Medicare Part D coverage · dexmethylphenidate hydrochloride · RxCUI 899557
dexmethylphenidate hydrochloride 2.5 MG Oral Tablet
Per the CMS 2026 Part D formulary file, dexmethylphenidate hydrochloride 2.5 MG Oral Tablet is covered by 4,555 Medicare Part D plans (90.2% of enrollable products), averaging Tier 2.4, with prior authorization required on 39.1% of covering formularies.
- 90.2%
- Plan coverage
- 4,555
- Plans covering
- T2.4
- Avg tier
- 39.1%
- Prior auth required
What the CMS Formulary Data Shows for dexmethylphenidate hydrochloride 2.5 MG Oral Tablet
Per the CMS 2026 Part D formulary file, dexmethylphenidate hydrochloride 2.5 MG Oral Tablet (RxNorm concept RXCUI 899557, generic name dexmethylphenidate hydrochloride) appears on 256 distinct formulary files spanning 4,555 Medicare Part D plan offerings - 90.2% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.4.
Real-world access to dexmethylphenidate hydrochloride 2.5 MG Oral Tablet depends on utilization management as much as tier placement: 39.1% of covering formularies require prior authorization. 0% require step therapy. 79.7% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 9,197 Part D beneficiaries filled dexmethylphenidate hydrochloride 2.5 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $6,100,623 and an average per-beneficiary annual cost of $663.33. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry dexmethylphenidate hydrochloride 2.5 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 256
- Plans covering
- 4,555
- Coverage rate
- 90.2%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 39.1% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 79.7% of formularies
2023 Medicare Spending
- Beneficiaries
- 9,197
- Total spending
- $6,100,623
- Avg per beneficiary
- $663.33
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering dexmethylphenidate hydrochloride 2.5 MG Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $0 | FL |
| 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 |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | Yes | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | Yes | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | Yes | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | Yes | $0 | NY |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | No | $0 | GA |
| KeyCare Advantage Plus (HMO C-SNP) | Isnp Ventures, LLC | T1 | No | $0 | MD |
| Premier Care (HMO-POS I-SNP) | Lifeworks Advantage, LLC | T1 | No | $0 | VA |
| Premier Care (HMO I-SNP) | Align Senior Care California Inc. | T1 | No | $0 | CA |
| Advantage Care (HMO) | Align Senior Care California Inc. | T1 | No | $0 | CA |
| Premier Care (HMO-POS I-SNP) | Align Senior Care MI, LLC | T1 | No | $0 | MI |
| Premier Care (HMO I-SNP) | Align Senior Care Florida, Inc. | T1 | No | $0 | FL |
Show the next 30 plans
| Perennial Advantage Freedom (HMO-POS) | Perennial Advantage OF Colorado, Inc. | T1 | No | $0 | CO |
| Perennial Advantage Premier (HMO-POS I-SNP) | Perennial Advantage OF Colorado, Inc. | T1 | No | $0 | CO |
| Perennial Advantage Freedom (HMO) | Perennial Advantage OF Colorado, Inc. | T1 | No | $0 | PA |
| Perennial Advantage Premier (HMO I-SNP) | Perennial Advantage OF Colorado, Inc. | T1 | No | $0 | PA |
| Perennial Advantage Freedom (HMO-POS) | Perennial Advantage OF Ohio, Inc. | T1 | No | $0 | OH |
| Perennial Advantage Premier (HMO-POS I-SNP) | Perennial Advantage OF Ohio, Inc. | T1 | No | $0 | OH |
| ProCare Advantage - Diabetes Care Management (HMO-POS C-SNP) | Procare Advantage, LLC | T1 | No | $0 | TX |
