Medicare Part D coverage · dicyclomine hydrochloride · RxCUI 991061

dicyclomine hydrochloride 10 MG Oral Capsule

Per the CMS 2026 Part D formulary file, dicyclomine hydrochloride 10 MG Oral Capsule is covered by 5,052 Medicare Part D plans (100% of enrollable products), averaging Tier 2, with prior authorization required on 41.5% of covering formularies.

100%
Plan coverage
5,052
Plans covering
T2
Avg tier
41.5%
Prior auth required

Verify with CMS →

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.

What the CMS Formulary Data Shows for dicyclomine hydrochloride 10 MG Oral Capsule

Per the CMS 2026 Part D formulary file, dicyclomine hydrochloride 10 MG Oral Capsule (RxNorm concept RXCUI 991061, generic name dicyclomine hydrochloride) appears on 328 distinct formulary files spanning 5,052 Medicare Part D plan offerings - 100% 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 dicyclomine hydrochloride 10 MG Oral Capsule depends on utilization management as much as tier placement: 41.5% of covering formularies require prior authorization. 0% require step therapy. 0.6% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 887,927 Part D beneficiaries filled dicyclomine hydrochloride 10 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $53,307,717 and an average per-beneficiary annual cost of $60.04. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry dicyclomine hydrochloride 10 MG Oral Capsule today.

Coverage Details

Formularies covering
328
Plans covering
5,052
Coverage rate
100%
Tier range
Tier 1 – Tier 4
Average tier
Tier 2, Generic

Restrictions

Prior authorization required
41.5% of formularies
Step therapy required
0% of formularies
Quantity limits
0.6% of formularies

2023 Medicare Spending

Beneficiaries
887,927
Total spending
$53,307,717
Avg per beneficiary
$60.04

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering dicyclomine hydrochloride 10 MG Oral Capsule

