 6
- Plans covering
- 221
- Coverage rate
- 4.4%
- Tier range
- Tier 3 – Tier 4
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 100% of formularies
Tier Distribution Across Plans
97 plans
Tier 3, Preferred Brand
3 plans
Tier 4, Non-Preferred
Standalone Drug Plans (PDP) Covering Abuse-Deterrent oxycodone hydrochloride 30 MG Oral Tablet
61 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $0 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $0 | - |
| HealthSpring TotalCare Plus (HMO D-SNP) | BRAVO HEALTH PENNSYLVANIA, INC. | T3 | No | No | $0 | CT |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $6.70 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $32.60 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $35.70 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $48.40 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $50.00 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $50.00 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $50.40 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $52.60 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $54.50 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $56.30 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $56.30 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $59.70 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $59.90 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $60.60 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $61.70 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $62.60 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $65.40 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $65.70 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $65.70 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $66.40 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $66.50 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $66.60 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $66.60 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $70.00 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $70.60 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $70.70 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $70.70 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $71.20 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $71.20 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $74.00 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $74.30 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $77.10 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $77.50 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $78.00 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $78.20 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $87.20 | - |
| HealthSpring Extra Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $91.60 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $95.60 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $104.20 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T3 | No | No | $109.30 | - |
Showing top 50 of 61 plans.
Medicare Advantage Plans (MA-PD) Covering Abuse-Deterrent oxycodone hydrochloride 30 MG Oral Tablet
39 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| HealthSpring TotalCare Plus (HMO D-SNP) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T3 | No | $0 | GA |
| HealthSpring TotalCare Plus (HMO D-SNP) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T3 | No | $0 | MO |
| HealthSpring TotalCare (HMO D-SNP) | CIGNA HEALTHCARE OF COLORADO, INC. | T3 | No | $0 | CO |
| HealthSpring TotalCare Plus (HMO D-SNP) | CIGNA HEALTHCARE OF COLORADO, INC. | T3 | No | $0 | CO |
| HealthSpring TotalCare (HMO D-SNP) | CIGNA HEALTHCARE OF COLORADO, INC. | T3 | No | $0 | OH |
| HealthSpring TotalCare Plus (HMO D-SNP) | CIGNA HEALTHCARE OF COLORADO, INC. | T3 | No | $0 | OH |
| HealthSpring TotalCare Plus (HMO D-SNP) | BRAVO HEALTH MID-ATLANTIC, INC. | T3 | No | $0 | MD |
| HealthSpring TotalCare Plus (HMO D-SNP) | BRAVO HEALTH PENNSYLVANIA, INC. | T3 | No | $0 | PA |
| HealthSpring TotalCare (HMO D-SNP) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T3 | No | $0 | MS |
| HealthSpring TotalCare Plus (HMO D-SNP) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T3 | No | $0 | MS |
| HealthSpring TotalCare (HMO D-SNP) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T3 | No | $0 | TX |
| HealthSpring TotalCare Plus (HMO D-SNP) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T3 | No | $0 | TN |
| HealthSpring TotalCare Plus (HMO D-SNP) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T3 | No | $0 | AR |
| HealthSpring TotalCare (HMO D-SNP) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T3 | No | $0 | TX |
| HealthSpring TotalCare Plus (HMO D-SNP) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T3 | No | $0 | AL |
| HealthSpring TotalCare (HMO D-SNP) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T3 | No | $0 | TX |
| HealthSpring TotalCare Plus (HMO D-SNP) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T3 | No | $0 | GA |
| HealthSpring TotalCare Plus (HMO D-SNP) | HEALTHSPRING OF FLORIDA, INC. | T3 | No | $0 | FL |
| HealthSpring TotalCare Plus (HMO D-SNP) | HEALTHSPRING OF FLORIDA, INC. | T3 | No | $0 | FL |
| HealthSpring TotalCare Plus (HMO D-SNP) | HEALTHSPRING OF FLORIDA, INC. | T3 | No | $0 | FL |
| HealthSpring TotalCare Plus (HMO D-SNP) | HEALTHSPRING OF FLORIDA, INC. | T3 | No | $0 | FL |
| HealthSpring TotalCare Plus (HMO D-SNP) | HEALTHSPRING OF FLORIDA, INC. | T3 | No | $0 | FL |
| HealthSpring TotalCare Plus (HMO D-SNP) | BRAVO HEALTH PENNSYLVANIA, INC. | T3 | No | $0 | NC |
| HealthSpring TotalCare (HMO D-SNP) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T3 | No | $2.60 | MO |
| HealthSpring TotalCare (HMO D-SNP) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T3 | No | $3.30 | AL |
| HealthSpring TotalCare (HMO D-SNP) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T3 | No | $3.40 | GA |
| HealthSpring TotalCare (HMO D-SNP) | HEALTHSPRING OF FLORIDA, INC. | T3 | No | $4.80 | FL |
| HealthSpring TotalCare (HMO D-SNP) | HEALTHSPRING OF FLORIDA, INC. | T3 | No | $4.80 | FL |
| HealthSpring TotalCare (HMO D-SNP) | HEALTHSPRING OF FLORIDA, INC. | T3 | No | $4.80 | FL |
| HealthSpring TotalCare (HMO D-SNP) | HEALTHSPRING OF FLORIDA, INC. | T3 | No | $4.80 | FL |
| HealthSpring TotalCare (HMO D-SNP) | HEALTHSPRING OF FLORIDA, INC. | T3 | No | $4.80 | FL |
| HealthSpring TotalCare (HMO D-SNP) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T3 | No | $8.70 | AR |
| HealthSpring Primary (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T3 | No | $17.70 | TN |
| HealthSpring TotalCare (HMO D-SNP) | BRAVO HEALTH PENNSYLVANIA, INC. | T3 | No | $19.70 | NC |
| HealthSpring Primary (HMO) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T3 | No | $23.90 | TN |
| HealthSpring TotalCare (HMO D-SNP) | HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. | T3 | No | $24.30 | GA |
| HealthSpring Preferred (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T4 | No | $0 | AZ |
| HealthSpring Alliance (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T4 | No | $0 | AZ |
| HealthSpring Preferred Savings (HMO) | BRAVO HEALTH PENNSYLVANIA, INC. | T4 | No | $0 | AZ |
Frequently Asked Questions
Is Abuse-Deterrent oxycodone hydrochloride 30 MG Oral Tablet covered by Medicare Part D?
Yes, Abuse-Deterrent oxycodone hydrochloride 30 MG Oral Tablet is covered by 221 Medicare Part D plans (4.4% of all Part D formularies).
What tier is Abuse-Deterrent oxycodone hydrochloride 30 MG Oral Tablet on Medicare Part D plans?
Abuse-Deterrent oxycodone hydrochloride 30 MG Oral Tablet averages Tier 3.5 across Part D plans, ranging from Tier 3 to Tier 4.
Does Abuse-Deterrent oxycodone hydrochloride 30 MG Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for Abuse-Deterrent oxycodone hydrochloride 30 MG Oral Tablet. Step therapy: 0%. Quantity limits: 100%.
Read our methodology - how this data is sourced, computed, and verified.
Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial