Medicare Part D coverage · citalopram · RxCUI 2591786
citalopram 30 MG Oral Capsule
Per the CMS 2026 Part D formulary file, citalopram 30 MG Oral Capsule is covered by 183 Medicare Part D plans (3.6% of enrollable products), averaging Tier 2.8, with prior authorization required on 0% of covering formularies.
- 3.6%
- Plan coverage
- 183
- Plans covering
- T2.8
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for citalopram 30 MG Oral Capsule
Per the CMS 2026 Part D formulary file, citalopram 30 MG Oral Capsule (RxNorm concept RXCUI 2591786, generic name citalopram) appears on 13 distinct formulary files spanning 183 Medicare Part D plan offerings - 3.6% 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 2.8.
Real-world access to citalopram 30 MG Oral Capsule depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 7.7% require step therapy. 23.1% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,454,397 Part D beneficiaries filled citalopram 30 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $62,841,142 and an average per-beneficiary annual cost of $43.21. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry citalopram 30 MG Oral Capsule today.
Coverage Details
- Formularies covering
- 13
- Plans covering
- 183
- Coverage rate
- 3.6%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 7.7% of formularies
- Quantity limits
- 23.1% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,454,397
- Total spending
- $62,841,142
- Avg per beneficiary
- $43.21
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering citalopram 30 MG Oral Capsule
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 |
| MCS Classicare RxMax (HMO) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Platino Ideal (HMO D-SNP) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Efectivo (HMO) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Essential (HMO-POS) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Platino Progreso (HMO D-SNP) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Primero (HMO C-SNP) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Firme (HMO) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare En Tu Hogar (HMO) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Hero (HMO) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Platino Total (HMO D-SNP) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare InteliCare (HMO) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Platino Maximo (HMO D-SNP) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Excede (HMO) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Estrella (HMO) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Platino Superior (HMO D-SNP) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| MCS Classicare Platino 185 (HMO D-SNP) | MCS Advantage, Inc. | T2 | No | $0 | PR |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T2 | No | $0 | MS |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T3 | No | $0 | UT |
Show the next 30 plans
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T3 | No | $0 | NV |
| Select Health Medicare Dual (HMO D-SNP) | Selecthealth, Inc. | T3 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T3 | No | $0 | UT |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T3 | No | $0 | NV |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T3 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T3 | No | $0 | CO |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T3 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T3 | No | $0 | CO |
| Select Health Medicare Flex (HMO) | Selecthealth, Inc. | T3 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T3 | No | $0 | CO |
| Select Health Medicare Active (HMO) | Selecthealth, Inc. | T3 | No | $0 | CO |
| Select Health Medicare Dual (HMO D-SNP) | Selecthealth, Inc. | T3 | No | $0 | NV |
| Select Health Medicare Wellness (HMO) | Selecthealth, Inc. | T3 | No | $0 | NV |
| MMM Supremo (HMO C-SNP) | MMM Healthcare, LLC | T3 | No | $0 | PR |
| MMM Diamante Platino (HMO D-SNP) | MMM Healthcare, LLC | T3 | No | $0 | PR |
| MMM Unico (HMO-POS) | MMM Healthcare, LLC | T3 | No | $0 | PR |
| MMM Elite (HMO-POS) | MMM Healthcare, LLC | T3 | No | $0 | PR |
| MMM Deluxe (HMO-POS) | MMM Healthcare, LLC | T3 | No | $0 | PR |
| MMM Dorado Platino (HMO D-SNP) | MMM Healthcare, LLC | T3 | No | $0 | PR |
| PMC Premier Platino (HMO D-SNP) | MMM Healthcare, LLC | T3 | No | $0 | PR |
| PMC Max (HMO-POS) | MMM Healthcare, LLC | T3 | No | $0 | PR |
| MMM Plenitud (HMO-POS) | MMM Healthcare, LLC | T3 | No | $0 | PR |
| MMM Valioso (HMO-POS) | MMM Healthcare, LLC | T3 | No | $0 | PR |
| MMM Combo Platino (HMO D-SNP) | MMM Healthcare, LLC | T3 | No | $0 | PR |
| MMM Flexi Platino (HMO D-SNP) | MMM Healthcare, LLC | T3 | No | $0 | PR |
| MMM Grandioso (HMO-POS) | MMM Healthcare, LLC | T3 | No | $0 | PR |
| MMM Mega Flex (HMO-POS) | MMM Healthcare, LLC | T3 | No | $0 | PR |
| MMM Relax Platino (HMO D-SNP) | MMM Healthcare, LLC | T3 | No | $0 | PR |
| MMM Balance (HMO-POS) | MMM Healthcare, LLC | T3 | No | $0 | PR |
| Mass General Brigham Advantage (PPO) | Mass General Brigham Health Plan, Inc. | T3 | No | $0 | MA |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is citalopram 30 MG Oral Capsule covered by Medicare Part D?
Yes, citalopram 30 MG Oral Capsule is covered by 183 Medicare Part D plans (3.6% of all Part D formularies).
What tier is citalopram 30 MG Oral Capsule on Medicare Part D plans?
citalopram 30 MG Oral Capsule averages Tier 2.8 across Part D plans, ranging from Tier 1 to Tier 4.
Does citalopram 30 MG Oral Capsule require prior authorization?
0% of Part D formularies require prior authorization for citalopram 30 MG Oral Capsule. Step therapy: 7.7%. Quantity limits: 23.1%.
How much does Medicare spend on citalopram 30 MG Oral Capsule?
In 2023, total Medicare Part D spending on citalopram 30 MG Oral Capsule was $62,841,142, covering 1,454,397 beneficiaries. The average spend per beneficiary was $43.21.
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
Similar prior-authorization rate
- metronidazole 10 MG/ML Topical Cream [Noritate] 0% PA
- 24 HR minocycline 40 MG Extended Release Oral Capsule [Emrosi] 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