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
Anthem Medicare Advantage (HMO-POS) Blue Cross OF California T1 Yes $0 CA
Anthem Medicare Advantage (HMO-POS) Blue Cross OF California T1 Yes $0 CA
Anthem Medicare Advantage (HMO-POS) Blue Cross OF California T1 Yes $0 CA
Anthem Medicare Advantage (HMO-POS) Blue Cross OF California T1 Yes $0 CA
Anthem Full Dual Advantage (HMO D-SNP) Anthem Insurance Companies, Inc. T1 Yes $0 IN
Anthem I PathWays Dual Care Advantage (HMO D-SNP) Anthem Insurance Companies, Inc. T1 Yes $0 IN
Anthem I PathWays Dual Care Advantage NFLOC (HMO D-SNP) Anthem Insurance Companies, Inc. T1 Yes $0 IN
Wellpoint Full Dual Advantage (HMO-POS D-SNP) Wellpoint Iowa, Inc. T1 Yes $0 IA
Wellpoint Full Dual Advantage 2 (HMO-POS D-SNP) Wellpoint Iowa, Inc. T1 Yes $0 IA
Wellpoint Full Dual Advantage (HMO D-SNP) Wellpoint West Virginia , Inc. T1 Yes $0 WV
Wellpoint Full Dual Advantage (HMO D-SNP) Wellpoint Washington, Inc. T1 Yes $0 WA
Wellpoint Dual Advantage (HMO D-SNP) Wellpoint Washington, Inc. T1 Yes $0 WA
Healthy Blue Dual Advantage (HMO D-SNP) Community Care Health Plan OF Louisiana, Inc. T1 Yes $0 LA
Healthy Blue Dual Advantage 2 (HMO D-SNP) Community Care Health Plan OF Louisiana, Inc. T1 Yes $0 LA
Anthem Dual Advantage (PPO D-SNP) Anthem Insurance Companies, Inc. T1 Yes $0 VA
Wellpoint Medicare Advantage 2 (HMO-POS) Wellpoint Texas, Inc. T1 Yes $0 TX
Wellpoint Kidney Care (HMO-POS C-SNP) Wellpoint Texas, Inc. T1 Yes $0 TX
Wellpoint Dual Advantage 2 (HMO D-SNP) Wellpoint Texas, Inc. T1 Yes $0 TX
Show the next 30 plans
Wellpoint Kidney Care (HMO-POS C-SNP) Wellpoint Texas, Inc. T1 Yes $0 TX
Wellpoint Full Dual Advantage Aligned (HMO D-SNP) Wellpoint Texas, Inc. T1 Yes $0 TX
Wellpoint Full Dual Advantage Aligned (HMO D-SNP) Wellpoint Texas, Inc. T1 Yes $0 TX
Wellpoint Full Dual Advantage Aligned (HMO D-SNP) Wellpoint Texas, Inc. T1 Yes $0 TX
Wellpoint Full Dual Advantage Aligned (HMO D-SNP) Wellpoint Texas, Inc. T1 Yes $0 TX
Wellpoint Full Dual Advantage 2 (HMO D-SNP) Wellpoint Texas, Inc. T1 Yes $0 TX
Wellpoint Full Dual Advantage 2 (HMO D-SNP) Wellpoint Texas, Inc. T1 Yes $0 TX
Wellpoint Full Dual Advantage (HMO D-SNP) Wellpoint Texas, Inc. T1 Yes $0 TX
Anthem I MyCare Ohio Full Dual Advantage (HMO D-SNP) Community Insurance Company T1 Yes $0 OH
Anthem Full Dual Advantage (HMO D-SNP) Community Insurance Company T1 Yes $0 OH
Anthem Full Dual Advantage 2 (HMO D-SNP) Community Insurance Company T1 Yes $0 OH
Anthem Full Dual Advantage (PPO D-SNP) Anthem Health Plans, Inc. T1 Yes $0 CT
Anthem Dual Advantage (PPO D-SNP) Anthem Health Plans, Inc. T1 Yes $0 CT
Wellpoint Full Dual Advantage (HMO D-SNP) Wellpoint NEW Jersey, Inc. T1 Yes $0 NJ
Wellpoint Kidney Care (HMO-POS C-SNP) Wellpoint NEW Jersey, Inc. T1 Yes $0 NJ
Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) Wellpoint NEW Jersey, Inc. T1 Yes $0 NJ
Anthem Medicare Advantage (HMO-POS) Healthkeepers, Inc. T1 Yes $0 VA
Anthem Full Dual Advantage (HMO D-SNP) Healthkeepers, Inc. T1 Yes $0 MO
Anthem Medicare Advantage 2 (HMO-POS) Healthkeepers, Inc. T1 Yes $0 VA
Anthem Kidney Care (HMO-POS C-SNP) Healthkeepers, Inc. T1 Yes $0 VA
Anthem Medicare Advantage (HMO-POS) Healthkeepers, Inc. T1 Yes $0 MO
Anthem Medicare Advantage 4 (HMO-POS) Healthkeepers, Inc. T1 Yes $0 VA
Anthem Medicare Advantage (HMO-POS) Healthkeepers, Inc. T1 Yes $0 IN
Anthem Full Dual Advantage 2 (HMO D-SNP) Healthkeepers, Inc. T1 Yes $0 MO
Anthem Chronic Care (HMO-POS C-SNP) Healthkeepers, Inc. T1 Yes $0 MO
Anthem Medicare Advantage (HMO-POS) Community Insurance Company T1 Yes $0 OH
Anthem Medicare Advantage (HMO) HMO Colorado, Inc. T1 Yes $0 CO
Anthem Full Dual Advantage Aligned (HMO D-SNP) Blue Cross OF California Partnership Plan, Inc. T1 Yes $0 CA
Anthem Full Dual Advantage 2 (HMO D-SNP) Healthkeepers, Inc. T1 Yes $0 VA
Anthem Dual Advantage (HMO D-SNP) Healthkeepers, Inc. T1 Yes $0 VA

Showing top 50 of 100 plans.

Frequently Asked Questions

Is dicyclomine hydrochloride 10 MG Oral Capsule covered by Medicare Part D?

Yes, dicyclomine hydrochloride 10 MG Oral Capsule is covered by 5,052 Medicare Part D plans (100% of all Part D formularies).

What tier is dicyclomine hydrochloride 10 MG Oral Capsule on Medicare Part D plans?

dicyclomine hydrochloride 10 MG Oral Capsule averages Tier 2 across Part D plans, ranging from Tier 1 to Tier 4.

Does dicyclomine hydrochloride 10 MG Oral Capsule require prior authorization?

41.5% of Part D formularies require prior authorization for dicyclomine hydrochloride 10 MG Oral Capsule. Step therapy: 0%. Quantity limits: 0.6%.

How much does Medicare spend on dicyclomine hydrochloride 10 MG Oral Capsule?

In 2023, total Medicare Part D spending on dicyclomine hydrochloride 10 MG Oral Capsule was $53,307,717, covering 887,927 beneficiaries. The average spend per beneficiary was $60.04.

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.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare