chlorthalidone 12.5 MG Oral Tablet [Hemiclor]

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chlorthalidone

RxCUI: 2709679

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.
0.4%
Plan Coverage
21
Plans Covering
T4
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for chlorthalidone 12.5 MG Oral Tablet [Hemiclor]

Per the CMS 2026 Part D formulary file, chlorthalidone 12.5 MG Oral Tablet [Hemiclor] (RxNorm concept RXCUI 2709679, generic name chlorthalidone) appears on 3 distinct formulary files spanning 21 Medicare Part D plan offerings - 0.4% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 4 to Tier 4, with a cross-plan average of Tier 4.

Real-world access to chlorthalidone 12.5 MG Oral Tablet [Hemiclor] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 783,324 Part D beneficiaries filled chlorthalidone 12.5 MG Oral Tablet [Hemiclor] in 2023, with total plan-and-beneficiary spending of $64,704,036 and an average per-beneficiary annual cost of $82.60. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry chlorthalidone 12.5 MG Oral Tablet [Hemiclor] today.

Coverage Details

Formularies covering
3
Plans covering
21
Coverage rate
0.4%
Tier range
Tier 4, Non-Preferred
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
0% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

2023 Medicare Spending

Beneficiaries
783,324
Total spending
$64,704,036
Avg per beneficiary
$82.60

Tier Distribution Across Plans

21 plans
Tier 4, Non-Preferred

Medicare Advantage Plans (MA-PD) Covering chlorthalidone 12.5 MG Oral Tablet [Hemiclor]

21 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
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
CDPHP $0 Medicare Rx (HMO) CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. T4 No $0 NY
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
Medicare BlueClassic (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $51.00 NY
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
Medicare BlueEnhanced (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $70.30 NY
Medicare BluePlus (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $86.40 NY
CDPHP Clear Rx (HMO) CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. T4 No $100.00 NY
CDPHP Choice Rx (HMO) CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. T4 No $135.00 NY
Medicare Blue Choice Optimum (HMO-POS) EXCELLUS HEALTH PLAN, INC. T4 No $146.00 NY

Frequently Asked Questions

Is chlorthalidone 12.5 MG Oral Tablet [Hemiclor] covered by Medicare Part D?

Yes, chlorthalidone 12.5 MG Oral Tablet [Hemiclor] is covered by 21 Medicare Part D plans (0.4% of all Part D formularies).

What tier is chlorthalidone 12.5 MG Oral Tablet [Hemiclor] on Medicare Part D plans?

chlorthalidone 12.5 MG Oral Tablet [Hemiclor] averages Tier 4 across Part D plans, ranging from Tier 4 to Tier 4.

Does chlorthalidone 12.5 MG Oral Tablet [Hemiclor] require prior authorization?

0% of Part D formularies require prior authorization for chlorthalidone 12.5 MG Oral Tablet [Hemiclor]. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on chlorthalidone 12.5 MG Oral Tablet [Hemiclor]?

In 2023, total Medicare Part D spending on chlorthalidone 12.5 MG Oral Tablet [Hemiclor] was $64,704,036, covering 783,324 beneficiaries. The average spend per beneficiary was $82.60.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial