citalopram 30 MG Oral Capsule
citalopram
RxCUI: 2591786
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 $62,854,506 and an average per-beneficiary annual cost of $43.22. 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
- $62,854,506
- Avg per beneficiary
- $43.22
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 |
| 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 |
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 $62,854,506, covering 1,454,397 beneficiaries. The average spend per beneficiary was $43.22.
Read our methodology - how this data is sourced, computed, and verified.