Medicare Part D coverage · dexlansoprazole · RxCUI 833204
dexlansoprazole 30 MG Delayed Release Oral Capsule
Per the CMS 2026 Part D formulary file, dexlansoprazole 30 MG Delayed Release Oral Capsule is covered by 2,104 Medicare Part D plans (41.6% of enrollable products), averaging Tier 3.2, with prior authorization required on 0% of covering formularies.
- 41.6%
- Plan coverage
- 2,104
- Plans covering
- T3.2
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for dexlansoprazole 30 MG Delayed Release Oral Capsule
Per the CMS 2026 Part D formulary file, dexlansoprazole 30 MG Delayed Release Oral Capsule (RxNorm concept RXCUI 833204, generic name dexlansoprazole) appears on 46 distinct formulary files spanning 2,104 Medicare Part D plan offerings - 41.6% 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 3.2.
Real-world access to dexlansoprazole 30 MG Delayed Release Oral Capsule depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 10.9% require step therapy. 84.8% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 178,875 Part D beneficiaries filled dexlansoprazole 30 MG Delayed Release Oral Capsule in 2023, with total plan-and-beneficiary spending of $315,328,215 and an average per-beneficiary annual cost of $1,762.84. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry dexlansoprazole 30 MG Delayed Release Oral Capsule today.
Coverage Details
- Formularies covering
- 46
- Plans covering
- 2,104
- Coverage rate
- 41.6%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 10.9% of formularies
- Quantity limits
- 84.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 178,875
- Total spending
- $315,328,215
- Avg per beneficiary
- $1,762.84
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering dexlansoprazole 30 MG Delayed Release Oral Capsule
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| Platino Blindao (HMO D-SNP) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Enlace (HMO D-SNP) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Advance (HMO D-snp) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Plus (HMO D-snp) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| 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 |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | No | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $0 | DE |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $13.10 | PA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $17.60 | PA |
| Highmark Health Options Duals Select (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $31.20 | DE |
| Wellpoint Medicare Advantage (HMO-POS) | Wellpoint West Virginia , Inc. | T2 | No | $0 | WV |
| Anthem Medicare Advantage 3 (HMO-POS) | Healthkeepers, Inc. | T2 | No | $0 | VA |
Show the next 30 plans
| Anthem Medicare Advantage 3 (HMO-POS) | Healthkeepers, Inc. | T2 | No | $0 | VA |
| Anthem Medicare Advantage 3 (HMO-POS) | Healthkeepers, Inc. | T2 | No | $0 | VA |
| Wellpoint Medicare Advantage 2 (HMO-POS) | Wellpoint Tennessee, Inc. | T2 | No | $0 | TN |
| Wellpoint Medicare Advantage 2 (HMO-POS) | Wellpoint Tennessee, Inc. | T2 | No | $0 | TN |
| Wellpoint Medicare Advantage 2 (HMO-POS) | Wellpoint Tennessee, Inc. | T2 | No | $0 | TN |
| Wellpoint Medicare Advantage 2 (HMO-POS) | Wellpoint Tennessee, Inc. | T2 | No | $0 | TN |
| 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 |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is dexlansoprazole 30 MG Delayed Release Oral Capsule covered by Medicare Part D?
Yes, dexlansoprazole 30 MG Delayed Release Oral Capsule is covered by 2,104 Medicare Part D plans (41.6% of all Part D formularies).
What tier is dexlansoprazole 30 MG Delayed Release Oral Capsule on Medicare Part D plans?
dexlansoprazole 30 MG Delayed Release Oral Capsule averages Tier 3.2 across Part D plans, ranging from Tier 1 to Tier 4.
Does dexlansoprazole 30 MG Delayed Release Oral Capsule require prior authorization?
0% of Part D formularies require prior authorization for dexlansoprazole 30 MG Delayed Release Oral Capsule. Step therapy: 10.9%. Quantity limits: 84.8%.
How much does Medicare spend on dexlansoprazole 30 MG Delayed Release Oral Capsule?
In 2023, total Medicare Part D spending on dexlansoprazole 30 MG Delayed Release Oral Capsule was $315,328,215, covering 178,875 beneficiaries. The average spend per beneficiary was $1,762.84.
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
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