Medicare Part D coverage · cyclobenzaprine hydrochloride · RxCUI 828320
cyclobenzaprine hydrochloride 5 MG Oral Tablet
Per the CMS 2026 Part D formulary file, cyclobenzaprine hydrochloride 5 MG Oral Tablet is covered by 5,034 Medicare Part D plans (99.6% of enrollable products), averaging Tier 2, with prior authorization required on 54.6% of covering formularies.
- 99.6%
- Plan coverage
- 5,034
- Plans covering
- T2
- Avg tier
- 54.6%
- Prior auth required
What the CMS Formulary Data Shows for cyclobenzaprine hydrochloride 5 MG Oral Tablet
Per the CMS 2026 Part D formulary file, cyclobenzaprine hydrochloride 5 MG Oral Tablet (RxNorm concept RXCUI 828320, generic name cyclobenzaprine hydrochloride) appears on 326 distinct formulary files spanning 5,034 Medicare Part D plan offerings - 99.6% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.
Real-world access to cyclobenzaprine hydrochloride 5 MG Oral Tablet depends on utilization management as much as tier placement: 54.6% of covering formularies require prior authorization. 0% require step therapy. 28.2% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 2,458,292 Part D beneficiaries filled cyclobenzaprine hydrochloride 5 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $70,240,119 and an average per-beneficiary annual cost of $28.57. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry cyclobenzaprine hydrochloride 5 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 326
- Plans covering
- 5,034
- Coverage rate
- 99.6%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 54.6% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 28.2% of formularies
2023 Medicare Spending
- Beneficiaries
- 2,458,292
- Total spending
- $70,240,119
- Avg per beneficiary
- $28.57
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering cyclobenzaprine hydrochloride 5 MG Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| Freedom VIP Care (HMO C-SNP) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | Yes | $0 | FL |
| Optimum Diamond Savings (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | Yes | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | Yes | $0 | FL |
| Optimum Diamond (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | Yes | $0 | FL |
| Freedom Medi-Medi Partial (HMO D-SNP) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom Medi-Medi Full (HMO D-SNP) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Optimum Emerald Partial (HMO D-SNP) | Optimum Healthcare, Inc. | T1 | Yes | $0 | FL |
| Optimum Emerald Full (HMO D-SNP) | Optimum Healthcare, Inc. | T1 | Yes | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
Show the next 30 plans
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom Máximo (HMO-POS) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Freedom Máximo (HMO-POS) | Freedom Health, Inc. | T1 | Yes | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T1 | Yes | $0 | FL |
| Optimum Platinum Plan (HMO) | Optimum Healthcare, Inc. | T1 | Yes | $0 | FL |
| Optimum Gold Plan (HMO) | Optimum Healthcare, Inc. | T1 | Yes | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T1 | Yes | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T1 | Yes | $0 | FL |
| Optimum Diamond Rewards COPD (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | Yes | $0 | FL |
| Optimum Diamond Savings COPD (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | Yes | $0 | FL |
| Optimum Gold Plus Plan (HMO) | Optimum Healthcare, Inc. | T1 | Yes | $0 | FL |
| Optimum Diamond Rewards COPD (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | Yes | $0 | FL |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $0 | FL |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | Yes | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | Yes | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | Yes | $0 | NJ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | Yes | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | Yes | $0 | AZ |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is cyclobenzaprine hydrochloride 5 MG Oral Tablet covered by Medicare Part D?
Yes, cyclobenzaprine hydrochloride 5 MG Oral Tablet is covered by 5,034 Medicare Part D plans (99.6% of all Part D formularies).
What tier is cyclobenzaprine hydrochloride 5 MG Oral Tablet on Medicare Part D plans?
cyclobenzaprine hydrochloride 5 MG Oral Tablet averages Tier 2 across Part D plans, ranging from Tier 1 to Tier 4.
Does cyclobenzaprine hydrochloride 5 MG Oral Tablet require prior authorization?
54.6% of Part D formularies require prior authorization for cyclobenzaprine hydrochloride 5 MG Oral Tablet. Step therapy: 0%. Quantity limits: 28.2%.
How much does Medicare spend on cyclobenzaprine hydrochloride 5 MG Oral Tablet?
In 2023, total Medicare Part D spending on cyclobenzaprine hydrochloride 5 MG Oral Tablet was $70,240,119, covering 2,458,292 beneficiaries. The average spend per beneficiary was $28.57.
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
- perampanel 0.5 MG/ML Oral Suspension [FYCOMPA] 54.6% PA
- probenecid 500 MG / sulopenem etzadroxil 500 MG Oral Tablet [Orlynvah] 54.5% PA
- rufinamide 400 MG Oral Tablet 54.9% PA
- rufinamide 200 MG Oral Tablet 54.9% PA
- hydroxyzine hydrochloride 10 MG Oral Tablet 55.1% PA
- 24 HR selegiline 0.25 MG/HR Transdermal System [Emsam] 55.2% PA