Medicare Part D coverage · doxepin · RxCUI 1000076
doxepin 50 MG Oral Capsule
Per the CMS 2026 Part D formulary file, doxepin 50 MG Oral Capsule is covered by 5,052 Medicare Part D plans (100% of enrollable products), averaging Tier 2.5, with prior authorization required on 29% of covering formularies.
- 100%
- Plan coverage
- 5,052
- Plans covering
- T2.5
- Avg tier
- 29%
- Prior auth required
What the CMS Formulary Data Shows for doxepin 50 MG Oral Capsule
Per the CMS 2026 Part D formulary file, doxepin 50 MG Oral Capsule (RxNorm concept RXCUI 1000076, generic name doxepin) 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 2.5.
Real-world access to doxepin 50 MG Oral Capsule depends on utilization management as much as tier placement: 29% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 276,316 Part D beneficiaries filled doxepin 50 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $78,711,446 and an average per-beneficiary annual cost of $284.86. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry doxepin 50 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 3, Preferred Brand
Restrictions
- Prior authorization required
- 29% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 276,316
- Total spending
- $78,711,446
- Avg per beneficiary
- $284.86
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering doxepin 50 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 |
| 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 | 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 |
| 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 doxepin 50 MG Oral Capsule covered by Medicare Part D?
Yes, doxepin 50 MG Oral Capsule is covered by 5,052 Medicare Part D plans (100% of all Part D formularies).
What tier is doxepin 50 MG Oral Capsule on Medicare Part D plans?
doxepin 50 MG Oral Capsule averages Tier 2.5 across Part D plans, ranging from Tier 1 to Tier 4.
Does doxepin 50 MG Oral Capsule require prior authorization?
29% of Part D formularies require prior authorization for doxepin 50 MG Oral Capsule. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on doxepin 50 MG Oral Capsule?
In 2023, total Medicare Part D spending on doxepin 50 MG Oral Capsule was $78,711,446, covering 276,316 beneficiaries. The average spend per beneficiary was $284.86.
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
- escitalopram 15 MG Oral Capsule 29% PA
- temazepam 15 MG Oral Capsule 29.2% PA
- roflumilast 0.5 MG Oral Tablet 29.3% PA
- betamethasone dipropionate 0.643 MG/ML / calcipotriene 0.05 MG/ML Topical Suspension 28.6% PA
- 12 HR hydrocodone bitartrate 10 MG Extended Release Oral Capsule 28.6% PA
- prednisolone 2 MG/ML Oral Solution 29.4% PA