Medicare Part D coverage · diclofenac sodium · RxCUI 857706
diclofenac sodium 50 MG / misoprostol 0.2 MG Delayed Release Oral Tablet
Per the CMS 2026 Part D formulary file, diclofenac sodium 50 MG / misoprostol 0.2 MG Delayed Release Oral Tablet is covered by 1,765 Medicare Part D plans (34.9% of enrollable products), averaging Tier 2.7, with prior authorization required on 0% of covering formularies.
- 34.9%
- Plan coverage
- 1,765
- Plans covering
- T2.7
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for diclofenac sodium 50 MG / misoprostol 0.2 MG Delayed Release Oral Tablet
Per the CMS 2026 Part D formulary file, diclofenac sodium 50 MG / misoprostol 0.2 MG Delayed Release Oral Tablet (RxNorm concept RXCUI 857706, generic name diclofenac sodium) appears on 135 distinct formulary files spanning 1,765 Medicare Part D plan offerings - 34.9% 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 2.7.
Real-world access to diclofenac sodium 50 MG / misoprostol 0.2 MG Delayed Release Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 16.3% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 3,196,668 Part D beneficiaries filled diclofenac sodium 50 MG / misoprostol 0.2 MG Delayed Release Oral Tablet in 2023, with total plan-and-beneficiary spending of $395,688,978 and an average per-beneficiary annual cost of $123.78. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry diclofenac sodium 50 MG / misoprostol 0.2 MG Delayed Release Oral Tablet today.
Coverage Details
- Formularies covering
- 135
- Plans covering
- 1,765
- Coverage rate
- 34.9%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 16.3% of formularies
2023 Medicare Spending
- Beneficiaries
- 3,196,668
- Total spending
- $395,688,978
- Avg per beneficiary
- $123.78
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering diclofenac sodium 50 MG / misoprostol 0.2 MG Delayed Release 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 |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | No | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | No | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | No | $0 | NJ |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | No | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | No | $0 | GA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | No | $0 | MI |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | No | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| PHP (HMO C-snp) | Aids Healthcare Foundation | T1 | No | $0 | CA |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | No | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | No | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
Show the next 30 plans
| DualConnect (HMO D-SNP) | Santa Clara County Health Authority | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | No | $0 | NY |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | No | $0 | NY |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | No | $0 | AR |
| 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 |
| Leon MediExtra (HMO) | Leon Health, Inc. | T1 | No | $0 | FL |
| Leon MediDual (HMO D-SNP) | Leon Health, Inc. | T1 | No | $0 | FL |
| Leon MediMore (HMO) | Leon Health, Inc. | T1 | No | $0 | FL |
| Leon MediMax (HMO D-SNP) | Leon Health, Inc. | T1 | No | $0 | FL |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | No | $4.80 | FL |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Hcsc Insurance Services Company | T1 | No | $4.80 | TX |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | No | $4.80 | FL |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS Insurance Company | T1 | No | $5.00 | OK |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Michigan, Inc. | T1 | No | $8.80 | MI |
| Tribute Select (HMO-POS I-SNP) | Arkansas Superior Select, Inc. | T1 | No | $8.90 | AR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | No | $10.50 | OR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | No | $10.50 | OR |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Illinois, Inc. | T1 | No | $15.20 | IL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | No | $17.00 | AZ |
| WellSense Added Value (HMO) | Boston Medical Center Health Plan, Inc. | T1 | No | $21.70 | NH |
| Alterwood Advantage Dual Value (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $31.20 | MD |
| Valor Health Plan (HMO I-SNP) | TSG Guard, Inc. | T1 | No | $31.40 | OH |
| WV Senior Advantage (HMO I-SNP) | West Virginia Senior Advantage, Inc. | T1 | No | $32.70 | WV |
| Hamaspik Medicare Select (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $34.50 | NY |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Colorado, Inc. | T1 | No | $35.20 | CO |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is diclofenac sodium 50 MG / misoprostol 0.2 MG Delayed Release Oral Tablet covered by Medicare Part D?
Yes, diclofenac sodium 50 MG / misoprostol 0.2 MG Delayed Release Oral Tablet is covered by 1,765 Medicare Part D plans (34.9% of all Part D formularies).
What tier is diclofenac sodium 50 MG / misoprostol 0.2 MG Delayed Release Oral Tablet on Medicare Part D plans?
diclofenac sodium 50 MG / misoprostol 0.2 MG Delayed Release Oral Tablet averages Tier 2.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does diclofenac sodium 50 MG / misoprostol 0.2 MG Delayed Release Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for diclofenac sodium 50 MG / misoprostol 0.2 MG Delayed Release Oral Tablet. Step therapy: 0%. Quantity limits: 16.3%.
How much does Medicare spend on diclofenac sodium 50 MG / misoprostol 0.2 MG Delayed Release Oral Tablet?
In 2023, total Medicare Part D spending on diclofenac sodium 50 MG / misoprostol 0.2 MG Delayed Release Oral Tablet was $395,688,978, covering 3,196,668 beneficiaries. The average spend per beneficiary was $123.78.
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
- tadalafil 5 MG Oral Tablet T2.7
- theophylline 300 MG Extended Release Oral Tablet T2.7
- ampicillin 100 MG/ML Injectable Solution T2.7
- timolol 20 MG Oral Tablet T2.7
- 1000 ML glucose 50 MG/ML / potassium chloride 0.02 MEQ/ML / sodium chloride 4.5 MG/ML Injection T2.7
- 20 ML potassium chloride 2 MEQ/ML Injection T2.7
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