| PruittHealth Premier Advantage (HMO I-SNP) | Pruitthealth Premier, Inc. | T1 | No | $0 | GA |
| Senior Health Plan Silver Plus (HMO) | Communitycare Government Programs, Inc. | T1 | No | $0 | OK |
| Senior Health Plan Oklahoma Dual Complete (HMO D-SNP) | Communitycare Government Programs, Inc. | T1 | No | $0 | OK |
| Community First Medicare Advantage Alamo Plan (HMO) | Community First Health Plans, Inc. | T1 | No | $0 | TX |
| Community First Medicare Advantage D-SNP (HMO D-SNP) | Community First Health Plans, Inc. | T1 | No | $0 | TX |
| Community DualCare Aligned (HMO D-SNP) | Community Health Choice Texas, Inc. | T1 | No | $0 | TX |
| Community DualCare Access (HMO D-SNP) | Community Health Choice Texas, Inc. | T1 | No | $0 | TX |
| El Paso Health Medicare Advantage Dual (HMO D-SNP) | EL Paso First Health Plans, Inc. | T1 | No | $0 | TX |
| El Paso Health Total (HMO) | EL Paso First Health Plans, Inc. | T1 | No | $0 | TX |
| El Paso Health Giveback (HMO) | EL Paso First Health Plans, Inc. | T1 | No | $0 | TX |
| Liberty Medicare Advantage (HMO C-SNP) | Liberty Advantage, LLC | T1 | No | $0 | NC |
| Peak Advantage Vista (PPO) | Peak Health Insurance Corporation | T1 | No | $0 | PA, WV |
| SECUR Edge (HMO I-SNP) | Secur Inc | T1 | No | $0 | FL |
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | No | $0 | AL |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | Yes | $0 | CA |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | Yes | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare OF NEW Jersey, Inc. | T1 | Yes | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | Yes | $0 | MN |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is dexmethylphenidate hydrochloride 2.5 MG Oral Tablet covered by Medicare Part D?
Yes, dexmethylphenidate hydrochloride 2.5 MG Oral Tablet is covered by 4,555 Medicare Part D plans (90.2% of all Part D formularies).
What tier is dexmethylphenidate hydrochloride 2.5 MG Oral Tablet on Medicare Part D plans?
dexmethylphenidate hydrochloride 2.5 MG Oral Tablet averages Tier 2.4 across Part D plans, ranging from Tier 1 to Tier 4.
Does dexmethylphenidate hydrochloride 2.5 MG Oral Tablet require prior authorization?
39.1% of Part D formularies require prior authorization for dexmethylphenidate hydrochloride 2.5 MG Oral Tablet. Step therapy: 0%. Quantity limits: 79.7%.
How much does Medicare spend on dexmethylphenidate hydrochloride 2.5 MG Oral Tablet?
In 2023, total Medicare Part D spending on dexmethylphenidate hydrochloride 2.5 MG Oral Tablet was $6,100,623, covering 9,197 beneficiaries. The average spend per beneficiary was $663.33.
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
- 10 ML furosemide 10 MG/ML Injection T2.4
- disulfiram 250 MG Oral Tablet T2.4
- hydrocortisone 10 MG/ML / neomycin 3.5 MG/ML / polymyxin B 10000 UNT/ML Otic Solution T2.4
- hydrochlorothiazide 12.5 MG / valsartan 320 MG Oral Tablet T2.4
- 168 HR ethinyl estradiol 0.00146 MG/HR / norelgestromin 0.00625 MG/HR Transdermal System [Xulane] T2.4
- amlodipine 5 MG / hydrochlorothiazide 12.5 MG / olmesartan medoxomil 20 MG Oral Tablet T2.4
Similar prior-authorization rate
- tiopronin 100 MG Oral Tablet 39.4% PA
- perampanel 0.5 MG/ML Oral Suspension 39.5% PA
- {2 (24 HR levomilnacipran 20 MG Extended Release Oral Capsule [Fetzima]) / 26 (24 HR levomilnacipran 40 MG Extended Release Oral Capsule [Fetzima]) } Pack [Fetzima Pack] 38.7% PA
- 24 HR levomilnacipran 120 MG Extended Release Oral Capsule [Fetzima] 38.7% PA
- perampanel 4 MG Oral Tablet 39.6% PA
- perampanel 2 MG Oral Tablet 39.6% PA