carisoprodol 250 MG Oral Tablet
carisoprodol
RxCUI: 730794
What the CMS Formulary Data Shows for carisoprodol 250 MG Oral Tablet
Per the CMS 2026 Part D formulary file, carisoprodol 250 MG Oral Tablet (RxNorm concept RXCUI 730794, generic name carisoprodol) appears on 20 distinct formulary files spanning 139 Medicare Part D plan offerings - 2.7% 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 2.3.
Real-world access to carisoprodol 250 MG Oral Tablet depends on utilization management as much as tier placement: 65% of covering formularies require prior authorization. 0% require step therapy. 80% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 62,766 Part D beneficiaries filled carisoprodol 250 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $5,394,217 and an average per-beneficiary annual cost of $85.94. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry carisoprodol 250 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 20
- Plans covering
- 139
- Coverage rate
- 2.7%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 65% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 80% of formularies
2023 Medicare Spending
- Beneficiaries
- 62,766
- Total spending
- $5,394,217
- Avg per beneficiary
- $85.94
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering carisoprodol 250 MG Oral Tablet
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 |
| SeniorCare Complete (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | Yes | $0 | MN |
| AbilityCare (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | Yes | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | ALAMEDA ALLIANCE FOR HEALTH | T1 | Yes | $0 | CA |
| 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 |
| 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 |
| Simply Extra Platinum (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Extra Platinum (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | 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 |
| Simply Integrated (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
Frequently Asked Questions
Is carisoprodol 250 MG Oral Tablet covered by Medicare Part D?
Yes, carisoprodol 250 MG Oral Tablet is covered by 139 Medicare Part D plans (2.7% of all Part D formularies).
What tier is carisoprodol 250 MG Oral Tablet on Medicare Part D plans?
carisoprodol 250 MG Oral Tablet averages Tier 2.3 across Part D plans, ranging from Tier 1 to Tier 4.
Does carisoprodol 250 MG Oral Tablet require prior authorization?
65% of Part D formularies require prior authorization for carisoprodol 250 MG Oral Tablet. Step therapy: 0%. Quantity limits: 80%.
How much does Medicare spend on carisoprodol 250 MG Oral Tablet?
In 2023, total Medicare Part D spending on carisoprodol 250 MG Oral Tablet was $5,394,217, covering 62,766 beneficiaries. The average spend per beneficiary was $85.94.
Read our methodology - how this data is sourced, computed, and verified.